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Miguel-Berges ML, Larruy-García A, De Miguel-Etayo P, Jimeno-Martinez A, Torres A, Moreno LA. Weight Status Determines the Impact of a School-Based Nutrition Education Intervention on Lifestyle Behaviors in Children. CHILDREN (BASEL, SWITZERLAND) 2024; 11:1093. [PMID: 39334625 PMCID: PMC11430318 DOI: 10.3390/children11091093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2024] [Revised: 08/28/2024] [Accepted: 08/29/2024] [Indexed: 09/30/2024]
Abstract
BACKGROUND/OBJECTIVES This study investigated the impact of the FLUYE school-based intervention on children's lifestyle behaviors, Mediterranean diet adherence, and emotional well-being in Spain. The objective was to promote healthy habits through nutrition education, physical activity, and emotional support within the school environment, with a focus on addressing the needs of both normal-weight and overweight/obese children. METHODS A total of 552 children aged 3 to 12 years participated in the study, with data collected at baseline (T0) and follow-up (T1). The intervention was designed to integrate health education into the school curriculum, emphasizing the development of personal competencies in diet, physical activity, and emotional well-being. The analysis included changes in dietary habits, screen time, physical activity, and psychosocial outcomes, with comparisons made between the normal-weight and overweight/obese groups. RESULTS Significant improvements were observed in water consumption and reductions in sugar-sweetened beverage intake across both weight groups. However, an increase in screen time, particularly among normal-weight children, highlighted ongoing challenges in reducing sedentary behavior. Adherence to the Mediterranean diet improved more significantly in the overweight/obese group, suggesting the program's effectiveness in promoting healthier eating patterns among at-risk children. Emotional well-being and self-esteem also saw significant enhancements, with children reporting increased feelings of pride and positivity post-intervention. CONCLUSIONS The FLUYE program effectively improved various aspects of children's lifestyle behaviors, particularly in dietary habits and emotional well-being. These findings underscore the importance of comprehensive, school-based interventions that address both physical and psychosocial aspects of health, especially for children at higher risk for obesity.
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Affiliation(s)
- María L. Miguel-Berges
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain; (A.L.-G.); (P.D.M.-E.); (A.J.-M.); (L.A.M.)
- Instituto Agroalimentario de Aragón (IA2), C/Miguel Servet 177, 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Avda. San Juan Bosco 13, 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición (CIBEROBN), (CB15/00043), Institute of Health Carlos III (ISCIII), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - Alicia Larruy-García
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain; (A.L.-G.); (P.D.M.-E.); (A.J.-M.); (L.A.M.)
- Instituto Agroalimentario de Aragón (IA2), C/Miguel Servet 177, 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Avda. San Juan Bosco 13, 50009 Zaragoza, Spain
| | - Pilar De Miguel-Etayo
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain; (A.L.-G.); (P.D.M.-E.); (A.J.-M.); (L.A.M.)
- Instituto Agroalimentario de Aragón (IA2), C/Miguel Servet 177, 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Avda. San Juan Bosco 13, 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición (CIBEROBN), (CB15/00043), Institute of Health Carlos III (ISCIII), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - Andrea Jimeno-Martinez
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain; (A.L.-G.); (P.D.M.-E.); (A.J.-M.); (L.A.M.)
- Instituto Agroalimentario de Aragón (IA2), C/Miguel Servet 177, 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Avda. San Juan Bosco 13, 50009 Zaragoza, Spain
| | - Antonio Torres
- School of Health Sciences Blanquerna, University Ramon Llull, 08022 Barcelona, Spain;
| | - Luis A. Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain; (A.L.-G.); (P.D.M.-E.); (A.J.-M.); (L.A.M.)
- Instituto Agroalimentario de Aragón (IA2), C/Miguel Servet 177, 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Avda. San Juan Bosco 13, 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición (CIBEROBN), (CB15/00043), Institute of Health Carlos III (ISCIII), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
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Moeller NC, Oestergaard L, Rasmussen MGB, Schmidt-Persson J, Larsen KT, Juhl CB. How to get children moving? The effectiveness of school-based interventions promoting physical activity in children and adolescents - A systematic review and meta-analysis of randomized controlled- and controlled studies. Health Place 2024; 89:103333. [PMID: 39163765 DOI: 10.1016/j.healthplace.2024.103333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 06/06/2024] [Accepted: 07/31/2024] [Indexed: 08/22/2024]
Abstract
This systematic review and meta-analysis summarizes the effectiveness of school-based physical activity (PA) interventions on children's and adolescents' PA. As no robust empirical evidence exists regarding what seems to characterize the school-based PA interventions that are most effective, we further aimed to map key factors of particular importance when trying to increase PA in early stages of life through school-based strategies. Intervention effects were calculated as standardized between-group (i.e., intervention vs. control) mean differences (SMD) in PA from baseline to follow-up. In total, 189 publications were included. Few studies (7%) were of high quality. Our results demonstrate that school-based interventions only have a small positive effect on children's and adolescents' PA levels. Compared to the effect observed during total day (SMD = 0.27, p < 0.001), a slightly larger effect was observed during school hours (SMD = 0.37, p < 0.001), while no intervention effect was observed during leisure time (SMD = 0.07, p = 0.20). There was a tendency for interventions to be more effective if theoretical frameworks for behavior changes were used in the design phase. The largest effect size was observed when experts from outside school delivered the program (SMD = 0.56, p = 0.01), but training of personnel involved in delivery was the determining factor for program effectiveness as no effect was observed if interventions were delivered primarily by schools' untrained staff (SMD = 0.06, p = 0.61). Intervention effects where larger if parents were involved in the intervention program (parents involved: SMD = 0.35, p < 0.001; parents not involved: SMD = 0.16, p = 0.02). Small positive intervention effects were sustained at long-term follow-up after end of intervention. Overall, the certainty of the evidence of the findings is rated as low.
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Affiliation(s)
- Niels Christian Moeller
- Department of Sports Science and Clinical Biomechanics, Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.
| | - Lars Oestergaard
- Department of Sports Science and Clinical Biomechanics, Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.
| | - Martin Gillies Banke Rasmussen
- Department of Sports Science and Clinical Biomechanics, Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.
| | - Jesper Schmidt-Persson
- Department of Sports Science and Clinical Biomechanics, Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.
| | - Kristian Traberg Larsen
- Department of Sports Science and Clinical Biomechanics, Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.
| | - Carsten Bogh Juhl
- Department of Sports Science and Clinical Biomechanics, Research Unit for Musculoskeletal Function and Physiotherapy, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark; Department of Occupational Therapy and Physiotherapy, Herlev and Gentofte Hospital, Copenhagen University Hospital, Denmark.
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McKay HA, Kennedy SG, Macdonald HM, Naylor PJ, Lubans DR. The Secret Sauce? Taking the Mystery Out of Scaling-Up School-Based Physical Activity Interventions. J Phys Act Health 2024; 21:731-740. [PMID: 38936808 DOI: 10.1123/jpah.2024-0274] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 04/16/2024] [Indexed: 06/29/2024]
Abstract
Over the last 4 decades, physical activity researchers have invested heavily in determining "what works" to promote healthy behaviors in schools. Single and multicomponent school-based interventions that target physical education, active transportation, and/or classroom activity breaks effectively increased physical activity among children and youth. Yet, few of these interventions are ever scaled-up and implemented under real-world conditions and in diverse populations. To achieve population-level health benefits, there is a need to design school-based health-promoting interventions for scalability and to consider key aspects of the scale-up process. In this opinion piece, we aim to identify challenges and advance knowledge and action toward scaling-up school-based physical activity interventions. We highlight the key roles of planning for scale-up at the outset, scale-up pathways, trust among partners and program support, program adaptation, evaluation of scale-up, and barriers and facilitators to scaling-up. We draw upon our experience scaling-up effective school-based interventions and provide a solid foundation from which others can work toward bridging the implementation-to-scale-up gap.
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Affiliation(s)
- Heather A McKay
- Active Aging Research Team, University of British Columbia, Vancouver, BC, Canada
- Department of Family Practice, University of British Columbia, Vancouver, BC, Canada
| | - Sarah G Kennedy
- School of Health Sciences, Western Sydney University, Penrith, NSW, Australia
| | - Heather M Macdonald
- Active Aging Research Team, University of British Columbia, Vancouver, BC, Canada
- Department of Family Practice, University of British Columbia, Vancouver, BC, Canada
| | - Patti-Jean Naylor
- School of Exercise Science, Physical and Health Education, Faculty of Education, University of Victoria, Victoria, BC, Canada
| | - David R Lubans
- Centre for Active Living and Learning, College of Human and Social Futures, University of Newcastle, Callaghan, NSW, Australia
- Active Living Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Long KZ, Beckmann J, Lang C, Seelig H, Nqweniso S, Probst-Hensch N, Pühse U, Steinmann P, Randt RD, Walter C, Utzinger J, Gerber M. Randomized Trial to Improve Body Composition and Micronutrient Status Among South African Children. Am J Prev Med 2024; 66:1078-1088. [PMID: 38309672 DOI: 10.1016/j.amepre.2024.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 01/23/2024] [Accepted: 01/23/2024] [Indexed: 02/05/2024]
Abstract
INTRODUCTION Physical activity (PA) promotion combined with multimicronutrient supplementation (MMNS) among school-age children may reduce fat mass accrual and increase muscle mass through different mechanisms and so benefit child health. This study determined the efficacy of combined interventions on body composition among South African schoolchildren and determined if micronutrients mediate these effects. STUDY DESIGN Longitudinal cluster randomized controlled trial of children followed from 2019 to 2021. Statistical analyses carried from 2022 to 2023. SETTING/PARTICIPANTS A total of 1,304 children 6-12 years of age recruited from public schools in Gqeberha, South Africa. INTERVENTION Children were randomized by classes to either: (a) a physical activity group (PA); (b) a MMNS group; (c) a physical activity + multimicronutrient supplementation group (PA + MMNS); and (d) a placebo control group. MAIN OUTCOME MEASURES Trajectories of overall and truncal fat free mass (FFM) and fat mass (FM) estimates in modeled at 9 and 21 months using latent growth curve models (LGCM). Changes in micronutrient concentrations at 9 months from baseline. RESULTS An increased FFM trajectory was found among children in the MMNS arm at 9 months (Beta 0.16, 95% CI = 0.12, 0.31). The PA and MMNS arms both had positive indirect effects on this trajectory at 9 months (Beta 0.66, 95% CI = 0.44, 0.88 and Beta 0.32 95% CI = 0.1 0.5, respectively) and similarly at 21 months when mediated by zinc concentration changes. A reduced FM trajectory was found among children in the PA promotion arm at 9 months when using this collection point as the referent intercept. This arm was inversely associated with the FM trajectory at 9 months when mediated by zinc changes. CONCLUSIONS PA and MMNS promotion in school-based interventions directly contributed to reductions in FM and increased FFM among South African children and indirectly through changes in micronutrient status. TRIAL REGISTRATION ISRCTN, ISRCTN29534081. Registered on August 9, 2018 Institutional review board: Ethikkommission Nordwest- und Zentralschweiz" (EKNZ, project number: Req-2018-00608). Date of approval: 2018.
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Affiliation(s)
- Kurt Z Long
- Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland.
| | - Johanna Beckmann
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Christin Lang
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Harald Seelig
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Siphesihle Nqweniso
- Department of Human Movement Science, Nelson Mandela University, Port Elizabeth, South Africa
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland
| | - Uwe Pühse
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Peter Steinmann
- Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland
| | - Rosa du Randt
- Department of Human Movement Science, Nelson Mandela University, Port Elizabeth, South Africa
| | - Cheryl Walter
- Department of Human Movement Science, Nelson Mandela University, Port Elizabeth, South Africa
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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Clevenger KA, McKee KL, McNarry MA, Mackintosh KA, Berrigan D. Association of Recess Provision With Accelerometer-Measured Physical Activity and Sedentary Time in a Representative Sample of 6- to 11-Year-Old Children in the United States. Pediatr Exerc Sci 2024; 36:83-90. [PMID: 37758264 DOI: 10.1123/pes.2023-0056] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/09/2023] [Accepted: 07/25/2023] [Indexed: 10/03/2023]
Abstract
PURPOSE To assess the association between the amount of recess provision and children's accelerometer-measured physical activity (PA) levels. METHODS Parents/guardians of 6- to 11-year-olds (n = 451) in the 2012 National Youth Fitness Survey reported recess provision, categorized as low (10-15 min; 31.9%), medium (16-30 min; 48.0%), or high (>30 min; 20.1%). Children wore a wrist-worn accelerometer for 7 days to estimate time spent sedentary, in light PA, and in moderate to vigorous PA using 2 different cut points for either activity counts or raw acceleration. Outcomes were compared between levels of recess provision while adjusting for covariates and the survey's multistage, probability sampling design. RESULTS Children with high recess provision spent less time sedentary, irrespective of type of day (week vs weekend) and engaged in more light or moderate to vigorous PA on weekdays than those with low recess provision. The magnitude and statistical significance of effects differed based on the cut points used to classify PA (eg, 4.7 vs 11.9 additional min·d-1 of moderate to vigorous PA). CONCLUSIONS Providing children with >30 minutes of daily recess, which exceeds current recommendations of ≥20 minutes, is associated with more favorable PA levels and not just on school days. Identifying the optimal method for analyzing wrist-worn accelerometer data could clarify the magnitude of this effect.
