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Werneck AO, Vancampfort D, Oyeyemi AL, Stubbs B, Silva DR. Associations between TV viewing, sitting time, physical activity and insomnia among 100,839 Brazilian adolescents. Psychiatry Res 2018; 269:700-706. [PMID: 30273895 DOI: 10.1016/j.psychres.2018.08.101] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 07/10/2018] [Accepted: 08/24/2018] [Indexed: 12/27/2022]
Abstract
Our aim was to examine the relationship between insomnia and levels of physical activity (PA) and time spent sitting and TV viewing among Brazilian adolescents. Data from the Brazilian Scholar Health Survey, a nationally representative survey of 9th grade adolescents [mean: 14.28 years (range: 11-18 years)] conducted in 2015 (n = 100,839) were used. Self-reported insomnia, TV viewing, sitting time and total PA (adapted International PA Questionnaire) were collected. Chronological age, race, type of city (capital or interior) country region, goodies ingestion and ultra-processed foods ingestion were covariates. Logistic regression analyses were conducted to assess the associations. A higher sitting time and TV viewing (≥8 h/day) was associated with a higher risk of insomnia among boys [sitting time: OR = 2.39 (95%CI = 1.88-3.04); TV:OR = 2.49(95%CI = 1.92-3.22) and girls [sitting time: OR = 2.17(95%CI = 1.84-2.57; TV:OR = 1.72(95%CI = 1.44-2.04)]. More than 4 h of sitting time per day was associated with higher risk of insomnia in adolescents who comply [boys: OR = 1.43(95%CI = 1.19-1.73); girls: OR = 1.66(95%CI = 1.41-1.94)] and who do not comply with the 300 min/week of physical activity recommendation [boys = OR = 1.35(95%CI = 1.13-1.60); girls: OR = 1.38(95%CI = 1.20-1.57)]. Our data suggest that higher levels of TV viewing or sitting are associated with sleep difficulties in this large cohort of adolescents, irrespective of their physical activity behavior.
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Affiliation(s)
- André O Werneck
- Study and Research Group in Metabolism, Nutrition, and Exercise (GEPEMENE), State University of Londrina, Rodovia Celso Garcia Cid, km 380, 86057-970 Londrina, Parana, Brazil.
| | - Davy Vancampfort
- Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium
| | - Adewale L Oyeyemi
- Department of Physiotherapy, College of Medical Sciences, University of Maiduguri, Maiduguri, Borno State, Nigeria
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK; South London and Maudsley NHS Foundation Trust, London, UK
| | - Danilo R Silva
- Departament of Physical Education, Federal University of Sergipe - UFS, São Cristóvão, Brazil
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Verloigne M, Ridgers ND, De Bourdeaudhuij I, Cardon G. Effect and process evaluation of implementing standing desks in primary and secondary schools in Belgium: a cluster-randomised controlled trial. Int J Behav Nutr Phys Act 2018; 15:94. [PMID: 30261883 PMCID: PMC6161341 DOI: 10.1186/s12966-018-0726-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 09/19/2018] [Indexed: 12/30/2022] Open
Abstract
Background Children and adolescents spend a lot of time sitting at school. Implementing standing desks in the classroom is one potential strategy to reduce and break up sitting time. The first aim was to evaluate the effect of implementing standing desks in classrooms in primary and secondary schools on pupils’ sitting-related behaviour and determinants. The second aim was to quantitatively and qualitatively evaluate the process of implementing the desks in the classroom. Methods We conducted a cluster-randomised controlled trial with a pre-, mid-, and post-test design including 10 intervention schools (5 primary, 5 secondary schools) and 9 control schools (5 primary, 4 secondary schools) across Flanders, Belgium. Three standing desks were placed in one class in each intervention school for 6 months. At pre-, mid- and post-test, all pupils (n = 311; 54.5% girls) completed a questionnaire whilst a subsample of three pupils per class wore an activPAL inclinometer for one school week. Focus groups with pupils and interviews with teachers were conducted at mid-test. Process evaluation questions were added to the mid- and post-test questionnaire for the intervention group. Qualitative data were analysed using NVivo 11. Multilevel regression analyses were conducted in MLwiN 2.31. Results Few significant intervention effects were observed, although activPAL data showed favourable intervention effects on primary school pupils’ sitting and standing time and bouts. Focus groups and interviews showed a generally positive attitude towards using standing desks in both teachers and pupils, although some barriers and suggestions for future implementation were noted, for example regarding the amount of desks per classroom. Quantitative process evaluation data showed a low individual use of standing desks (between 57 and 83 min per week), which significantly decreased across the school year for primary school pupils only. Conclusions Although pupils and teachers were generally positive about the desks, relatively few intervention effects were found. Future studies should consider how to optimise the use of standing desks in classrooms to impact on sitting time, by for example, determining the most feasible intervention design and by encouraging the continued use of standing desks throughout the school year. Moreover, additional intervention strategies (e.g. educational strategies) might be needed. Trial registration NCT03163004. ClinicalTrials.gov. Registered 22 May 2017 (retrospectively registered). Electronic supplementary material The online version of this article (10.1186/s12966-018-0726-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Maïté Verloigne
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium. .,Research Foundation (FWO), Egmontstraat 1, 1000, Brussel, Belgium.
