Patients engaged in significantly more mild and total exercise during summer vacation than they did during the fall semester. They also engaged in significantly less vigorous exercise during summer vacation than they did in the fall semester. Female respondents engaged in significantly less moderate (P = .019), vigorous (P < .001), and total (P = .015) exercise than did their male counterparts but showed no difference in mild exercise. During the summer and fall, nearly 50% of the adolescents followed their cardiologist's recommendations for exercise. Adolescents with mild CHD engaged in more exercise during summer vacation but engaged in more vigorous exercise during the fall semester. Approximately one half did not follow the exercise intensity recommended by cardiologists. Inadequate exercise patterns may lead to cardiovascular complications. Planned interventions related to exercise instruction are needed for adolescents with CHD.

This study identified a gap between the ideal and actual classroom environments. We suggest that the government, schools, and health education teachers improve classroom environments during school health programs to satisfy students' expectations and thus increase their learning efficacy and overall well-being.

This study provides preliminary evidence that incorporating self-esteem activities into the regular school health and physical education curriculum can result in minor effects in students' physical self-esteem and family self-esteem. Findings may provide teachers and school administrators with information to help them design programs to improve students' self-esteem. This study also reminds health professionals to focus on providing self-esteem-building programs when working with adolescent clients.