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Affiliation(s)
- Kimberly A Clevenger
- Department of Kinesiology and Health Science, Utah State University, Logan, UT,USA
| | - Katherine L McKee
- Department of Kinesiology and Health Science, Utah State University, Logan, UT,USA
| | - Melitta A McNarry
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Faculty of Science and Engineering, Swansea University, Swansea,United Kingdom
| | - Kelly A Mackintosh
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Faculty of Science and Engineering, Swansea University, Swansea,United Kingdom
| | - David Berrigan
- Health Behaviors Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD,USA
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Cai S, Liu Y, Dang J, Zhong P, Shi D, Chen Z, Hu P, Ma J, Dong Y, Song Y, Raat H. Clustering of Multilevel Factors Among Children and Adolescents: Associations With Health-Related Physical Fitness. J Phys Act Health 2024; 21:29-39. [PMID: 37922895 DOI: 10.1123/jpah.2023-0051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 07/13/2023] [Accepted: 09/07/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND To identify the clustering characteristics of individual-, family-, and school-level factors, and examine their associations with health-related physical fitness. METHODS A total of 145,893 Chinese children and adolescents aged 9-18 years participated in this cross-sectional study. The 2-step cluster analysis was conducted to identify clusters among individual-, family-, and school-level factors. Physical fitness indicator was calculated through sex- and age-specific z scores of forced vital capacity, standing long jump, sit-and-reach flexibility, body muscle strength, endurance running, and body mass index. RESULTS Three, 3, and 5 clusters were automatically identified at individual, family, and school levels, respectively. Students with low physical fitness indicator were more likely to be in the "longest sedentary time and skipping breakfast" cluster (odds ratio [OR] = 1.18; 95% confidence interval [CI], 1.12-1.24), and "physical inactivity and insufficient protein consumption" cluster (OR = 1.07; 95% CI, 1.02-1.12) at individual level, the "single children and high parental education level" cluster (OR = 1.15; 95% CI, 1.10-1.21), and "no physical activity support and preference" cluster (OR = 1.30; 95% CI, 1.25-1.36) at family level, and the "physical education occupied" cluster (OR = 1.06; 95% CI, 1.01-1.11), and "insufficient physical education frequency" cluster (OR = 1.16; 95% CI, 1.08-1.24) at school level. Girls were more vulnerable to individual- and school-level clusters, while boys were more susceptible to family clusters; the younger students were more sensitive to school clusters, and the older students were more susceptible to family clusters (P-interaction < .05). CONCLUSIONS This study confirmed different clusters at multilevel factors and proved their associations with health-related physical fitness, thus providing new perspective for developing targeted interventions.
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Affiliation(s)
- Shan Cai
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, BJ, China
- National Health Commission Key Laboratory of Reproductive Health, Beijing, BJ, China
| | - Yunfei Liu
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, BJ, China
- National Health Commission Key Laboratory of Reproductive Health, Beijing, BJ, China
| | - Jiajia Dang
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, BJ, China
- National Health Commission Key Laboratory of Reproductive Health, Beijing, BJ, China
| | - Panliang Zhong
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, BJ, China
- National Health Commission Key Laboratory of Reproductive Health, Beijing, BJ, China
| | - Di Shi
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, BJ, China
- National Health Commission Key Laboratory of Reproductive Health, Beijing, BJ, China
| | - Ziyue Chen
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, BJ, China
- National Health Commission Key Laboratory of Reproductive Health, Beijing, BJ, China
| | - Peijin Hu
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, BJ, China
- National Health Commission Key Laboratory of Reproductive Health, Beijing, BJ, China
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, BJ, China
- National Health Commission Key Laboratory of Reproductive Health, Beijing, BJ, China
| | - Yanhui Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, BJ, China
- National Health Commission Key Laboratory of Reproductive Health, Beijing, BJ, China
| | - Yi Song
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, BJ, China
- National Health Commission Key Laboratory of Reproductive Health, Beijing, BJ, China
| | - Hein Raat
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
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Morgado MC, Sousa M, Coelho AB, Vale S, Costa JA, Seabra A. Effects of "Football and Nutrition for Health" program on body composition, physical fitness, eating behaviours, nutritional knowledge, and psychological status among 7 to 10 years school children. Front Pediatr 2023; 11:1251053. [PMID: 38027281 PMCID: PMC10663241 DOI: 10.3389/fped.2023.1251053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Noncommunicable diseases and obesity are between the major health threat due to consumption of unhealthy foods and limited time spent on physical activities, a situation of particular concern among children. Since children spend most of their time at school, this study intends to investigate the effect of a school intervention program, which combines recreational football and nutrition education, on body composition, physical fitness, physical activity, blood pressure and heart rate, eating behaviours, nutritional knowledge, and psychological status in elementary school children. Methods A total of 67 children, between 7 and 10 years old, were allocated into three groups: the Football Group (FG) which held 2 weekly sessions of 60 min of recreational football, the Nutrition and Football Group (NFG) which held 2 sessions per week of 60 min of recreational football plus 60 min of nutritional education and the Control Group (CG) which maintained its usual curriculum. The intervention lasted 12 weeks. All measurements were collected before and after the intervention. Results Intervention groups significantly (p < 0.05) improved BMI Z-score, rest heart rate, horizontal jump and shuttle test, physical activity level, and psychosocial health. The NFG group significantly decreased (p < 0.05) waist-to-height ratio and blood pressure, and significantly increased (p < 0.05) nutritional knowledge, fruit, and fish consumption. While FG significantly decreased (p < 0.05) the percentage of fat mass and significantly increased (p < 0.05) muscle mass and performance in the 20 m sprint. Discussion The results have shown to improve nutritional status, explosive strength, aerobic and neuromuscular fitness, as well as increase the level of physical activity. The nutritional education sessions contributed to increase nutritional knowledge and to improve the consumption of healthy food groups in a ludic-educational way. The "Football and Nutrition for Health" program was able to induce short-term improvements in several health markers, highlighting the role of the school curriculum in children's health.
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Affiliation(s)
- Micaela C. Morgado
- Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
- Portugal Football School (PFS), Portuguese Football Federation (FPF), Cruz Quebrada - Dafundo, Portugal
| | - Mónica Sousa
- CIDEFES, Universidade Lusófona, Lisboa, Portugal
- CINTESIS@RISE, NOVA Medical School (NMS), Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Lisboa, Portugal
| | - André B. Coelho
- Research Center for Sport and Physical Activity (CIDAF), Faculty of Sports Science and Physical Education, University of Coimbra, Coimbra, Portugal
| | - Susana Vale
- Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
- Porto School of Education, Polytechnic Institute of Porto, Porto, Portugal
| | - Júlio A. Costa
- Portugal Football School (PFS), Portuguese Football Federation (FPF), Cruz Quebrada - Dafundo, Portugal
| | - André Seabra
- Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
- Portugal Football School (PFS), Portuguese Football Federation (FPF), Cruz Quebrada - Dafundo, Portugal
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Hewawitharana SC, Woodward-Lopez G, Ohri-Vachaspati P, Acciai F, Thompson HR, Pugliese J, Gosliner W. Latent class analysis identifies a promising combination of Supplemental Nutrition Assistance Program-Education interventions for improving student cardiorespiratory fitness. Prev Med 2023; 175:107687. [PMID: 37648085 DOI: 10.1016/j.ypmed.2023.107687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 08/21/2023] [Accepted: 08/27/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVE To inform Supplemental Nutrition Assistance Program Education (SNAP-Ed) and other school-based interventions aiming to improve youth cardiorespiratory fitness, this study aimed to identify which SNAP-Ed school-based physical activity intervention combinations were associated with better student cardiorespiratory fitness. METHODS This study, utilizing cross-sectional secondary data, included 5th and 7th grade students who attended SNAP-Ed-eligible public schools in California (n = 442,743 students; 4271 schools) and had complete 2016-17 state-mandated fitness test results. Latent class analysis was used to identify underlying school-based intervention combinations. Propensity score methods were used to ensure comparability of intervention and comparison schools, by calculating inverse probability weights. Multilevel models, using those inverse probability weights, assessed the associations between the identified intervention combinations and student cardiorespiratory fitness, as measured by VO2max. The models were adjusted for school-level variables (urbanicity, percent of students eligible for free- or reduced-price meals, total enrollment, and school type), child-level variables (age, gender, and race/ethnicity), and for clustering of students within schools. RESULTS We found that students attending schools with interventions focusing on comprehensive policy changes along with improving opportunities for physical activity had, on average, 1.17 mL/kg/min (95% CI: 0.72, 1.62) greater VO2max than students attending schools without any intervention. They also had statistically significantly greater VO2max compared to students attending schools with any other type of intervention combination. CONCLUSION Our results suggest that comprehensive school-based physical activity interventions that include policy changes along with improving physical activity opportunities may be the most effective approach for improving fitness and may warrant prioritization in SNAP-Ed efforts.
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Affiliation(s)
- Sridharshi C Hewawitharana
- University of California, Division of Agriculture and Natural Resources, Nutrition Policy Institute, Oakland, CA, United States of America.
| | - Gail Woodward-Lopez
- University of California, Division of Agriculture and Natural Resources, Nutrition Policy Institute, Oakland, CA, United States of America
| | - Punam Ohri-Vachaspati
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States of America
| | - Francesco Acciai
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States of America
| | - Hannah R Thompson
- University of California, Division of Agriculture and Natural Resources, Nutrition Policy Institute, Oakland, CA, United States of America; University of California, Berkeley, School of Public Health Berkeley, CA, United States of America
| | - John Pugliese
- California Department of Public Health, Sacramento, CA, United States of America
| | - Wendi Gosliner
- University of California, Division of Agriculture and Natural Resources, Nutrition Policy Institute, Oakland, CA, United States of America
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9
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Santos F, Sousa H, Gouveia ÉR, Lopes H, Peralta M, Martins J, Murawska-Ciałowicz E, Żurek G, Marques A. School-Based Family-Oriented Health Interventions to Promote Physical Activity in Children and Adolescents: A Systematic Review. Am J Health Promot 2023; 37:243-262. [PMID: 36413351 PMCID: PMC9850376 DOI: 10.1177/08901171221113836] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE This study aimed to systematically review and analyse intervention programs in a school context centred on the family, focused on increasing youths' physical activity. DATA SOURCE The research was carried out in the PubMed, Scopus and Web of Science databases. STUDY INCLUSION CRITERIA Studies were included if participants were children or adolescents, focusing on school-based intervention studies with parental involvement and physical activity, sedentary behaviour or physical fitness outcomes. DATA EXTRACTION The search was performed according to the PRISMA protocol. A total of 416 articles were identified. After being considered for eligibility and duplicates, 22 studies were identified as relevant for inclusion. DATA SYNTHESIS Sample and intervention characteristics, objective, the role of the family, outcomes measures, main findings regarding the outcomes and risk of bias. RESULTS Ten studies reported improvements in physical activity, 6 in sedentary behaviour and 9 in the components of physical fitness and/or skills related to healthy behaviours and lifestyles. Most of the interventions adopted a multidisciplinary and multi-component approach. CONCLUSIONS Most interventions employed a school's multidisciplinary/multi-component approach to promoting physical activity, nutrition, and general education for healthier lifestyle behaviours. The impact of school-based interventions involving families on youth's physical activity levels is still a relatively emerging theme. Further research is needed given the diversity of the intervention's characteristics and the disparity in the results' efficacy.