| | - Nicola D Ridgers
- Deakin University, Geelong, Australia, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, 221 Burwood Hwy, Burwood, VIC, 3125, Australia
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium
| | - Greet Cardon
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium
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53
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Contardo Ayala AM, Sudholz B, Salmon J, Dunstan DW, Ridgers ND, Arundell L, Timperio A. The impact of height-adjustable desks and prompts to break-up classroom sitting on adolescents' energy expenditure, adiposity markers and perceived musculoskeletal discomfort. PLoS One 2018; 13:e0203938. [PMID: 30235241 PMCID: PMC6147438 DOI: 10.1371/journal.pone.0203938] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 08/30/2018] [Indexed: 11/19/2022] Open
Abstract
Adolescents spend large amounts of time sitting at school. Little is known about the impact of reducing and breaking-up prolonged sitting during school lessons on adolescents' health. This study aimed to investigate the impact of an intervention to reduce classroom sitting time on adolescents' energy expenditure (EE; kcal/lesson), body mass index (BMI), waist circumference (WC), and musculoskeletal discomfort. A secondary school classroom was equipped with height-adjustable desks, posters promoting the health benefits of and strategies for breaking-up sitting time, and desk stickers reminding students to periodically stand up. Classroom teachers participated in a professional development session. Using a quasi-experimental design, differences between 49 participants who utilised the intervention classroom 2-5 times/week and a comparison group (39 adolescents, matched by year level and subject) who used traditional classrooms, were examined. EE, BMI and WC were objectively measured and musculoskeletal discomfort was self-reported at baseline, 4-weeks, and 17-weeks. Hierarchical linear and multilevel logistic regression-mixed models were used to examine intervention effects, adjusting for baseline values, sex and age. EE was significantly higher at 4-weeks and 17-weeks (29.4 and 37.7 kcal/lesson, respectively), BMI was higher at 4-weeks (0.34 kg/m2), and WC was lower at 4-weeks and 17-weeks (-3.53 and -2.64 cm, respectively) in the intervention compared to the comparison group. No intervention effect was found for musculoskeletal discomfort. Findings provide preliminary indications that these strategies may benefit health among adolescents in the short term. However, extended longer-duration trials are needed to determine longer-term health effects.
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Affiliation(s)
- Ana María Contardo Ayala
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Australia
| | - Bronwyn Sudholz
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Australia
| | - Jo Salmon
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Australia
| | - David W. Dunstan
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Australia
- Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Nicola D. Ridgers
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Australia
| | - Lauren Arundell
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Australia
| | - Anna Timperio
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Australia
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54
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Silva DR, Minderico CS, Pinto F, Collings PJ, Cyrino ES, Sardinha LB. Impact of a classroom standing desk intervention on daily objectively measured sedentary behavior and physical activity in youth. J Sci Med Sport 2018; 21:919-924. [PMID: 29409737 DOI: 10.1016/j.jsams.2018.01.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 11/28/2017] [Accepted: 01/17/2018] [Indexed: 11/20/2022]
Abstract
OBJECTIVES We investigated the impact of a standing desk intervention on daily objectively monitored sedentary behavior and physical activity in 6th grade school students. DESIGN Cluster non-randomised controlled trial. METHOD Two classes (intervention students: n=22 [aged 11.8±0.4years]; control students: n=27 [11.6±0.5years]) from a public school in Lisbon were selected. The intervention involved replacing traditional seated classroom desks for standing desks, for a total duration of 16 weeks, in addition to performing teacher training and holding education/motivation sessions with students and parents. Sedentary behavior (ActivPAL inclinometer) and physical activity (Actigraph GT3X+ accelerometer) were measured for seven days immediately before and after the intervention. RESULTS There were no differences in baseline behaviors between intervention and control groups (p>0.05). At follow-up (16 weeks), it was observed that the intervention group had decreased time spent sitting (total week: -6.8% and at school: -13.0% relative to baseline) and increased standing (total week: 16.5% and at school: 31.0%) based on inclinometer values (p-value for interaction group*time <0.05). No significant differences in activity outcomes were observed outside school time (week or weekend) between groups. CONCLUSION We conclude that a 16 week classroom standing desk intervention successfully reduced sitting time and increase standing time at school, with no observed compensatory effects outside of school time.
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Affiliation(s)
- Danilo R Silva
- Study and Research Group in Metabolism, Nutrition, and Exercise - GEPEMENE, Londrina State University, Brazil; Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Portugal
| | - Cláudia S Minderico
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Portugal
| | - Fernando Pinto
- Departament of Social Sciences, Eça de Queiros High School, Portugal
| | - Paul J Collings
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, United Kingdom; University of York, Department of Health Sciences, United Kingdom
| | - Edilson S Cyrino
- Study and Research Group in Metabolism, Nutrition, and Exercise - GEPEMENE, Londrina State University, Brazil
| | - Luís B Sardinha
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Portugal.
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55
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Ee J, Parry S, Oliveira BID, McVeigh JA, Howie E, Straker L. Does a Classroom Standing Desk Intervention Modify Standing and Sitting Behaviour and Musculoskeletal Symptoms during School Time and Physical Activity during Waking Time? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081668. [PMID: 30082657 PMCID: PMC6121556 DOI: 10.3390/ijerph15081668] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 07/25/2018] [Accepted: 08/02/2018] [Indexed: 01/03/2023]
Abstract
Children are increasingly spending more time sedentary at school and during leisure time. This study examined the effects of a standing desk intervention in a classroom on children's standing and sitting time at school, sedentary and physical activity levels throughout the day (waking hours), and musculoskeletal discomfort. A within-subjects crossover study design was used. Participants used either a standing desk or traditional seated desk for 21 days before swapping desks for another 21 days. Accelerometry and musculoskeletal discomfort data were collected during the last seven days of each 21-day period. Mixed models were used to analyse accelerometry data. Zero-inflated regression models and logistic regression models were used to analyse discomfort data. Forty-seven male students (aged 10⁻11 years) participated in the study. Standing time was 21 min/school day higher (p < 0.001) and sitting time was 24 min/school day lower (p = 0.003) when standing desks were used. No significant differences were found in sedentary and physical activity time during waking hours between the standing desk and seated desk conditions. Students were less likely to report musculoskeletal discomfort in the neck, shoulder, elbows and lower back when using standing desks (OR 0.52⁻0.74). Standing desks significantly increased classroom standing time and decreased musculoskeletal discomfort reports but had no overall effect on daily physical activity levels. Schools should consider moving towards classrooms enabling a variety of postures to potentially improve the long-term health of children.
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Affiliation(s)
- Jolyn Ee
- Curtin University, Kent Street, Bentley, Perth 6102, Western Australia, Australia.
| | - Sharon Parry
- Curtin University, Kent Street, Bentley, Perth 6102, Western Australia, Australia.
| | | | - Joanne A McVeigh
- Curtin University, Kent Street, Bentley, Perth 6102, Western Australia, Australia.
| | - Erin Howie
- Curtin University, Kent Street, Bentley, Perth 6102, Western Australia, Australia.
| | - Leon Straker
- Curtin University, Kent Street, Bentley, Perth 6102, Western Australia, Australia.
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Clemes SA, Bingham DD, Pearson N, Chen YL, Edwardson C, McEachan R, Tolfrey K, Cale L, Richardson G, Fray M, Bandelow S, Jaicim NB, Salmon J, Dunstan D, Barber SE. Stand Out in Class: restructuring the classroom environment to reduce sedentary behaviour in 9-10-year-olds - study protocol for a pilot cluster randomised controlled trial. Pilot Feasibility Stud 2018; 4:103. [PMID: 29850027 PMCID: PMC5966899 DOI: 10.1186/s40814-018-0295-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 05/10/2018] [Indexed: 11/10/2022] Open
Abstract
Background Sedentary behaviour (sitting) is a highly prevalent negative health behaviour, with individuals of all ages exposed to environments that promote prolonged sitting. Excessive sedentary behaviour adversely affects health in children and adults. As sedentary behaviour tracks from childhood into adulthood, the reduction of sedentary time in young people is key for the prevention of chronic diseases that result from excessive sitting in later life. The sedentary school classroom represents an ideal setting for environmental change, through the provision of sit-stand desks. Whilst the use of sit-stand desks in classrooms demonstrates positive effects in some key outcomes, evidence is currently limited by small samples and/or short intervention durations, with few studies adopting randomised controlled trial (RCT) designs. This paper describes the protocol of a pilot cluster RCT of a sit-stand desk intervention in primary school classrooms. Methods/Design A two-arm pilot cluster RCT will be conducted in eight primary schools (four intervention, four control) with at least 120 year 5 children (aged 9-10 years). Sit-stand desks will replace six standard desks in the intervention classrooms. Teachers will be encouraged to ensure all pupils are exposed to the sit-stand desks for at least 1 h/day on average using a rotation system. Schools assigned to the control arm will continue with their usual practice, no environmental changes will be made to their classrooms. Measurements will be taken at baseline, before randomisation, and at the end of the schools' academic year. In this study, the primary outcomes of interest will be school and participant recruitment and attrition, acceptability of the intervention, and acceptability and compliance to the proposed outcome measures (including activPAL-measured school-time and school-day sitting, accelerometer-measured physical activity, adiposity, blood pressure, cognitive function, academic progress, engagement, and behaviour) for inclusion in a definitive trial. A full process evaluation and an exploratory economic evaluation will also be conducted to further inform a definitive trial. Discussion The primary output of this study will be acceptability data to inform the development of a definitive cluster RCT designed to examine the efficacy of this intervention on health- and education-related outcomes in UK primary school children. Trial registration ISRCTN12915848 (retrospectively registered, date registered 9 November 2016).
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Affiliation(s)
- Stacy A Clemes
- 1National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.,NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Daniel D Bingham
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
| | - Natalie Pearson
- 1National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Yu-Ling Chen
- 1National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Charlotte Edwardson
- NIHR Leicester Biomedical Research Centre, Leicester, UK.,4Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Rosemary McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
| | - Keith Tolfrey
- 1National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.,NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Lorraine Cale
- 1National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Gerry Richardson
- 5Centre for Health Economics, University of York, Heslington, York, UK
| | - Mike Fray
- 6Loughborough Design School, Loughborough University, Loughborough, UK
| | - Stephan Bandelow
- 1National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | | | - Jo Salmon
- 8Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - David Dunstan
- 9Baker IDI Heart and Diabetes Institute, Melbourne, Australia.,10Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Sally E Barber
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
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57
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Wick K, Faude O, Manes S, Zahner L, Donath L. I Can Stand Learning: A Controlled Pilot Intervention Study on the Effects of Increased Standing Time on Cognitive Function in Primary School Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15020356. [PMID: 29462986 PMCID: PMC5858425 DOI: 10.3390/ijerph15020356] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 02/05/2018] [Accepted: 02/12/2018] [Indexed: 12/17/2022]
Abstract
Sedentarism is considered an independent cardiovascular risk factor. Thus, the present study investigated the effects of employing standing desks in classrooms on cognitive function. The intervention class (IG; n = 19) was supplied with standing desks and balance pads for 11 weeks. The control class (CG; n = 19) received lessons as usual. Standing time was assessed objectively (accelerometers) and subjectively (self-report sheets, external classroom observers). The impact of standing on the digit span task and Eriksen flanker task was analysed. The standing time of the IG was higher during the school day in comparison to the CG (lesson: p = 0.004; break: p = 0.003). The intra-class correlation coefficient between self-reports and external observation was high (ICC = 0.94). The IG improved slightly on the Digit Span Task compared to CG. Employing standing desks for at least 1 h per school day serves as a feasible and effective opportunity to improve cognitive function.