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Affiliation(s)
- Francisco Santos
- Department of Physical Education
and Sport, University
de Madeira, Funchal, Portugal
| | - Honorato Sousa
- Department of Physical Education
and Sport, University
de Madeira, Funchal, Portugal
| | - Élvio Rúbio Gouveia
- Department of Physical Education
and Sport, University
de Madeira, Funchal, Portugal,LARSYS,
Interactive
Technologies Institute, Funchal,
Portugal,Élvio Rúbio Gouveia, Universidade da
Madeira, Departamento de Educação Física e Desporto, Campus Universitário da
Penteada; 9000-390 Funchal, Portugal.
| | - Helder Lopes
- Department of Physical Education
and Sport, University
de Madeira, Funchal, Portugal
| | - Miguel Peralta
- Research Center in Sports Sciences,
Health Sciences, and Human Development (CIDESD), Vila Real, Portugal,CIPER, Faculdade de Motricidade
Humana, Universidade de Lisboa, Lisboa, Portugal
| | - João Martins
- Research Center in Sports Sciences,
Health Sciences, and Human Development (CIDESD), Vila Real, Portugal,CIPER, Faculdade de Motricidade
Humana, Universidade de Lisboa, Lisboa, Portugal
| | | | - Grzegorz Żurek
- Physiology and Biochemistry
Department, University
School of Physical Education in
Wrocław, Wrocław, Poland
| | - Adilson Marques
- Research Center in Sports Sciences,
Health Sciences, and Human Development (CIDESD), Vila Real, Portugal,CIPER, Faculdade de Motricidade
Humana, Universidade de Lisboa, Lisboa, Portugal
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10
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Clark JE, Sirois E, Wiszniak MF. The impact of bias on developing healthy lifestyles, understanding if personal perspectives impact modeling and recommendations of diet and exercise by educators to their students. SPORT SCIENCES FOR HEALTH 2023; 19:1-13. [PMID: 36721727 PMCID: PMC9880936 DOI: 10.1007/s11332-023-01042-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 01/02/2023] [Indexed: 01/28/2023]
Abstract
Purpose Educators have an ability to imprint healthy behavior in children. Yet, little is known about how a bias by educators might impact imprinting on students. Therefore, we examined if educators' bias in opinions about diet and exercise influence the manner they are discussed with students. Methods 340 (144 F/196 M) educators from over 14 states (USA) provided responses regarding: personal opinions about and history of following diets or using exercise regimens; perspective on commonly held beliefs regarding diet, exercise, body image and morphology; and who should provide recommendations. Responses were tabulated for average and percentage with subsequent analysis by Pearson correlations or keyword frequencies of responses. Results Almost all (97%) understand social pressures related to body image and need to portray healthy behaviors to students. Bias was evident based on history of recommending or discouraging a specific diet (r = 0.77) or a dietary supplement (r = 0.66), recommending exercise they used (r = 0.89) or discouraging ones not used (r = 0.65). Most (85%) understand that social and mass media are not reliable sources, yet, relied on the same sources for information that reinforced their opinions. Conclusion Findings indicate (1) portrayal of healthy behaviors to students exist but expressed opinion that families have a greater influence than educators on healthy lifestyles, (2) there appears to be an unawareness of personal bias or expression of implicit bias toward behaviors projected to students, and (3) health/physical education and life science teachers may be able to act as a source of unbiased information to provide resources to a school site to aid in developing healthy lifestyles.
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Affiliation(s)
- James E. Clark
- Scientific Health: Education and Human Performance, Oakley, CA 94561 USA
- Los Medanos College, Brentwood Center, Brentwood, CA 94513 USA
| | - Emily Sirois
- Scientific Health: Education and Human Performance, Oakley, CA 94561 USA
| | - Martha F. Wiszniak
- Scientific Health: Education and Human Performance, Oakley, CA 94561 USA
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11
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Lang JJ, Zhang K, Agostinis-Sobrinho C, Andersen LB, Basterfield L, Berglind D, Blain DO, Cadenas-Sanchez C, Cameron C, Carson V, Colley RC, Csányi T, Faigenbaum AD, García-Hermoso A, Gomes TNQF, Gribbon A, Janssen I, Jurak G, Kaj M, Kidokoro T, Lane KN, Liu Y, Löf M, Lubans DR, Magnussen CG, Manyanga T, McGrath R, Mota J, Olds T, Onywera VO, Ortega FB, Oyeyemi AL, Prince SA, Ramírez-Vélez R, Roberts KC, Rubín L, Servais J, Silva DAS, Silva DR, Smith JJ, Song Y, Stratton G, Timmons BW, Tomkinson GR, Tremblay MS, Wong SHS, Fraser BJ. Top 10 International Priorities for Physical Fitness Research and Surveillance Among Children and Adolescents: A Twin-Panel Delphi Study. Sports Med 2023; 53:549-564. [PMID: 36001291 PMCID: PMC9399984 DOI: 10.1007/s40279-022-01752-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND The measurement of physical fitness has a history that dates back nearly 200 years. Recently, there has been an increase in international research and surveillance on physical fitness creating a need for setting international priorities that could help guide future efforts. OBJECTIVE This study aimed to produce a list of the top 10 international priorities for research and surveillance on physical fitness among children and adolescents. METHODS Using a twin-panel Delphi method, two independent panels consisting of 46 international experts were identified (panel 1 = 28, panel 2 = 18). The panel participants were asked to list up to five priorities for research or surveillance (round 1), and then rated the items from their own panel on a 5-point Likert scale of importance (round 2). In round 3, experts were asked to rate the priorities identified by the other panel. RESULTS There was strong between-panel agreement (panel 1: rs = 0.76, p < 0.01; panel 2: rs = 0.77, p < 0.01) in the priorities identified. The list of the final top 10 priorities included (i) "conduct longitudinal studies to assess changes in fitness and associations with health". This was followed by (ii) "use fitness surveillance to inform decision making", and (iii) "implement regular and consistent international/national fitness surveys using common measures". CONCLUSIONS The priorities identified in this study provide guidance for future international collaborations and research efforts on the physical fitness of children and adolescents over the next decade and beyond.
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Affiliation(s)
- Justin J. Lang
- grid.415368.d0000 0001 0805 4386Centre for Surveillance and Applied Research, Public Health Agency of Canada, 785 Carling Ave, Ottawa, ON K9A 0K9 Canada ,grid.28046.380000 0001 2182 2255School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON Canada ,grid.414148.c0000 0000 9402 6172Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON Canada
| | - Kai Zhang
- grid.414148.c0000 0000 9402 6172Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON Canada ,grid.28046.380000 0001 2182 2255School of Human Kinetics, University of Ottawa, Ottawa, ON Canada
| | - César Agostinis-Sobrinho
- grid.14329.3d0000 0001 1011 2418Faculty of Health Sciences, Klaipeda University, Klaipeda, Lithuania
| | - Lars Bo Andersen
- grid.477239.c0000 0004 1754 9964Department of Sport, Food and Natural Sciences. Western, Norway University of Applied Science, Bergen, Norway
| | - Laura Basterfield
- grid.1006.70000 0001 0462 7212Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Daniel Berglind
- grid.4714.60000 0004 1937 0626Department of Global Public Health and Centre for Epidemiology and Community Medicine (CES), Karolinska Institutet, Stockholm, Sweden
| | - Dylan O. Blain
- grid.12362.340000 0000 9280 9077Institute of Management and Health, University of Wales Trinity Saint David, Wales, UK
| | - Cristina Cadenas-Sanchez
- grid.4489.10000000121678994PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Christine Cameron
- grid.418590.10000 0001 2164 2780Canadian Fitness and Lifestyle Research Institute, Ottawa, ON Canada
| | - Valerie Carson
- grid.17089.370000 0001 2190 316XFaculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB Canada
| | - Rachel C. Colley
- grid.413850.b0000 0001 2097 5698Health Analysis Division, Statistics Canada, Ottawa, ON Canada
| | - Tamás Csányi
- Department of Physical Education Theory and Methodology, Hungarian University of Sports Science, Budapest, Hungary ,grid.5591.80000 0001 2294 6276Faculty of Primary and Pre-School Education, ELTE, Eötvös Loránd University, Budapest, Hungary
| | - Avery D. Faigenbaum
- grid.264500.50000 0004 0400 5239Kinesiology and Health Science, The College of New Jersey, Ewing, NJ USA
| | - Antonio García-Hermoso
- grid.410476.00000 0001 2174 6440Navarrabiomed, Hospital Universitario de Navarra (HUN), Navarra Institute for Health Research (IdiSNA), Universidad Pública de Navarra (UPNA), Pamplona, Navarra Spain
| | - Thayse Natacha Q. F. Gomes
- grid.411252.10000 0001 2285 6801Department of Physical Education, Federal University of Sergipe, São Cristóvão, SE Brazil
| | - Aidan Gribbon
- grid.413850.b0000 0001 2097 5698Centre for Population Health Data, Statistics Canada, Ottawa, ON Canada
| | - Ian Janssen
- grid.410356.50000 0004 1936 8331School of Kinesiology and Health Studies, Queen’s University, Kingston, ON Canada ,grid.410356.50000 0004 1936 8331Department of Public Health Sciences, Queen’s University, Kingston, ON Canada
| | - Gregor Jurak
- grid.8954.00000 0001 0721 6013Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Mónika Kaj
- grid.511942.aHungarian School Sport Federation, Budapest, Hungary
| | - Tetsuhiro Kidokoro
- grid.412200.50000 0001 2228 003XResearch Institute for Health and Sport Science, Nippon Sport Science University, Tokyo, Japan
| | - Kirstin N. Lane
- grid.143640.40000 0004 1936 9465School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC Canada
| | - Yang Liu
- grid.412543.50000 0001 0033 4148School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai, China ,grid.412543.50000 0001 0033 4148Shanghai Research Center for Physical Fitness and Health of Children and Adolescents, Shanghai University of Sport, Shanghai, China
| | - Marie Löf
- grid.4714.60000 0004 1937 0626Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden ,grid.5640.70000 0001 2162 9922Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - David R. Lubans
- grid.266842.c0000 0000 8831 109XCentre for Active Living and Learning, College of Human and Social Futures, The University of Newcastle, Callaghan, NSW Australia
| | - Costan G. Magnussen
- grid.1051.50000 0000 9760 5620Baker Heart and Diabetes Institute, Melbourne, VIC Australia ,grid.1374.10000 0001 2097 1371Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland ,grid.1374.10000 0001 2097 1371Centre for Population Health Research, Turku University Hospital, University of Turku, Turku, Finland ,grid.1009.80000 0004 1936 826XMenzies Institute for Medical Research, University of Tasmania, Hobart, TAS Australia
| | - Taru Manyanga
- grid.266876.b0000 0001 2156 9982Division of Medical Sciences, University of Northern British Columbia, Prince George, BC Canada
| | - Ryan McGrath
- grid.261055.50000 0001 2293 4611Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND USA ,grid.509356.c0000 0004 0420 0122Fargo VA Healthcare System, Fargo, ND USA
| | - Jorge Mota
- grid.5808.50000 0001 1503 7226Laboratory for Integrative and Translational Research in Population Health (ITR), Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sports, University of Porto (FADEUP), Porto, Portugal
| | - Tim Olds
- grid.1026.50000 0000 8994 5086Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA Australia ,grid.1008.90000 0001 2179 088XMurdoch Children’s Research Institute, University of Melbourne, Parkville, Melbourne, VIC Australia
| | - Vincent O. Onywera
- grid.9762.a0000 0000 8732 4964Department of Physical Education, Exercise and Sports Science, Kenyatta University, Nairobi, Kenya
| | - Francisco B. Ortega
- grid.4489.10000000121678994PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain ,grid.9681.60000 0001 1013 7965Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Adewale L. Oyeyemi
- grid.413017.00000 0000 9001 9645Department of Physiotherapy, University of Maiduguri, Maiduguri, Nigeria
| | - Stephanie A. Prince
- grid.415368.d0000 0001 0805 4386Centre for Surveillance and Applied Research, Public Health Agency of Canada, 785 Carling Ave, Ottawa, ON K9A 0K9 Canada ,grid.28046.380000 0001 2182 2255School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON Canada
| | - Robinson Ramírez-Vélez
- grid.410476.00000 0001 2174 6440Navarrabiomed, Hospital Universitario de Navarra (HUN), Navarra Institute for Health Research (IdiSNA), Universidad Pública de Navarra (UPNA), Pamplona, Navarra Spain ,grid.442065.10000 0004 0486 4893Facultad de Ciencias de la Educación, Unidad Central del Valle del Cauca (UCEVA), Túlua, Colombia ,grid.413448.e0000 0000 9314 1427CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Karen C. Roberts