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Affiliation(s)
- Katharina Wick
- Institute of Psychosocial Medicine and Psychotherapy, University Hospital, Friedrich-Schiller-University Jena, Jena 07743, Germany.
| | - Oliver Faude
- Department of Sport, Exercise and Health, University of Basel, Basel 4052, Switzerland.
| | - Susanne Manes
- Institute of Psychosocial Medicine and Psychotherapy, University Hospital, Friedrich-Schiller-University Jena, Jena 07743, Germany.
| | - Lukas Zahner
- Department of Sport, Exercise and Health, University of Basel, Basel 4052, Switzerland.
| | - Lars Donath
- Department of Sport, Exercise and Health, University of Basel, Basel 4052, Switzerland.
- Institute of Exercise Training and Computer Science in Sport, German Sport University Cologne, Köln 50933, Germany.
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Jerome M, Janz KF, Baquero B, Carr LJ. Introducing sit-stand desks increases classroom standing time among university students. Prev Med Rep 2017; 8:232-237. [PMID: 29159019 PMCID: PMC5683670 DOI: 10.1016/j.pmedr.2017.10.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 10/27/2017] [Accepted: 10/30/2017] [Indexed: 10/26/2022] Open
Abstract
Excessive sedentary behavior has been associated with many negative health outcomes. While an understudied health topic, there is evidence that university students are excessively sedentary. Sit-stand desks have been shown to reduce sedentary time among pre-university students (ages 5-18 years) and sedentary workers but have not been tested in university classrooms. This study tested the effects of introducing sit-stand desks into a university classroom on student's classroom sitting and standing behaviors. Using a cross-over design, students received access to both traditional seated desks and sit-stand desks for six weeks. Data were collected between September and December, 2016. We recruited 304 healthy undergraduate university students enrolled in one of two small (25 seats) classrooms at a large Midwestern university during the fall of 2016. Average minutes of standing/hour/student, average percent class time spent standing, and the number of sit-stand transitions/student/hour were directly observed with video camera surveillance. Participants stood significantly more (p < 0.001) when provided access to sit-stand desks (7.2 min/h/student; 9.3% of class time spent standing) compared to when they had access to seated desks (0.7 min/h/student; 1.6% of class time spent standing) but no differences were observed for the number of sit-stand transitions (p = 0.47). Students reported high favorability for the sit-stand desks and improvements in several student engagement and affective outcomes while using the sit-stand desks. These findings support introducing sit-stand desks in university classrooms as an approach to reduce sedentary behaviors of university students.
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Affiliation(s)
- Matthew Jerome
- Department of Health and Human Physiology, University of Iowa, 225 South Grand Avenue, Iowa City, IA 52242, United States
| | - Kathleen F Janz
- Department of Health and Human Physiology, University of Iowa, 225 South Grand Avenue, Iowa City, IA 52242, United States
| | - Barbara Baquero
- Department of Community and Behavioral Health, University of Iowa, 145 N Riverside Dr, Iowa City, IA 52246, United States
| | - Lucas J Carr
- Department of Health and Human Physiology, University of Iowa, 225 South Grand Avenue, Iowa City, IA 52242, United States
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59
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Routen AC, Biddle SJH, Bodicoat DH, Cale L, Clemes S, Edwardson CL, Glazebrook C, Harrington DM, Khunti K, Pearson N, Salmon J, Sherar LB. Study design and protocol for a mixed methods evaluation of an intervention to reduce and break up sitting time in primary school classrooms in the UK: The CLASS PAL (Physically Active Learning) Programme. BMJ Open 2017; 7:e019428. [PMID: 29122808 PMCID: PMC5695437 DOI: 10.1136/bmjopen-2017-019428] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
INTRODUCTION Children engage in a high volume of sitting in school, particularly in the classroom. A number of strategies, such as physically active lessons (termed movement integration (MI)), have been developed to integrate physical activity into this learning environment; however, no single approach is likely to meet the needs of all pupils and teachers. This protocol outlines an implementation study of a primary school-based MI intervention: CLASS PAL (Physically Active Learning) programme. This study aims to (A) determine the degree of implementation of CLASS PAL, (B) identify processes by which teachers and schools implement CLASS PAL and (C) investigate individual (pupil and teacher) level and school-level characteristics associated with implementation of CLASS PAL. METHODS AND ANALYSIS The intervention will provide teachers with a professional development workshop and a bespoke teaching resources website. The study will use a single group before-and-after design, strengthened by multiple interim measurements. Six state-funded primary schools will be recruited within Leicestershire, UK.Evaluation data will be collected prior to implementation and at four discrete time points during implementation: At measurement 0 (October 2016), school, teacher and pupil characteristics will be collected. At measurements 0 and 3 (June-July 2017), accelerometry, cognitive functioning, self-reported sitting and classroom engagement data will be collected. At measurements 1(December 2016-March 2017) and 3 , teacher interviews (also at measurement 4; September-October 2017) and pupil focus groups will be conducted, and at measurements 1 and 2 (April-May 2017), classroom observations. Implementation will be captured through website analytics and ongoing teacher completed logs. ETHICS AND DISSEMINATION Ethical approval was obtained through the Loughborough University Human Participants Ethics Sub-Committee (Reference number: R16-P115). Findings will be disseminated via practitioner and/or research journals and to relevant regional and national stakeholders through print and online media and dissemination event(s).
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Affiliation(s)
- Ash C Routen
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Stuart J H Biddle
- Active Living & Public Health, Institute of Sport, Exercise and Active Living (ISEAL), Victoria University, Melbourne, Victoria, Australia
- Institute for Resilient Regions, University of Southern Queensland, Springfield, Queensland, Australia
| | - Danielle H Bodicoat
- Diabetes Research Centre, University of Leicester, Leicester, UK
- The Leicester Biomedical Research Centre, Leicester and Loughborough, UK
| | - Lorraine Cale
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Stacy Clemes
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Charlotte L Edwardson
- Diabetes Research Centre, University of Leicester, Leicester, UK
- The Leicester Biomedical Research Centre, Leicester and Loughborough, UK
| | - Cris Glazebrook
- School of Medicine, Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
| | - Deirdre M Harrington
- Diabetes Research Centre, University of Leicester, Leicester, UK
- The Leicester Biomedical Research Centre, Leicester and Loughborough, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK
- The Leicester Biomedical Research Centre, Leicester and Loughborough, UK
| | - Natalie Pearson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Jo Salmon
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Lauren B Sherar
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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60
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Erwin H, Beighle A, Routen A, Montemayor B. Perceptions of Using Sit-to-Stand Desks in a Middle School Classroom. Health Promot Pract 2017; 19:68-74. [PMID: 28868936 DOI: 10.1177/1524839917730046] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The purpose of this study was to explore the feasibility of sit-to-stand desks in a middle school classroom. Participants used sit-to-stand desks during health class. Momentary time sampling was used for physical activity and behavioral observations. Results indicate students sat 37%, stood 59%, and walked 4% of the time. Misbehaviors occurred 4% of the observed period. The following themes emerged: focus, freedom, distractions, and design. Sit-to-stand desks appear to encourage standing during instruction while simultaneously limiting misbehaviors. Students indicated some distractions but were generally positive toward desk implementation and suggested they supported learning behaviors. The teacher echoed most of the student themes.
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Affiliation(s)
| | | | - Ash Routen
- 2 Loughborough University, Leicestershire, UK
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Routen AC, Chalkley AE, Sherar LB. Getting a GRIP (getting research into practice) on movement integration in the school classroom. PHYSICAL THERAPY REVIEWS 2017. [DOI: 10.1080/10833196.2017.1306900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Ash C. Routen
- School of Sport, Exercise and Health Sciences, Loughborough University , Loughborough, UK
| | - Anna E. Chalkley
- School of Sport, Exercise and Health Sciences, Loughborough University , Loughborough, UK
| | - Lauren B. Sherar
- School of Sport, Exercise and Health Sciences, Loughborough University , Loughborough, UK
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62
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Hinckson E, Salmon J, Benden M, Clemes SA, Sudholz B, Barber SE, Aminian S, Ridgers ND. Standing Classrooms: Research and Lessons Learned from Around the World. Sports Med 2017; 46:977-87. [PMID: 26626071 DOI: 10.1007/s40279-015-0436-2] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Children spend between 50 and 70 % of their time sitting while at school. Independent of physical activity levels, prolonged sitting is associated with poor health outcomes in adulthood. While there is mixed evidence of health associations among children and adolescents, public health guidelines in the USA, UK, Australia and Canada now recommend young people should break up long periods of sitting as frequently as possible. A potentially effective approach for reducing and breaking up sitting throughout the day is changing the classroom environment. This paper presents an overview of a relatively new area of research designed to reduce youth sitting time while at school by changing the classroom environment (n = 13 studies). Environmental changes included placement of height-adjustable or stand-biased standing desks/workstations with stools, chairs, exercise balls, bean bags or mats in the classroom. These 13 published studies suggest that irrespective of the approach, youth sitting time was reduced by between ~44 and 60 min/day and standing time was increased by between 18 and 55 min/day during classroom time at school. Other benefits include increased energy expenditure and the potential for improved management of students' behaviour in the classroom. However, few large trials have been conducted, and there remains little evidence regarding the impact on children's learning and academic achievement. Nevertheless, with an increasing demand placed on schools and teachers regarding students' learning outcomes, strategies that integrate moving throughout the school day and that potentially enhance the learning experience and future health outcomes for young people warrant further exploration.
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Affiliation(s)
- Erica Hinckson
- Auckland University of Technology, Centre for Child Health Research, National Institute of Public and Mental Health, Auckland, New Zealand.