- grid.415368.d0000 0001 0805 4386Centre for Surveillance and Applied Research, Public Health Agency of Canada, 785 Carling Ave, Ottawa, ON K9A 0K9 Canada
| | - Lukáš Rubín
- grid.6912.c0000000110151740Department of Physical Education and Sport, Technical University of Liberec, Liberec, Czech Republic ,grid.10979.360000 0001 1245 3953Institute of Active Lifestyle, Palacký University Olomouc, Olomouc, Czech Republic
| | - Jennifer Servais
- grid.413850.b0000 0001 2097 5698Centre for Population Health Data, Statistics Canada, Ottawa, ON Canada
| | - Diego Augusto Santos Silva
- grid.411237.20000 0001 2188 7235Sports Center, Federal University of Santa Catarina, Florianópolis, SC Brazil
| | - Danilo R. Silva
- grid.411252.10000 0001 2285 6801Department of Physical Education, Federal University of Sergipe, São Cristóvão, SE Brazil ,grid.441837.d0000 0001 0765 9762Faculty of Health Science, Universidad Autónoma de Chile, Santiago, Chile
| | - Jordan J. Smith
- grid.266842.c0000 0000 8831 109XCentre for Active Living and Learning, College of Human and Social Futures, The University of Newcastle, Callaghan, NSW Australia
| | - Yi Song
- grid.11135.370000 0001 2256 9319Institute of Child and Adolescent Health, School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Gareth Stratton
- grid.4827.90000 0001 0658 8800Applied Sport Technology Exercise and Medicine Research Centre, Faculty Science and Engineering, Swansea University, Wales, UK
| | - Brian W. Timmons
- grid.414148.c0000 0000 9402 6172Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON Canada ,grid.25073.330000 0004 1936 8227Child Health and Exercise Medicine Program, McMaster University, Hamilton, ON Canada
| | - Grant R. Tomkinson
- grid.1026.50000 0000 8994 5086Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA Australia ,grid.266862.e0000 0004 1936 8163Department of Education, Health and Behavior Studies, University of North Dakota, Grand Forks, ND USA
| | - Mark S. Tremblay
- grid.414148.c0000 0000 9402 6172Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON Canada ,grid.28046.380000 0001 2182 2255Department of Pediatrics, University of Ottawa, Ottawa, ON Canada ,grid.34428.390000 0004 1936 893XDepartment of Health Sciences, Carleton University, Ottawa, ON Canada
| | - Stephen H. S. Wong
- grid.10784.3a0000 0004 1937 0482Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Brooklyn J. Fraser
- grid.1009.80000 0004 1936 826XMenzies Institute for Medical Research, University of Tasmania, Hobart, TAS Australia
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12
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Wang S, Liu B, Liu J. EFFECTS OF SCHOOL SOCCER TRAINING ON THE HEALTH AND FITNESS OF OBESE CHILDREN. REV BRAS MED ESPORTE 2023. [DOI: 10.1590/1517-8692202329012022_0794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
Abstract
ABSTRACT Introduction Based on the representative data reflecting the level of physical development and athletic quality, such as the “National Physical Health Test for Students”, it is shown that the physical health status of adolescents and children in China is decreasing annually, and the trend of obesity is gradually increasing. Objective Analyze and study the effect of training on the physical fitness of obese children aged 12 to 14 through school soccer training. Methods The effect of school soccer training on the health and physical fitness of obese children aged 12-14 years was studied, and conclusions were drawn by the literature method, experimental method, mathematical statistical method, and logical analysis method. Forty-eight screened obese children were randomly assigned to the experimental and control groups, 24 in each group. The experimental group underwent 12 weeks of soccer training, and the control group underwent 12 weeks of no training control. The subjects’ body composition and flexibility quality indices were measured post-intervention. Results The visceral fat index, body fat rate, and muscle rate of boys and girls progressed expressively, with a significant difference (P <0.05). Muscle weight is also known as lean body weight, with an expressive increase in muscle tone. In comparison, the increase in fat weight and muscle ratio in boys was expressively higher than in girls. Conclusion Regular long-term school soccer training can increase mobility in obese children, increase physical flexibility, and help promote physical health and prevent injury. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.
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Affiliation(s)
| | - Baiqing Liu
- Zhongnan University of Economics and Law, China
| | - Jingle Liu
- Zhongnan University of Economics and Law, China
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13
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Jago R, Salway R, House D, Beets M, Lubans DR, Woods C, de Vocht F. Rethinking children's physical activity interventions at school: A new context-specific approach. Front Public Health 2023; 11:1149883. [PMID: 37124783 PMCID: PMC10133698 DOI: 10.3389/fpubh.2023.1149883] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 03/21/2023] [Indexed: 05/02/2023] Open
Abstract
Physical activity is important for children's health. However, evidence suggests that many children and adults do not meet international physical activity recommendations. Current school-based interventions have had limited effect on physical activity and alternative approaches are needed. Context, which includes school setting, ethos, staff, and sociodemographic factors, is a key and largely ignored contributing factor to school-based physical activity intervention effectiveness, impacting in several interacting ways. Conceptualization Current programs focus on tightly-constructed content that ignores the context in which the program will be delivered, thereby limiting effectiveness. We propose a move away from uniform interventions that maximize internal validity toward a flexible approach that enables schools to tailor content to their specific context. Evaluation designs Evaluation of context-specific interventions should explicitly consider context. This is challenging in cluster randomized controlled trial designs. Thus, alternative designs such as natural experiment and stepped-wedge designs warrant further consideration. Primary outcome A collective focus on average minutes of moderate-to-vigorous intensity physical activity may not always be the most appropriate choice. A wider range of outcomes may improve children's physical activity and health in the long-term. In this paper, we argue that greater consideration of school context is key in the design and analysis of school-based physical activity interventions and may help overcome existing limitations in the design of effective interventions and thus progress the field. While this focus on context-specific interventions and evaluation is untested, we hope to stimulate debate of the key issues to improve future physical activity intervention development and implementation.
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Affiliation(s)
- Russell Jago
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, United Kingdom
- *Correspondence: Russell Jago,
| | - Ruth Salway
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Danielle House
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
| | - Michael Beets
- Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - David Revalds Lubans
- Centre for Active Living and Learning, College of Human and Social Futures, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, Newcastle, NSW, Australia
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Catherine Woods
- Physical Activity for Health Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
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14
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Ramírez-Vélez R, García-Hermoso A, Correa-Rodríguez M, Fernández-Irigoyen J, Palomino-Echeverría S, Santamaría E, Correa-Bautista JE, González-Ruíz K, Izquierdo M. Effects of Different Doses of Exercise on Inflammation Markers Among Adolescents With Overweight/Obesity: HEPAFIT Study. J Clin Endocrinol Metab 2022; 107:e2619-e2627. [PMID: 35038337 PMCID: PMC9472258 DOI: 10.1210/clinem/dgac021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Indexed: 11/30/2022]
Abstract
PROPOSE Obesity-related metabolic risk factors in adolescents who are overweight/obese may be associated with systemic low-grade inflammation; therefore, we investigated whether 6 months of exercise training altered markers of inflammation. METHODS Secondary analyses of a randomized controlled exercise-based intervention trial (September 2017-December 2018). Adolescents aged 11 to 17 years (Tanner stage II-V), 70% girls, with a body mass index z-score at or above the 85th percentile, and/or with excess of adiposity (body fat ≥ 30%). The participants were randomly assigned to the following 4 groups for 6 months: (1) standard physical education lessons, as a control (CTRL); (2) high-intensity physical education class (HIPE); (3) low-to-moderate intensity physical education class (LIPE); (4) a combined group (PLUS). Inflammatory markers and immune molecules including chemokines, cytokines, and growth factors (n = 65 biomarkers) were determined by cytokine antibody array. RESULTS Of the 120 randomly assigned participants, 95 were included in the analysis. Considering these 22 proteins, the LIPE group shows statistical significance in 9 proteins with log-fold change (logFC) and P < 0.05 (in BLC, eotaxin, fibroblast growth factor-6 [FGF-6], GCP-2, I-309, IGFBP-4, MCP-4, NAP-2, and PARC), followed by the PLUS group in 9 proteins (BLC, pro-epidermal growth factor, eotaxin, FGF-6, MCP-4, NAP-2, osteopontin, PARC, and RANTES), the HIPE group in 7 proteins (FGF-4, FGF-7, GCP-2, IGF-1, IGFBP-1, IGFBP-4, and MIP-1 delta), and the CTRL group in 6 proteins (FGF-4, IP-10, Leptin, MCP-1, MIG, and MIP-1 delta). However, subanalysis performed to detect differentially expressed proteins at baseline and after intervention, with significance at an adjusted P value ≤ 0.05 and absolute log fold-change (logFC) ≥ 1.0, showed 3 downregulated proteins in the LIPE group (BLC(logFC) = 1.27, eotaxin(logFC) = 1.18, and MCP-4(logFC) = 1.14), and 4 proteins in the HIPE group (BLC(logFC) = 1.45, FGF-6(logFC) = 1.20, MCP-4(logFC) = 1.50, and PARC(logFC) = 1.33), supporting that the changes we observed in the exercise groups were not time-related changes but occurred in response to exercise. CONCLUSIONS Implementing a 6-month physical exercise program in overweight/obese adolescents, based on LIPE and PLUS groups, significantly change several circulating inflammatory levels. Interventions involving supervised physical exercise may reduce the associated effects of systemic low-grade inflammation, thus preventing the development of obesity-related metabolic diseases in adolescents with overweight/obesity.
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Affiliation(s)
- Robinson Ramírez-Vélez
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Navarra Institute for Health Research (IdiSNA), Universidad Pública de Navarra (UPNA), 31008 Pamplona, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Antonio García-Hermoso
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Navarra Institute for Health Research (IdiSNA), Universidad Pública de Navarra (UPNA), 31008 Pamplona, Spain
- Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Facultad de Ciencias Médicas, Universidad de Santiago de Chile, USACH, Santiago 9170022, Chile
| | - María Correa-Rodríguez
- Department of Nursing, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain
- Biosanitary Research Institute (ibs.GRANADA), Granada, Spain
| | - Joaquín Fernández-Irigoyen
- Proteored-Institute of Health Carlos III (ISCIII), Clinical Neuroproteomics Unit, Navarrabiomed, Navarra Health Department, Public University of Navarra, Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain
| | - Sara Palomino-Echeverría
- Translational Bioinformatics Unit (TransBio), Navarrabiomed, Navarra Health Department, Public University of Navarra, Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain
| | - Enrique Santamaría
- Proteored-Institute of Health Carlos III (ISCIII), Clinical Neuroproteomics Unit, Navarrabiomed, Navarra Health Department, Public University of Navarra, Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain
| | - Jorge Enrique Correa-Bautista
- Grupo Rendimiento Físico Militar “RENFIMIL”, Escuela Militar de Cadetes “General José María Córdova”, Bogotá, 111711, Colombia
| | - Katherine González-Ruíz
- Grupo de Investigación Salud y Movimiento. Programa de Fisioterapia. Facultad de Salud, Universidad Santiago de Cali, 760035, Colombia
- Programa de Doctorado en Ciencias Biomédicas y Biológicas, Escuela de Medicina y Ciencias de la Salud - Facultad de Ciencias Naturales y Matemáticas, Universidad del Rosario, Bogotá, 111221, Colombia
| | - Mikel Izquierdo
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Navarra Institute for Health Research (IdiSNA), Universidad Pública de Navarra (UPNA), 31008 Pamplona, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence: Mikel Izquierdo, PhD, Department of Health Sciences, Public University of Navarra, Avenida de Barañain s/n, 31008, Pamplona, Spain.