| | - Jo Salmon
- Centre for Physical Activity and Nutrition Research, Deakin University, Melbourne, VIC, Australia
| | - Mark Benden
- Ergonomics Centre, Environmental and Occupational Health, Texas A&M, Austin, TX, USA
| | - Stacey A Clemes
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Bronwyn Sudholz
- Centre for Physical Activity and Nutrition Research, Deakin University, Melbourne, VIC, Australia
| | - Sally E Barber
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
| | - Saeideh Aminian
- Auckland University of Technology, Centre for Child Health Research, National Institute of Public and Mental Health, Auckland, New Zealand
| | - Nicola D Ridgers
- Centre for Physical Activity and Nutrition Research, Deakin University, Melbourne, VIC, Australia
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63
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Saunders TJ, Vallance JK. Screen Time and Health Indicators Among Children and Youth: Current Evidence, Limitations and Future Directions. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2017; 15:323-331. [PMID: 27798796 DOI: 10.1007/s40258-016-0289-3] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Despite accumulating evidence linking screen-based sedentary behaviours (i.e. screen time) with poorer health outcomes among children and youth <18 years of age, the prevalence of these behaviours continues to increase, with roughly half of children and youth exceeding the public health screen time recommendation of 2 h per day or less. The purpose of this article is to provide an overview of key research initiatives aimed at understanding the associations between screen time and health indicators including physical health, quality of life and psychosocial health. Available evidence suggests that screen time is deleteriously associated with numerous health indicators in child and youth populations, including adiposity, aerobic fitness, quality of life, self-esteem, pro-social behaviour, academic achievement, depression and anxiety. However, few longitudinal or intervention studies have been conducted, with most of these studies focusing on physical health indicators. While most studies have used self-reported assessments of screen time, the availability of more objective assessment methods presents important opportunities (e.g. more accurate and precise assessment of sedentary time and screen time) and challenges (e.g. privacy and participant burden). Novel statistical approaches such as isotemporal substitution modelling and compositional analysis, as well as studies using longitudinal and experimental methodologies, are needed to better understand the health impact of excessive screen time, and to develop strategies to minimise or reverse the negative impacts of these behaviours. The evidence to date suggests a clear need for policy aimed at minimising the hazardous health consequences associated with screen time among children and youth.
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Affiliation(s)
- Travis J Saunders
- Department of Applied Human Sciences, Faculty of Science, University of Prince Edward Island, Charlottetown, PEI, Canada
| | - Jeff K Vallance
- Faculty of Health Disciplines, Centre for Nursing and Health Studies, Athabasca University, Athabasca, AB, Canada.
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Contardo Ayala AM, Salmon J, Timperio A, Sudholz B, Ridgers ND, Sethi P, Dunstan DW. Impact of an 8-Month Trial Using Height-Adjustable Desks on Children's Classroom Sitting Patterns and Markers of Cardio-Metabolic and Musculoskeletal Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13121227. [PMID: 27973414 PMCID: PMC5201368 DOI: 10.3390/ijerph13121227] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 11/30/2016] [Accepted: 12/06/2016] [Indexed: 11/19/2022]
Abstract
During school hours, children can sit for prolonged and unbroken periods of time. This study investigated the impact of an 8-month classroom-based intervention focusing on reducing and breaking-up sitting time on children’s cardio-metabolic risk factors (i.e., body mass index, waist circumference, blood pressure) and perceptions of musculoskeletal discomfort. Two Year-6 classes (24 students per class) in one primary school were assigned to either an intervention or control classroom. The intervention classroom was equipped with height-adjustable desks and the teacher was instructed in the delivery of pedagogical strategies to reduce and break-up sitting in class. The control classroom followed standard practice using traditional furniture. At baseline, and after 8-months, time spent sitting, standing, stepping, and sitting-bouts (occasions of continuous sitting) as well as the frequency of sit-to-stand transitions were obtained from activPAL inclinometers and the time spent in light-intensity physical activity was obtained from ActiGraph accelerometers. Demographics and musculoskeletal characteristics were obtained from a self-report survey. Hierarchical linear mixed models found that during class-time, children’s overall time spent sitting in long bouts (>10 min) were lower and the number of sit-to-stand transitions were higher in the intervention group compared to the control group, while no changes were observed for musculoskeletal pain/discomfort. No significant intervention effects were found for the anthropometrics measures and blood pressure. Height-adjustable desks and pedagogical strategies to reduce/break-up sitting can positively modify classroom sitting patterns in children. Longer interventions, larger and varied sample size may be needed to show health impacts; however, these desks did not increase musculoskeletal pain/discomfort.
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Affiliation(s)
- Ana María Contardo Ayala
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC 3125, Australia.
| | - Jo Salmon
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC 3125, Australia.
| | - Anna Timperio
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC 3125, Australia.
| | - Bronwyn Sudholz
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC 3125, Australia.
| | - Nicola D Ridgers
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC 3125, Australia.
| | - Parneet Sethi
- Physical Activity Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, VIC 3004, Australia.
| | - David W Dunstan
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC 3125, Australia.
- Physical Activity Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, VIC 3004, Australia.
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC 3000, Australia.
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Benzo RM, Gremaud AL, Jerome M, Carr LJ. Learning to Stand: The Acceptability and Feasibility of Introducing Standing Desks into College Classrooms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13080823. [PMID: 27537901 PMCID: PMC4997509 DOI: 10.3390/ijerph13080823] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 07/29/2016] [Accepted: 08/09/2016] [Indexed: 01/03/2023]
Abstract
Prolonged sedentary behavior is an independent risk factor for multiple negative health outcomes. Evidence supports introducing standing desks into K-12 classrooms and work settings to reduce sitting time, but no studies have been conducted in the college classroom environment. The present study explored the acceptability and feasibility of introducing standing desks in college classrooms. A total of 993 students and 149 instructors completed a single online needs assessment survey. This cross-sectional study was conducted during the fall semester of 2015 at a large Midwestern University. The large majority of students (95%) reported they would prefer the option to stand in class. Most students (82.7%) reported they currently sit during their entire class time. Most students (76.6%) and instructors (86.6%) reported being in favor of introducing standing desks into college classrooms. More than half of students and instructors predicted having access to standing desks in class would improve student’s “physical health”, “attention”, and “restlessness”. Collectively, these findings support the acceptability of introducing standing desks in college classrooms. Future research is needed to test the feasibility, cost-effectiveness and efficacy of introducing standing desks in college classrooms. Such studies would be useful for informing institutional policies regarding classroom designs.
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Affiliation(s)
- Roberto M Benzo
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA 52240, USA.
| | - Allene L Gremaud
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA 52240, USA.
| | - Matthew Jerome
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA 52240, USA.
| | - Lucas J Carr
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA 52240, USA.
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Hegarty LM, Mair JL, Kirby K, Murtagh E, Murphy MH. School-based Interventions to Reduce Sedentary Behaviour in Children: A Systematic Review. AIMS Public Health 2016; 3:520-541. [PMID: 29546180 PMCID: PMC5689814 DOI: 10.3934/publichealth.2016.3.520] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 08/03/2016] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Prolonged, uninterrupted periods of sedentary time may be associated with increased risk of Type II diabetes, cardiovascular disease and all-cause mortality even if the minimum recommended levels of daily physical activity are achieved. It is reported that children spend approximately 80% of their day engaged in sedentary behaviours. Since children spend a large portion of their waking time at school, school-based interventions targeting excessive or interrupted periods of sedentary time have been investigated in a number of studies. However, results of the effectiveness of studies to-date have been inconsistent. AIM To conduct a systematic review to evaluate the effectiveness of school-based interventions designed to reduce sedentary behaviour on objectively measured sedentary time in children. METHODS Five electronic databases were searched to retrieve peer-reviewed studies published in English up to and including August 2015. Studies that reported objectively measured sedentary time before and after a school-based intervention to reduce sedentary time were included in the review. Risk of bias was assessed using the Cochrane Collaboration method. RESULTS Our search identified eleven papers reporting eight interventions. Studies focused on the physical environment, the curriculum, individual in-class activities, homework activities or a combination of these strategies. Three studies reported decreases in sedentary time following intervention. Study follow-up periods ranged from immediately post-intervention to 12 months. None of the studies were judged to have a low risk of bias. CONCLUSIONS Multicomponent interventions which also include the use of standing desks may be an effective method for reducing children's sedentary time in a school-based intervention. However, longer term trials are needed to determine the sustained effectiveness of such interventions on children's sedentary time.
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Affiliation(s)
- Lynda M. Hegarty
- School of Sport, Ulster University, Jordanstown, Northern Ireland
| | - Jacqueline L. Mair
- Sport and Exercise Sciences Research Institute, Ulster University, Jordanstown, Northern Ireland
| | - Karen Kirby
- School of Psychology, Ulster University, Magee, Londonderry, Northern Ireland
| | - Elaine Murtagh
- Department of Arts, Education and Physical Education, Mary Immaculate College, University of Limerick, Limerick, Ireland
| | - Marie H. Murphy
- Sport and Exercise Sciences Research Institute, Ulster University, Jordanstown, Northern Ireland
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Sudholz B, Timperio A, Ridgers ND, Dunstan DW, Baldock R, Holland B, Salmon J. The Impact and Feasibility of Introducing Height-Adjustable Desks on Adolescents' Sitting in a Secondary School Classroom. AIMS Public Health 2016; 3:274-287. [PMID: 29546162 PMCID: PMC5690354 DOI: 10.3934/publichealth.2016.2.274] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 05/09/2016] [Indexed: 11/18/2022] Open
Abstract
Children spend over 60% of their school day sitting; much of this occurs in the classroom. Emerging research has examined the impact of environmental interventions on classroom sitting. While this research is promising, it has predominantly focused on the primary school setting. This study examined the impact and feasibility of height-adjustable desks on time spent sitting/standing during classroom lessons in a secondary school. Traditional desks in a Melbourne secondary school classroom were replaced with 27 height-adjustable desks (intervention classroom). Forty-three adolescents (51% male; mean age 13.7 ± 1.4 years) from Grades 7, 9 and 10 wore an inclinometer and accelerometer for schooldays and completed a survey after using the desks during lessons for seven weeks. Ten teachers (50% male) completed a survey. Time spent sitting, standing, and the length of sitting bouts were compared between periods when adolescents were in the intervention classroom versus traditional classrooms (matched on teacher and subject). Compared to the traditional classroom, adolescents spent 25% less time sitting and 24% more time standing in the intervention classroom (effect size > 0.8), and had a greater frequency of short sitting bouts and fewer longer bouts. The majority of teachers (71%) and students (70%) reported wanting to continue to use the height-adjustable desks. When standing during lessons, adolescents reported working well (69%); however, a third reported difficulties paying attention (28%) and becoming distracted (36%). Few teachers reported negative influences on adolescents' ability to work (14%) and concentrate (14%). Half the adolescents reported leg, or back pain with standing. Introducing height-adjustable desks resulted in lower levels of sitting compared with traditional classrooms, was acceptable and had some adverse effects on concentration and discomfort. The study provides preliminary evidence that height-adjustable desks may help reduce prolonged sitting in school among adolescents. Future research should incorporate a control group and explore behavioural and academic outcomes.