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Di Maglie A, Marsigliante S, My G, Colazzo S, Muscella A. Effects of a physical activity intervention on schoolchildren fitness. Physiol Rep 2022; 10:e15115. [PMID: 35075816 PMCID: PMC8787616 DOI: 10.14814/phy2.15115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 10/25/2021] [Accepted: 10/26/2021] [Indexed: 06/14/2023] Open
Abstract
The global prevalence of childhood obesity is high. Obesity main causes are linked to sedentary lifestyles. Increasing physical activity (PA) and reducing sedentary activities are recommended to prevent and treat obesity. This study aimed to evaluate the effectiveness of a 6-month school PA intervention on obesity prevention and healthy behaviors in school-aged children. Participating students (10-11 years of age) were randomly divided into an intervention group and a control group. Children in the intervention group (n = 80) participated in a multicomponent PA that included improvement in extracurricular physical activities (with an additional 40 min per day for 5/6 days per week). Children (n = 80) in the control group participated in usual practice. Participants had mean body mass index of 19.7 ± 2.9 kg/m2 , and 33.7% of them were overweight or with obesity at T0. The change in body mass index in intervention group (-2.4 ± 0.6 kg/m2 ) was significantly different from that in control group (3.01 ± 1.8 kg/m2 ). The effects on waist circumference, waist-to-height ratio, and physic fitness were also significant in intervention group compared with control group (all p < 0.05). Furthermore, there is a significant decrease in overweight or children with obesity in the experimental group (to 17.5%, p < 0.05). These findings suggest that a school-based intervention program represents an effective strategy for decreasing the number of overweight and children with obesity.
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Affiliation(s)
- Antonio Di Maglie
- Department of History, Society and Human StudiesUniversity of SalentoLecceItaly
| | - Santo Marsigliante
- Department of Biological and Environmental Science and Technologies (DiSTeBA)University of SalentoLecceItaly
| | - Giulia My
- Department of Biological and Environmental Science and Technologies (DiSTeBA)University of SalentoLecceItaly
| | - Salvatore Colazzo
- Department of History, Society and Human StudiesUniversity of SalentoLecceItaly
| | - Antonella Muscella
- Department of Biological and Environmental Science and Technologies (DiSTeBA)University of SalentoLecceItaly
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16
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Christiansen F, Ahlqvist VH, Nyroos M, Löfgren H, Berglind D. Physical Activity through a Classroom-Based Intervention: A Pragmatic Non-Randomized Trial among Swedish Adolescents in an Upper Secondary School. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111041. [PMID: 34769561 PMCID: PMC8583372 DOI: 10.3390/ijerph182111041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/12/2021] [Accepted: 10/16/2021] [Indexed: 11/16/2022]
Abstract
Schools are an important arena to curb the decline in physical activity (PA) in youth. School-based interventions with accelerometer-measured PA are warranted. This study aimed to increase accelerometer-measured PA in adolescents following a 12-month school-based intervention. Two school-classes of 16–18-year-old Swedish students were allocated to intervention group and control group. Accelerometer-measured PA was gathered at baseline, 6- and 12-month follow-up. Mixed-effects linear regression was used to investigate between-group and within-group differences in mean minutes per day (min/day) of moderate to vigorous PA (MVPA), light PA (LPA) and sedentary time (ST). Fifty-seven students participated (intervention group = 31, control group = 26). At 12-month follow-up, the intervention group performed 5.9 (95% CI: −4.3, 16.2) min/day more in MVPA, 1.8 (95% CI: −17.9, 14.2) min/day less in LPA, and 4.1 (95% CI: −27.3, 19.2) min/day less in ST compared to the control group. Within the intervention group, there was no significant change in PA. Within the control group, LPA decreased (95% CI: −19.6, −0.2; p = 0.044) and ST increased (95% CI: 1.8, 30.8; p = 0.028). Although no between-group differences in PA were statistically significant, the within-group changes may suggest a preventive impact on the decline in PA during adolescence.
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Affiliation(s)
- Filip Christiansen
- Department of Global Public Health, Karolinska Institutet, 171 77 Stockholm, Sweden; (V.H.A.); (D.B.)
- Correspondence: ; Tel.: +46-070-424-91-49
| | - Viktor H. Ahlqvist
- Department of Global Public Health, Karolinska Institutet, 171 77 Stockholm, Sweden; (V.H.A.); (D.B.)
| | - Mikaela Nyroos
- Department of Education, Umeå University, 901 87 Umeå, Sweden;
| | - Hans Löfgren
- Department of the Police Education Unit, Umeå University, 901 87 Umeå, Sweden;
| | - Daniel Berglind
- Department of Global Public Health, Karolinska Institutet, 171 77 Stockholm, Sweden; (V.H.A.); (D.B.)
- Centre for Epidemiology and Community Medicine, Region Stockholm, 104 31 Stockholm, Sweden
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17
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Reif A, Triska C, Nader M, Scharhag J, Tschan H, Wessner B. Influence of an increased number of physical education lessons on the motor performance of adolescents-A non-interventional cohort study. PLoS One 2021; 16:e0258305. [PMID: 34648537 PMCID: PMC8516264 DOI: 10.1371/journal.pone.0258305] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 09/23/2021] [Indexed: 12/04/2022] Open
Abstract
Increasing the amount of regular physical education lessons in school is currently discussed in many countries in order to increase physical activity in youth. The purpose of this study was to compare the motor performance of pupils from an observation group participating in a school trial of two additional physical education lessons (5 lessons of each 50 min/week) without a specific intervention program to a control group with a regular amount of three physical education lessons (3 lessons of each 50 min/week) as indicated by the standard Austrian school curriculum. In this cohort study motor performance of 140 adolescents (12.7±0.5 years) was assessed by means of the German Motor Performance Test 6–18 over a period of 1.5 years with measurement time points before (T1), after eight months (T2) and at the end of the observation period (T3). Two- and three-way mixed analysis of variance were used to detect time, group and interaction effects. Although the observation group demonstrated a higher total motor performance score at all time points (P = 0.005), the improvement over time in total motor performance (P < 0.001) was more pronounced in the control group. Girls and boys developed differently over time (time*gender interaction: P = 0.001), whereby group allocation did not affect this interaction (time*gender*group: P = 0.167). Anyway, girls of control group tend to benefit most of additional physical education lessons. Sports club members scored significantly higher in motor performance across the observation period (P = 0.018) irrespective of group allocation. These findings indicate that there could be a ceiling effect in what the pupils could achieve in terms of motor performance as the pupils of the observation group might have reached this point earlier than their counterparts in the control group. Nevertheless, sports club membership seems to reveal some benefits. Whether improving quality and specificity of the single physical lessons might be superior to merely adding additional ones needs to be confirmed in future studies.
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Affiliation(s)
- Astrid Reif
- Department Sports Medicine, Exercise Physiology and Prevention, Institute of Sport Science, Centre for Sport Science and University Sports, University of Vienna, Vienna, Austria
- * E-mail:
| | - Christoph Triska
- Department Sports Medicine, Exercise Physiology and Prevention, Institute of Sport Science, Centre for Sport Science and University Sports, University of Vienna, Vienna, Austria
| | - Michael Nader
- Department Sports Medicine, Exercise Physiology and Prevention, Institute of Sport Science, Centre for Sport Science and University Sports, University of Vienna, Vienna, Austria
| | - Jürgen Scharhag
- Department Sports Medicine, Exercise Physiology and Prevention, Institute of Sport Science, Centre for Sport Science and University Sports, University of Vienna, Vienna, Austria
| | - Harald Tschan
- Department Sports Medicine, Exercise Physiology and Prevention, Institute of Sport Science, Centre for Sport Science and University Sports, University of Vienna, Vienna, Austria
| | - Barbara Wessner
- Department Sports Medicine, Exercise Physiology and Prevention, Institute of Sport Science, Centre for Sport Science and University Sports, University of Vienna, Vienna, Austria
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Neil-Sztramko SE, Caldwell H, Dobbins M. School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18. Cochrane Database Syst Rev 2021; 9:CD007651. [PMID: 34555181 PMCID: PMC8459921 DOI: 10.1002/14651858.cd007651.pub3] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Physical activity among children and adolescents is associated with lower adiposity, improved cardio-metabolic health, and improved fitness. Worldwide, fewer than 30% of children and adolescents meet global physical activity recommendations of at least 60 minutes of moderate to vigorous physical activity per day. Schools may be ideal sites for interventions given that children and adolescents in most parts of the world spend a substantial amount of time in transit to and from school or attending school. OBJECTIVES The purpose of this review update is to summarise the evidence on effectiveness of school-based interventions in increasing moderate to vigorous physical activity and improving fitness among children and adolescents 6 to 18 years of age. Specific objectives are: • to evaluate the effects of school-based interventions on increasing physical activity and improving fitness among children and adolescents; • to evaluate the effects of school-based interventions on improving body composition; and • to determine whether certain combinations or components (or both) of school-based interventions are more effective than others in promoting physical activity and fitness in this target population. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, BIOSIS, SPORTDiscus, and Sociological Abstracts to 1 June 2020, without language restrictions. We screened reference lists of included articles and relevant systematic reviews. We contacted primary authors of studies to ask for additional information. SELECTION CRITERIA Eligible interventions were relevant to public health practice (i.e. were not delivered by a clinician), were implemented in the school setting, and aimed to increase physical activity among all school-attending children and adolescents (aged 6 to 18) for at least 12 weeks. The review was limited to randomised controlled trials. For this update, we have added two new criteria: the primary aim of the study was to increase physical activity or fitness, and the study used an objective measure of physical activity or fitness. Primary outcomes included proportion of participants meeting physical activity guidelines and duration of moderate to vigorous physical activity and sedentary time (new to this update). Secondary outcomes included measured body mass index (BMI), physical fitness, health-related quality of life (new to this update), and adverse events (new to this update). Television viewing time, blood cholesterol, and blood pressure have been removed from this update. DATA COLLECTION AND ANALYSIS: Two independent review authors used standardised forms to assess each study for relevance, to extract data, and to assess risk of bias. When discrepancies existed, discussion occurred until consensus was reached. Certainty of evidence was assessed according to GRADE. A random-effects meta-analysis based on the inverse variance method was conducted with participants stratified by age (children versus adolescents) when sufficient data were reported. Subgroup analyses explored effects by intervention type. MAIN RESULTS Based on the three new inclusion criteria, we excluded 16 of the 44 studies included in the previous version of this review. We screened an additional 9968 titles (search October 2011 to June 2020), of which 978 unique studies were potentially relevant and 61 met all criteria for this update. We included a total of 89 studies representing complete data for 66,752 study participants. Most studies included children only (n = 56), followed by adolescents only (n = 22), and both (n = 10); one study did not report student age. Multi-component interventions were most common (n = 40), followed by schooltime physical activity (n = 19), enhanced physical education (n = 15), and before and after school programmes (n = 14); one study explored both enhanced physical education and an after school programme. Lack of blinding of participants, personnel, and outcome assessors and loss to follow-up were the most common sources of bias. Results show that school-based physical activity interventions probably result in little to no increase in time engaged in moderate to vigorous physical activity (mean difference (MD) 0.73 minutes/d, 95% confidence interval (CI) 0.16 to 1.30; 33 studies; moderate-certainty evidence) and may lead to little to no decrease in sedentary time (MD -3.78 minutes/d, 95% CI -7.80 to 0.24; 16 studies; low-certainty evidence). School-based physical activity interventions may improve physical fitness reported as maximal oxygen uptake (VO₂max) (MD 1.19 mL/kg/min, 95% CI 0.57 to 1.82; 13 studies; low-certainty evidence). School-based physical activity interventions may result in a very small decrease in BMI z-scores (MD -0.06, 95% CI -0.09 to -0.02; 21 studies; low-certainty evidence) and may not impact BMI expressed as kg/m² (MD -0.07, 95% CI -0.15 to 0.01; 50 studies; low-certainty evidence). We are very uncertain whether school-based physical activity interventions impact health-related quality of life or adverse events. AUTHORS' CONCLUSIONS Given the variability of results and the overall small effects, school staff and public health professionals must give the matter considerable thought before implementing school-based physical activity interventions. Given the heterogeneity of effects, the risk of bias, and findings that the magnitude of effect is generally small, results should be interpreted cautiously.
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Affiliation(s)
| | - Hilary Caldwell
- Department of Kinesiology, Child Health & Exercise Medicine Program, McMaster University, Hamilton, Canada
| | - Maureen Dobbins
- School of Nursing, McMaster University, Hamilton, Canada
- National Collaborating Centre for Methods and Tools, Hamilton, Canada
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19
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Bunik M, Shek L, Valenzuela M, Munson AL, Federspiel D, Helmkamp L, Haemer M, Dickinson LM. Bikes for Life: Measuring the effects of a bicycle distribution program on 6 to 12-year-old children's BMI and health behaviors. Obes Res Clin Pract 2021; 15:491-498. [PMID: 34521597 DOI: 10.1016/j.orcp.2021.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/26/2021] [Accepted: 09/03/2021] [Indexed: 11/19/2022]
Abstract
Treating pediatric obesity is challenging. The objective was to evaluate effect of receiving a bicycle on (a) physical activity, (b) sedentary activity, (c) Body Mass Index (BMI), and (d) eating habits. A stepped-wedge randomized controlled trial of 6- to 12-year-old patients with overweight/obesity was conducted April 2012-2018. Participants were randomized to wait 0, 2, 4, or 6 months for a bicycle. Outcomes on activity, BMI and eating were collected at 3, 6, 9- and 12-months after children received a bicycle. A total of 525 participants with 387 (74%) completed 3-month follow-up questionnaire, and 346 (66%) completed 12-month follow-up visit. Participants were mostly Latino/a (71%) and low income (58%), and 31% had never ridden a bicycle. Median baseline BMI was 98th percentile. At 3 months, 62% reported bicycle use last week, on average 3.6 days. Time spent on sedentary activities decreased by 48 min/day (p = 0.04), and time spent playing sports increased by 1.7 h/week (p < 0.01). No reduction in BMI was seen. Consumption of sugary drinks decreased (by 0.59 servings/week, p < 0.01), and consumption of vegetables increased (0.71 servings/week, p = 0.04). At 12 months, sedentary time, sugary drink and vegetable consumption remained significantly more favorable than at enrollment (p < 0.01, p < 0.01, p = 0.04 respectively), but not significantly different (p = 0.47 for sedentary, p = 0.73 for sugary drink) and significantly less favorable (p < 0.01 for vegetables) than at the time of intervention. Participants reported riding bicycle, improved activity and dietary habits, though reversion towards baseline behavior was seen by one year and no change in BMI from enrollment.
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Affiliation(s)
- Maya Bunik
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, 13001 E 17th Pl, Aurora, CO 80045, United States; Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, 13001 E 17th Pl, Aurora, CO 80045, United States.
| | - Laura Shek
- Child Health Advocacy Institute, Children's Hospital Colorado, 13123 E 16th Ave, Aurora, CO 80045, United States.
| | - Maria Valenzuela
- Child Health Advocacy Institute, Children's Hospital Colorado, 13123 E 16th Ave, Aurora, CO 80045, United States.
| | - Anna-Lisa Munson
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, 13001 E 17th Pl, Aurora, CO 80045, United States; Pediatrics, Denver Health, 777 Bannock St, Denver, CO 80204, United States.
| | - Deborah Federspiel
- Child Health Advocacy Institute, Children's Hospital Colorado, 13123 E 16th Ave, Aurora, CO 80045, United States.
| | - Laura Helmkamp
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, 13001 E 17th Pl, Aurora, CO 80045, United States.
| | - Matthew Haemer
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, 13001 E 17th Pl, Aurora, CO 80045, United States; Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, 13001 E 17th Pl, Aurora, CO 80045, United States.
| | - L Miriam Dickinson
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, 13001 E 17th Pl, Aurora, CO 80045, United States; Department of Family Medicine, University of Colorado Anschutz Medical Campus, 13001 E 17th Pl, Aurora, CO 80045, United States.
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20
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Battaglia G, Giustino V, Tabacchi G, Lanza M, Schena F, Biino V, Giuriato M, Gallotta MC, Guidetti L, Baldari C, Gennaro A, Palma A, Bellafiore M. Interrelationship Between Age, Gender, and Weight Status on Motor Coordination in Italian Children and Early Adolescents Aged 6-13 Years Old. Front Pediatr 2021; 9:738294. [PMID: 34568243 PMCID: PMC8461257 DOI: 10.3389/fped.2021.738294] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 08/17/2021] [Indexed: 11/15/2022] Open
Abstract
Although numerous evidences reported a negative correlation between motor coordination (MC) and overweight/obesity in children and adolescents, the interrelationship between age, gender, and weight status is still debatable. Hence, the aim of this cross-sectional study was to examine the association between MC and weight status according to age and gender across childhood and early adolescence in a large sample of Italian elementary and middle school students. A number of 1961 Italian school students (1,026 boys, 935 girls) was stratified in three consecutive age groups (6-7, 8-10, and 11-13 years) and four weight status categories (underweight, normal weight, overweight, and obese) according to Cole's body mass index (BMI) cut-off points for children. MC performance was assessed measuring motor quotient (MQ) with the Körperkoordinationstest für Kinder (KTK). Results showed significantly lower MQ levels in children in overweight (OW) and with obesity (OB) in both sexes for all age groups than peers in normal weight (NW), except in 6-7-year-old boys. Girls in OW and with OB had similar MQ levels across all age groups, while younger boys in OW and with OB showed higher MQ levels than older ones (p < 0.05). The 6-7-year-old boys showed better MQ levels than girls peers in NW, OW, and with OB, while 8-10-year-old boys in underweight (UW), NW, and OW; and 11-13-year-old boys only in NW (p < 0.05). No interaction effect was found between age, gender, and weight status on MQ levels. These outcomes showed the negative impact of higher weight status on MC performance according to age and gender, pointing out the importance of planning targeted motor programs that consider these variables to improve MC performance.
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Affiliation(s)
- Giuseppe Battaglia
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Valerio Giustino
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Garden Tabacchi
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Massimo Lanza
- Department of Neuroscience, Biomedicine and Movement, University of Verona, Veneto, Italy
| | - Federico Schena
- Department of Neuroscience, Biomedicine and Movement, University of Verona, Veneto, Italy
| | - Valentina Biino
- Department of Neuroscience, Biomedicine and Movement, University of Verona, Veneto, Italy
| | - Matteo Giuriato
- Department of Neuroscience, Biomedicine and Movement, University of Verona, Veneto, Italy
| | - Maria Chiara Gallotta
- Department of Physiology and Pharmacology “Vittorio Erspamer”, Sapienza University of Rome, Rome, Italy
| | - Laura Guidetti
- Department Unicusano, University Niccolò Cusano, Rome, Italy
| | - Carlo Baldari
- Department of Theoretical and Applied Sciences, eCampus University, Rome, Italy
| | - Antonino Gennaro
- Department of Biomedical, Dental Sciences and Morphofunctional Imaging, AOU “G. Martino”, University of Messina, Messina, Italy
| | - Antonio Palma
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Marianna Bellafiore
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
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Reijman MD, Kusters DM, Wiegman A. Advances in familial hypercholesterolaemia in children. THE LANCET. CHILD & ADOLESCENT HEALTH 2021; 5:652-661. [PMID: 34119028 DOI: 10.1016/s2352-4642(21)00095-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/12/2021] [Accepted: 03/22/2021] [Indexed: 12/11/2022]
Abstract
Familial hypercholesterolaemia is a common, dominantly inherited disease that results in high concentrations of low-density lipoprotein cholesterol and in premature cardiovascular disease. To prevent cardiovascular disease and premature mortality, patients with the condition need to be identified and to start treatment early in life. In this Review, we discuss the treatment of heterozygous and homozygous familial hypercholesterolaemia in children, including lifestyle modifications, current pharmacological treatment options, and promising novel lipid-lowering treatments. In particular, these new therapies are expected to improve outcomes for patients with severe heterozygous familial hypercholesterolaemia or statin intolerance. For patients with homozygous familial hypercholesterolaemia, lipoprotein apheresis is currently the most valuable therapy available, but new approaches might reduce the need for this effective yet invasive, time-consuming, and expensive treatment.
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Affiliation(s)
- M Doortje Reijman
- Department of Pediatrics, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - D Meeike Kusters
- Department of Pediatrics, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Albert Wiegman
- Department of Pediatrics, Amsterdam University Medical Center, Amsterdam, Netherlands.
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22
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Nally S, Carlin A, Blackburn NE, Baird JS, Salmon J, Murphy MH, Gallagher AM. The Effectiveness of School-Based Interventions on Obesity-Related Behaviours in Primary School Children: A Systematic Review and Meta-Analysis of Randomised Controlled Trials. CHILDREN (BASEL, SWITZERLAND) 2021; 8:489. [PMID: 34201145 PMCID: PMC8228296 DOI: 10.3390/children8060489] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 05/25/2021] [Accepted: 06/05/2021] [Indexed: 12/11/2022]
Abstract
School-based interventions are promising for targeting a change in obesity-related behaviours in children. However, the efficacy of school-based interventions to prevent obesity remains unclear. This review examined the effectiveness of school-based interventions at changing obesity-related behaviours (increased physical activity, decreased sedentary behaviour and improved nutrition behaviour) and/or a change in BMI/BMI z-score. Following PRISMA guidelines, seven databases were systematically searched from 1 January 2009 to 31 December 2020. Two review authors independently screened studies for eligibility, completed data extraction and assessed the risk of bias of each of the included studies. Forty-eight studies met the inclusion criteria and were included in a narrative synthesis. Thirty-seven studies were eligible for inclusion in a meta-analysis. The findings demonstrate that interventions in children when compared to controls resulted in a small positive treatment effect in MVPA in the control group (2.14; 95% CI = 0.77, 3.50). There was no significant effect on sedentary behaviour, energy intake, and fruit and vegetable intake, and BMI kg/m2. A small significant reduction was found between groups in BMI z-score (-0.04; 95% CI = -0.07, -0.01) in favour of the intervention. The findings have important implications for future intervention research in terms of the effectiveness of intervention components and characteristics.
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Affiliation(s)
- Sarah Nally
- Centre for Exercise Medicine, Physical Activity and Health, Sports and Exercise Sciences Research Institute, Jordanstown Campus, University of Ulster, Newtownabbey BT37 0QB, UK; (A.C.); (M.H.M.)
| | - Angela Carlin
- Centre for Exercise Medicine, Physical Activity and Health, Sports and Exercise Sciences Research Institute, Jordanstown Campus, University of Ulster, Newtownabbey BT37 0QB, UK; (A.C.); (M.H.M.)
| | - Nicole E. Blackburn
- Centre for Health and Rehabilitation Technologies, Institute of Nursing and Health Research, School of Health Sciences, University of Ulster, Newtownabbey BT37 0QB, UK;
| | - Judith S. Baird
- Nutrition Innovation Centre for Food and Health (NICHE), Biomedical Sciences Research Institute, Coleraine Campus, University of Ulster, Coleraine BT52 1SA, UK; (J.S.B.); (A.M.G.)
| | - Jo Salmon
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong 3217, Australia;
| | - Marie H. Murphy
- Centre for Exercise Medicine, Physical Activity and Health, Sports and Exercise Sciences Research Institute, Jordanstown Campus, University of Ulster, Newtownabbey BT37 0QB, UK; (A.C.); (M.H.M.)
| | - Alison M. Gallagher
- Nutrition Innovation Centre for Food and Health (NICHE), Biomedical Sciences Research Institute, Coleraine Campus, University of Ulster, Coleraine BT52 1SA, UK; (J.S.B.); (A.M.G.)
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23
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Escaron AL, Vega-Herrera C, Martinez C, Steers N, Lara M, Hochman M. Impact of a school-level intervention on leisure-time physical activity levels on school grounds in under-resourced school districts. Prev Med Rep 2021; 22:101377. [PMID: 33996390 PMCID: PMC8105665 DOI: 10.1016/j.pmedr.2021.101377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 03/28/2021] [Indexed: 11/25/2022] Open
Abstract
Even the best school physical education programs fall short of providing enough physical activity (PA) to meet students' PA guidelines thus increasing PA at other times throughout the school day could help students meet recommended PA levels. Unstructured leisure-time periods during the school day represent an opportunity to promote PA, particularly among students in underserved school districts. Between 2014 and 2018, we partnered with 14 elementary and 5 secondary schools in low-income Latino communities to increase students' leisure time moderate to vigorous physical activity (MVPA). Schools received consultation and technical assistance on their wellness policy, and some created wellness committees. Schools selected 1-2 PA/nutrition promotion activities for the academic year. Following the System for Observing Play and Leisure Activity in Youth protocol, we conducted a pre- vs. post- analysis of observations of school time student PA (levels of MVPA, energy expenditure, proportion of areas in which games and sports were prominent) in 4936 pre-intervention play areas and 4404 post-intervention areas before school, during lunch recess, and after school. We utilized linear and logistic regression analyses to test pre/post changes in these dependent variables using school area characteristics, period of observation, and temperature as covariates. Following our intervention, MVPA levels before school, during lunch recess, and after school increased significantly from 19.8% at baseline to 25.6% among elementary girls and from 25.4% to 33.2% among elementary boys. Decomposition of these effects suggested that the benefits were partially mediated by increased adult playground supervision. We did not observe any significant changes in PA levels among secondary school girls or boys. Our school-level intervention aimed at promoting PA was associated with modest but meaningful increases in leisure-time PA among elementary, but not secondary, school students. The effects were attributable in part to increased adult supervision on the playground.