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Affiliation(s)
- Bronwyn Sudholz
- Deakin University, Geelong, Australia. Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences
| | - Anna Timperio
- Deakin University, Geelong, Australia. Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences
| | - Nicola D. Ridgers
- Deakin University, Geelong, Australia. Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences
| | - David W. Dunstan
- Deakin University, Geelong, Australia. Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences
- Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia
- School of Public Health, The University of Queensland, Herston Road, Herston, Brisbane, QLD 4006, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Malvern East, VIC, Australia
- School of Sport Science, Exercise and Health, The University of Western Australia, Perth, WA, Australia
- Mary MacKillop Institute for Health Research, The Australian Catholic University, Melbourne, VIC, Australia
| | - Rick Baldock
- The Australian Council for Health and Physical Education, South Australian Branch, SA, Australia
| | - Bernie Holland
- The Australian Council for Health and Physical Education, Victorian Branch, SA, Australia
| | - Jo Salmon
- Deakin University, Geelong, Australia. Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences
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Sherry AP, Pearson N, Clemes SA. The effects of standing desks within the school classroom: A systematic review. Prev Med Rep 2016; 3:338-47. [PMID: 27419034 PMCID: PMC4929187 DOI: 10.1016/j.pmedr.2016.03.016] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 03/29/2016] [Accepted: 03/31/2016] [Indexed: 11/28/2022] Open
Abstract
Background The school classroom environment often dictates that pupils sit for prolonged periods which may be detrimental for children's health. Replacing traditional school desks with standing desks may reduce sitting time and provide other benefits. The aim of this systematic review was to assess the impact of standing desks within the school classroom. Method Studies published in English up to and including June 2015 were located from online databases and manual searches. Studies implementing standing desks within the school classroom, including children and/or adolescents (aged 5–18 years) which assessed the impact of the intervention using a comparison group or pre–post design were included. Results Eleven studies were eligible for inclusion; all were set in primary/elementary schools, and most were conducted in the USA (n = 6). Most were non-randomised controlled trials (n = 7), with durations ranging from a single time point to five months. Energy expenditure (measured over 2 h during school day mornings) was the only outcome that consistently demonstrated positive results (three out of three studies). Evidence for the impact of standing desks on sitting, standing, and step counts was mixed. Evidence suggested that implementing standing desks in the classroom environment appears to be feasible, and not detrimental to learning. Conclusions Interventions utilising standing desks in classrooms demonstrate positive effects in some key outcomes but the evidence lacks sufficient quality and depth to make strong conclusions. Future studies using randomised control trial designs with larger samples, longer durations, with sitting, standing time and academic achievement as primary outcomes, are warranted. We assessed the impact of classroom standing desks in 11 studies. Diverse implementation strategies and outcome measures were used across studies. Mixed results were found for most outcome measures including sitting and standing. Most studies were low quality which limited the ability to draw strong conclusions. More studies of longer duration that assess sitting and standing time are needed.
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Affiliation(s)
- Aron P Sherry
- School of Sport, Exercise & Health Sciences, Loughborough University, Loughborough, UK
| | - Natalie Pearson
- School of Sport, Exercise & Health Sciences, Loughborough University, Loughborough, UK
| | - Stacy A Clemes
- School of Sport, Exercise & Health Sciences, Loughborough University, Loughborough, UK
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Minges KE, Chao AM, Irwin ML, Owen N, Park C, Whittemore R, Salmon J. Classroom Standing Desks and Sedentary Behavior: A Systematic Review. Pediatrics 2016; 137:e20153087. [PMID: 26801914 PMCID: PMC4732360 DOI: 10.1542/peds.2015-3087] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/16/2015] [Indexed: 11/24/2022] Open
Abstract
CONTEXT Reducing sedentary behaviors, or time spent sitting, is an important target for health promotion in children. Standing desks in schools may be a feasible, modifiable, and acceptable environmental strategy to this end. OBJECTIVE To examine the impact of school-based standing desk interventions on sedentary behavior and physical activity, health-related outcomes, and academic and behavioral outcomes in school-aged children. DATA SOURCES Ovid Embase, Medline, PsycINFO, Web of Science, Global Health, and CINAHL. STUDY SELECTION Full-text peer-reviewed journal publications written in English; samples of school-aged youth (5-18 years of age); study designs including the same participants at baseline and follow-up; and use of a standing desk as a component of the intervention. DATA EXTRACTION Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS Eight studies satisfied selection criteria and used quasi-experimental (n = 4), randomized controlled trial (n = 3), and pre-post, no control (n = 1) designs. When examined, time spent standing increased in all studies (effect sizes: 0.38-0.71), while sitting time decreased from a range of 59 to 64 minutes (effect sizes: 0.27-0.49). Some studies reported increased physical activity and energy expenditure and improved classroom behavior. LIMITATIONS One-half of the studies had nonrandomized designs, and most were pilot or feasibility studies. CONCLUSIONS This initial evidence supports integrating standing desks into the classroom environment; this strategy has the potential to reduce sitting time and increase standing time among elementary schoolchildren. Additional research is needed to determine the impact of standing desks on academic performance and precursors of chronic disease risk.
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Affiliation(s)
- Karl E Minges
- School of Nursing, Yale University, Orange, Connecticut;
| | - Ariana M Chao
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania; Center for Weight and Eating Disorders, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Melinda L Irwin
- Department of Chronic Disease Epidemiology, School of Public Health, Yale University, New Haven, Connecticut
| | - Neville Owen
- Baker IDI Heart & Diabetes Institute, Melbourne, Australia; School of Public Health, The University of Queensland, Brisbane, Australia; School of Population and Global Health, University of Melbourne, Melbourne, Australia; Department of Medicine, Monash University, Melbourne, Australia; and
| | - Chorong Park
- School of Nursing, Yale University, Orange, Connecticut
| | | | - Jo Salmon
- Centre for Physical Activity and Nutrition Research, Deakin University, Burwood, Australia
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