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Affiliation(s)
- Anne L. Escaron
- The AltaMed Institute for Health Equity, AltaMed Health Services Corporation, 2040 Camfield Ave, Los Angeles, CA 90040, United States
| | - Celia Vega-Herrera
- The AltaMed Institute for Health Equity, AltaMed Health Services Corporation, 2040 Camfield Ave, Los Angeles, CA 90040, United States
| | - Corina Martinez
- The AltaMed Institute for Health Equity, AltaMed Health Services Corporation, 2040 Camfield Ave, Los Angeles, CA 90040, United States
| | - Neil Steers
- David Geffen School of Medicine, UCLA Division of General Internal Medicine and Health Services Research, University of California, Los Angeles, 1100 Glendon Avenue, Suite 850, Los Angeles, CA 90024, United States
| | - Marielena Lara
- The RAND Corporation, 1776 Main Street, Santa Monica, CA 90401, United States
| | - Michael Hochman
- Gehr Family Center for Health Systems Science, Keck School of Medicine, University of Southern California, 2020 Zonal Avenue IRD 320, Los Angeles, CA 90033, United States
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Corder KL, Brown HE, Croxson CHD, Jong ST, Sharp SJ, Vignoles A, Wilkinson PO, Wilson ECF, van Sluijs EMF. A school-based, peer-led programme to increase physical activity among 13- to 14-year-old adolescents: the GoActive cluster RCT. PUBLIC HEALTH RESEARCH 2021. [DOI: 10.3310/phr09060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
Adolescent physical activity levels are low and are associated with rising disease risk and social disadvantage. The Get Others Active (GoActive) intervention was co-designed with adolescents and teachers to increase physical activity in adolescents.
Objective
To assess the effectiveness and cost-effectiveness of the school-based GoActive programme in increasing adolescents’ moderate-to-vigorous physical activity.
Design
A cluster randomised controlled trial with an embedded mixed-methods process evaluation.
Setting
Non-fee-paying schools in Cambridgeshire and Essex, UK (n = 16). Schools were computer randomised and stratified by socioeconomic position and county.
Participants
A total of 2862 Year 9 students (aged 13–14 years; 84% of eligible students).
Intervention
The iteratively developed feasibility-tested refined 12-week intervention trained older adolescents (mentors) and in-class peer leaders to encourage classes to undertake two new weekly activities. Mentors met with classes weekly. Students and classes gained points and rewards for activity in and out of school.
Main outcome measures
The primary outcome was average daily minutes of accelerometer-assessed moderate-to-vigorous physical activity at 10 months post intervention. Secondary outcomes included accelerometer-assessed activity during school, after school and at weekends; self-reported physical activity and psychosocial outcomes; cost-effectiveness; well-being and a mixed-methods process evaluation. Measurement staff were blinded to allocation.
Results
Of 2862 recruited participants, 2167 (76%) attended 10-month follow-up measurements and we analysed the primary outcome for 1874 (65.5%) participants. At 10 months, there was a mean decrease in moderate-to-vigorous physical activity of 8.3 (standard deviation 19.3) minutes in control participants and 10.4 (standard deviation 22.7) minutes in intervention participants (baseline-adjusted difference –1.91 minutes, 95% confidence interval –5.53 to 1.70 minutes; p = 0.316). The programme cost £13 per student compared with control. Therefore, it was not cost-effective. Non-significant indications of differential impacts suggested detrimental effects among boys (boys –3.44, 95% confidence interval –7.42 to 0.54; girls –0.20, 95% confidence interval –3.56 to 3.16), but favoured adolescents from lower socioeconomic backgrounds (medium/low 4.25, 95% confidence interval –0.66 to 9.16; high –2.72, 95% confidence interval –6.33 to 0.89). Mediation analysis did not support the use of any included intervention components to increase physical activity. Some may have potential for improving well-being. Students, teachers and mentors mostly reported enjoying the GoActive intervention (56%, 87% and 50%, respectively), but struggled to conceptualise their roles. Facilitators of implementation included school support, embedding a routine, and mentor and tutor support. Challenges to implementation included having limited school space for activities, time, and uncertainty of teacher and mentor roles.
Limitations
Retention on the primary outcome at 10-month follow-up was low (65.5%), but we achieved our intended sample size, with retention comparable to similar trials.
Conclusions
A rigorously developed school-based intervention (i.e. GoActive) was not effective in countering the age-related decline in adolescent physical activity. Overall, this mixed-methods evaluation provides transferable insights for future intervention development, implementation and evaluation.
Future work
Interdisciplinary research is required to understand educational setting-specific implementation challenges. School leaders and authorities should be realistic about expectations of the effect of school-based physical activity promotion strategies implemented at scale.
Trial registration
Current Controlled Trials ISRCTN31583496.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 9, No. 6. See the NIHR Journals Library website for further project information. This work was additionally supported by the Medical Research Council (London, UK) (Unit Programme number MC_UU_12015/7) and undertaken under the auspices of the Centre for Diet and Activity Research (Cambridge, UK), a UK Clinical Research Collaboration Public Health Research Centre of Excellence. Funding from the British Heart Foundation (London, UK), Cancer Research UK (London, UK), Economic and Social Research Council (Swindon, UK), Medical Research Council, the National Institute for Health Research (Southampton, UK) and the Wellcome Trust (London, UK), under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged (087636/Z/08/Z; ES/G007462/1; MR/K023187/1). GoActive facilitator costs were borne by Essex and Cambridgeshire County Councils.
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Affiliation(s)
- Kirsten L Corder
- Centre for Diet and Activity Research and MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Helen E Brown
- Centre for Diet and Activity Research and MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Caroline HD Croxson
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Stephanie T Jong
- Centre for Diet and Activity Research and MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Stephen J Sharp
- Centre for Diet and Activity Research and MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Anna Vignoles
- Faculty of Education, University of Cambridge, Cambridge, UK
| | - Paul O Wilkinson
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Edward CF Wilson
- Cambridge Centre for Health Services Research, University of Cambridge, Cambridge, UK
- Health Economics Group, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Esther MF van Sluijs
- Centre for Diet and Activity Research and MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
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25
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Wassenaar TM, Wheatley CM, Beale N, Nichols T, Salvan P, Meaney A, Atherton K, Diaz-Ordaz K, Dawes H, Johansen-Berg H. The effect of a one-year vigorous physical activity intervention on fitness, cognitive performance and mental health in young adolescents: the Fit to Study cluster randomised controlled trial. Int J Behav Nutr Phys Act 2021; 18:47. [PMID: 33789683 PMCID: PMC8011147 DOI: 10.1186/s12966-021-01113-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 03/16/2021] [Indexed: 12/13/2022] Open
Abstract
Background Physical activity (PA) may positively stimulate the brain, cognition and mental health during adolescence, a period of dynamic neurobiological development. High-intensity interval training (HIIT) or vigorous PA interventions are time-efficient, scalable and can be easily implemented in existing school curricula, yet their effects on cognitive, academic and mental health outcomes are unclear. The primary aim of the Fit to Study trial was to investigate whether a pragmatic and scalable HIIT-style VPA intervention delivered during school physical education (PE) could improve attainment in maths. The primary outcome has previously been reported and was null. Here, we report the effect of the intervention on prespecified secondary outcomes, including cardiorespiratory fitness, cognitive performance, and mental health in young adolescents. Methods The Fit to Study cluster randomised controlled trial included Year 8 pupils (n = 18,261, aged 12–13) from 104 secondary state schools in South/Mid-England. Schools were randomised into an intervention condition (n = 52), in which PE teachers delivered an additional 10 min of VPA per PE lesson for one academic year (2017–2018), or into a “PE as usual” control condition. Secondary outcomes included assessments of cardiorespiratory fitness (20-m shuttle run), cognitive performance (executive functions, relational memory and processing speed) and mental health (Strength and Difficulties Questionnaire and self-esteem measures). The primary intention-to-treat (ITT) analysis used linear models and structural equation models with cluster-robust standard errors to test for intervention effects. A complier-average causal effect (CACE) was estimated using a two-stage least squares procedure. Results The HIIT-style VPA intervention did not significantly improve cardiorespiratory fitness, cognitive performance (executive functions, relational memory or processed speed), or mental health (all p > 0.05). Subgroup analyses showed no significant moderation of intervention effects by sex, socioeconomic status or baseline fitness levels. Changes in cardiorespiratory fitness were not significantly related to changes in cognitive or mental health outcomes. The trial was marked by high drop-out and low intervention compliance. Findings from the CACE analysis were in line with those from the ITT analysis. Conclusion The one-academic year HIIT-style VPA intervention delivered during regular school PE did not significantly improve fitness, cognitive performance or mental health, but these findings should be interpreted with caution given low implementation fidelity and high drop-out. Well-controlled, large-scale, school-based trials that examine the effectiveness of HIIT-style interventions to enhance cognitive and mental health outcomes are warranted. Trial registration ISRCTN registry, 15,730,512. Trial protocol and analysis plan for primary outcome prospectively registered on 30th March 2017. ClinicalTrials.gov, NCT03286725. Secondary measures (focus of current manuscript) retrospectively registered on 18 September 2017. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-021-01113-y.
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Affiliation(s)
- T M Wassenaar
- Wellcome Centre For Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK
| | - C M Wheatley
- Wellcome Centre For Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK
| | - N Beale
- Department of Sport Health Sciences and Social Work, Centre for Movement Occupational and Rehabilitation Sciences, Oxford Brookes Centre for Nutrition and Health, Oxford Brookes University, Oxford, OX3 0BP, UK
| | - T Nichols
- Wellcome Centre For Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK.,Oxford Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, UK
| | - P Salvan
- Wellcome Centre For Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK
| | - A Meaney
- Department of Sport Health Sciences and Social Work, Centre for Movement Occupational and Rehabilitation Sciences, Oxford Brookes Centre for Nutrition and Health, Oxford Brookes University, Oxford, OX3 0BP, UK
| | - K Atherton
- Wellcome Centre For Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK
| | - K Diaz-Ordaz
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - H Dawes
- Department of Sport Health Sciences and Social Work, Centre for Movement Occupational and Rehabilitation Sciences, Oxford Brookes Centre for Nutrition and Health, Oxford Brookes University, Oxford, OX3 0BP, UK
| | - H Johansen-Berg
- Wellcome Centre For Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK.
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26
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Pombo A, Luz C, de Sá C, Rodrigues LP, Cordovil R. Effects of the COVID-19 Lockdown on Portuguese Children's Motor Competence. CHILDREN-BASEL 2021; 8:children8030199. [PMID: 33800046 PMCID: PMC7999374 DOI: 10.3390/children8030199] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/02/2021] [Accepted: 03/04/2021] [Indexed: 12/21/2022]
Abstract
During long periods without school, children are more susceptible to unhealthy behaviors, such as an increase in sedentary behaviors, which has a negative impact on children’s motor competence (MC). The COVID-19 lockdown offered us a unique opportunity to test, in a quasi-experimental setting, the impact of lockdown movement restrictions on children’s MC. We assessed the motor competence of 114 children aged 6–9 years using the motor competence assessment. All children were tested before and after the COVID-19 lockdown. Chi-square and 2 × 2 ANOVA (sex by moment) were used to further analyze the data. Regardless of sex, motor performances in all tests (except for jumping sideways in boys) were lower when compared with performances before lockdown. There was a marked decreasing trend in children’s levels of MC, shifting from an upper to a lower quartile in different tests. The results after the lockdown were always significantly inferior to the results before lockdown in all motor tests (except jumping sideways), in the three components of MC, and in global MC. Children’s global MC score decreased by an average of 13 points in boys and 16 points in girls. The imposed movement restrictions had a negative effect on children’s motor competence development.
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Affiliation(s)
- André Pombo
- Faculdade de Motricidade Humana, Universidade de Lisboa, 1499-002 Cruz-Quebrada, Portugal
- Escola Superior de Educação de Lisboa, Instituto Politécnico de Lisboa, 1549-003 Lisboa, Portugal;
- Correspondence:
| | - Carlos Luz
- Escola Superior de Educação de Lisboa, Instituto Politécnico de Lisboa, 1549-003 Lisboa, Portugal;
- Centro Interdisciplinar de Estudos Educacionais, CIED, 1549-003 Lisboa, Portugal
| | - Cristina de Sá
- Departamento de Ciências do Movimento Humano, Universidade Federal de São Paulo, Santos 11015-020, Brazil;
| | - Luis Paulo Rodrigues
- Escola Superior de Desporto e Lazer, Instituto Politécnico de Viana do Castelo, 4960-320 Melgaço, Portugal;
- Research Center in Sports Sciences Health Sciences and Human Development, CIDESD, 5000-801 Vila Real, Portugal
| | - Rita Cordovil
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, 1499-002 Cruz-Quebrada, Portugal;
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27
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Podnar H, Jurić P, Karuc J, Saez M, Barceló MA, Radman I, Starc G, Jurak G, Đurić S, Potočnik ŽL, Sorić M. Comparative effectiveness of school-based interventions targeting physical activity, physical fitness or sedentary behaviour on obesity prevention in 6- to 12-year-old children: A systematic review and meta-analysis. Obes Rev 2021; 22:e13160. [PMID: 33462934 DOI: 10.1111/obr.13160] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 10/04/2020] [Accepted: 10/05/2020] [Indexed: 12/18/2022]
Abstract
A systematic search of the literature was performed to compare the effects of interventions that targeted sedentary behaviours or physical activity (PA) or physical fitness on primary prevention of obesity in 6- to 12-year-old children. The search identified 146 reports that provided relevant data for meta-analysis. Point estimates in % body fat were higher for fitness interventions compared with PA interventions (standardized mean difference = -0.11%; 95% CI = -0.26 to 0.04, and -0.04%; 95% CI = -0.15 to 0.06, respectively). Including sedentary behaviour to a PA- or fitness-oriented intervention was not accompanied by an increase in intervention effectiveness, as the point estimates were slightly smaller compared with those for PA- or fitness-only interventions. Overall, the effects tended to be larger in girls than in boys, especially for PA + sedentary behaviour interventions. There was some evidence for inequality, as the effects on body mass index were seen when interventions were delivered in the general population (standardized mean difference = -0.05, 95% CI = -0.07 to -0.02), but not in groups of disadvantaged children (standardized mean difference = -0.01, 95% CI = -0.29 to 0.19). In conclusion, school-based PA interventions appear to be an effective strategy in the primary prevention of childhood obesity among 6- to 12-year-old children, but targeting sedentary behaviour in addition to PA or fitness does not increase the effectiveness of the intervention.
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Affiliation(s)
- Hrvoje Podnar
- Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia
| | - Petra Jurić
- Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia
| | - Josip Karuc
- Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia
| | - Marc Saez
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain.,CIBER of Epidemiology and Public Health, Madrid, Spain
| | - Maria A Barceló
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain.,CIBER of Epidemiology and Public Health, Madrid, Spain
| | - Ivan Radman
- Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia
| | - Gregor Starc
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Gregor Jurak
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Saša Đurić
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | | | - Maroje Sorić
- Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia.,Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
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28
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The effect of physical activity intervention and nutritional habits on anthropometric measures in elementary school children: the health oriented pedagogical project (HOPP). Int J Obes (Lond) 2021; 45:1677-1686. [PMID: 33972698 PMCID: PMC8310789 DOI: 10.1038/s41366-021-00830-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 02/23/2021] [Accepted: 04/21/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Overweight and obesity are a burden of the modern world that requires urgent action. Prevention has proven to be efficient in the fight against overweight and obesity. As many children gain excessive weight at an early age, intervention during school years are important. While daily physical activity (PA) is known to have an influence on overweight and obesity prevention, the importance of a healthy lifestyle, including dietary habits, should not be underestimated. The aim of this study was to assess how a combination of daily PA and healthy/unhealthy diet affect the anthropometric measures of 4th graders in Norway. METHODS The Health Oriented Pedagogical Project (HOPP) is a longitudinal intervention in primary school children, which includes increased amount of daily physical activity during teaching- active learning. Assessed were weight, muscle and bone mass, as well as fat mass, using a bio-impedance Tanita scale. A dietary survey, Ungkost 2000, with 18 multiple-choice questions was used to evaluate the overall nutrition characteristics of the children. RESULTS Between 2015 and 2018, a total of 917 (intervention group n = 614, control group n = 303) 4th graders from nine different schools from the south-east part of Norway participated. We observed that daily PA and a regular healthy diet increases-while an unhealthy diet decreases-muscle and bone mass despite daily PA. Daily PA appears to counteract some of the effects of an unhealthy diet on weight and fat mass. In addition, daily PA and a regular intake of fruits and berries lowers weight and fat mass in children with overweight. CONCLUSION Combination of daily 45-minute of PA and a healthy diet leads to reductions in body weight and incease in muscle and bone mass in elementary school children.
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29
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Wong RSM, Yu EYT, Wong TWL, Fung CSC, Choi CSY, Or CKL, Liu KSN, Wong CKH, Ip P, Lam CLK. Development and pilot evaluation of a mobile app on parent-child exercises to improve physical activity and psychosocial outcomes of Hong Kong Chinese children. BMC Public Health 2020; 20:1544. [PMID: 33054753 PMCID: PMC7556926 DOI: 10.1186/s12889-020-09655-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 10/07/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Parent-child exercises involve children and parents to do workout together and have positive effects on physical and mental health. We developed a mobile app on parent-child exercises called Family Move, which combines coaching videos with game features such as points and level system to enhance the health and wellbeing of both children and parents through parent-child exercises. This pilot pre-post study investigated whether the Family Move app-based intervention had a positive effect on children's health-related quality of life (HRQOL), psychosocial wellbeing, and physical activity (PA) level. METHODS We recruited 67 parent-child pairs. During the 8-week intervention, these pairs were invited to perform parent-child exercises using the Family Move app. Points were automatically added to the user account after viewing a coaching video. In-game ranking was available to enhance user engagement. Parent proxy-report questionnaires on children's HRQOL, psychosocial wellbeing, and PA were administered at baseline and 1- and 6-month follow-up. Paired samples t-tests were conducted to evaluate post-intervention changes in child outcomes (HRQOL, psychosocial wellbeing, and PA). Multiple linear regressions were used to examine these changes as a function of in-game ranking. RESULTS 52 (78%) viewed at least one coaching video in the Family Move app. Children's PA level significantly increased at 1-month (d = 0.32, p = 0.030) and 6-month (d = 0.30, p = 0.042) follow-up, whereas their psychosocial problems declined at 6-month follow-up (d = 0.35, p = 0.005). Higher in-game ranking was significantly associated with fewer psychosocial problems at 1-month follow-up (β = - 0.15, p = 0.030). CONCLUSIONS Our findings suggest that the Family Move app could be a possible intervention to increase children's PA level and psychosocial wellbeing through parent-child exercise. TRIAL REGISTRATION ClinicalTrials.gov number, NCT03279354 , registered September 11, 2017 (Prospectively registered).
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Affiliation(s)
- Rosa Sze Man Wong
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F, Ap Lei Chau Clinic, 161 Ap Lei Chau Main Street, Ap Lei Chau, Hong Kong, Hong Kong.,Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Esther Yee Tak Yu
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F, Ap Lei Chau Clinic, 161 Ap Lei Chau Main Street, Ap Lei Chau, Hong Kong, Hong Kong.
| | | | - Colman Siu Cheung Fung
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F, Ap Lei Chau Clinic, 161 Ap Lei Chau Main Street, Ap Lei Chau, Hong Kong, Hong Kong
| | | | - Calvin Ka Lun Or
- Department of Industrial and Manufacturing Systems Engineering, The University of Hong Kong, Hong Kong, Hong Kong
| | - Kiki Sze Nga Liu
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F, Ap Lei Chau Clinic, 161 Ap Lei Chau Main Street, Ap Lei Chau, Hong Kong, Hong Kong
| | - Carlos King Ho Wong
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F, Ap Lei Chau Clinic, 161 Ap Lei Chau Main Street, Ap Lei Chau, Hong Kong, Hong Kong
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Cindy Lo Kuen Lam
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F, Ap Lei Chau Clinic, 161 Ap Lei Chau Main Street, Ap Lei Chau, Hong Kong, Hong Kong
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30
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Hankonen N, Absetz P, Araújo-Soares V. Changing activity behaviours in vocational school students: the stepwise development and optimised content of the 'let's move it' intervention. Health Psychol Behav Med 2020; 8:440-460. [PMID: 34040880 PMCID: PMC8114352 DOI: 10.1080/21642850.2020.1813036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 06/11/2020] [Indexed: 11/17/2022] Open
Abstract
Background: School-based interventions that increase physical activity (PA) in a sustainable way are lacking. Systematic and participatory, theory and evidence-based intervention development may enhance the effectiveness of complex behavioural interventions in the long term. However, detailed descriptions of the intervention development process are rarely openly published, hindering transparency and progress in the field. Aims: To illustrate a stepwise process to develop intervention targeting PA and sedentary behaviour (SB) among older adolescents, and to describe the final, optimised version of the intervention, detailing content of sessions by theoretical determinants and techniques. Methods: Two established intervention development frameworks (Intervention Mapping and Behaviour Change Wheel) were integrated, leading to a comprehensive evidence and theory-based process. It was informed by empirical studies, literature reviews, expert and stakeholder consultation, including scenario evaluation and component pre-testing. In all steps, contextual fit and potential for sustainability were ensured by stakeholder engagement. Results: As a large majority of youth opposed decreasing screen time, increasing PA and decreasing SB were defined as target behaviours, with peers and the school context including classroom practices as key social environments in influencing youth PA (problem specification, step 1). Behavioural diagnosis (step 2) identified a variety of determinants in the domains of capability (e.g. self-regulation skills), motivation (e.g. outcome expectations) and environmental opportunities. These were organised into an intervention theory integrating several formal theories, including Self-Determination Theory. Theory-aligned principles guided material design (Step 3). Feasibility RCT allowed optimisation into a final intervention protocol (step 4). Conclusions: Intervention elements target students directly, and indirectly by changing teacher behaviour and the school and wider environment. A systematic development and optimisation led to a high potential for sustainability. The detailed intervention content, with specification of the hypothesised mechanisms, allows for other researchers to replicate, adapt or refine parts or the whole intervention, considering specific target groups and (sub-)cultures.
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Affiliation(s)
- Nelli Hankonen
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Pilvikki Absetz
- Department of Public Health and Clinical Nutrition, University of Eastern Finland, Joensuu, Finland
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31
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Chalkley AE, Routen AC, Harris JP, Cale LA, Gorely T, Sherar LB. An Evaluation of the Implementation of a UK School-Based Running Program. CHILDREN (BASEL, SWITZERLAND) 2020; 7:E151. [PMID: 32992838 PMCID: PMC7601773 DOI: 10.3390/children7100151] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 09/23/2020] [Accepted: 09/24/2020] [Indexed: 11/19/2022]
Abstract
The adoption of school-based running programs has rapidly increased over the last five years in the UK and globally. However, there is currently a lack of information on how these initiatives are implemented, and whether they are generalizable and/or sustainable. This study evaluated the implementation (including reach, fidelity, and dose) of a school-based running program over seven months to inform future delivery. This observational study used a mixed-method, single-group, before-and-after design strengthened by multiple interim measurements to evaluate the implementation of an optional school-based running program. Five state-funded primary schools in Leicestershire, UK, participated, with 17 teachers and 189 (81 boys (47.4%) and 90 girls (52.6%)) Year 5 pupils (aged 9-10 years) from eight classes. During the 2016/2017 academic year, data were collected via several measures (including interviews, focus groups, observations, questionnaires, and teacher implementation logs) at multiple levels (i.e., school and individual) and at multiple time points during implementation. Follow up qualitative data were also collected during 2017/2018. The school-based running program achieved good reach, with 100% of pupils opting to participate at some point during the academic year. All schools implemented the program with good fidelity, although the level of implementation varied between schools and over time. The average number of sessions held per week ranged from 0.94-3.89 with the average distance accumulated per pupil per week ranging from 0.02 to 2.91 kilometers and boys being more likely than girls to be classed as high-level participators. Despite an initial drop off in participation over time, all schools remained engaged in the program and continued to implement it until the end of the school year. Contextual features (e.g., staff capacity and resources) differed between schools and influenced the quality of implementation and the frequency of delivery. The school-based running program is simple, inexpensive, and versatile and can be implemented by schools with relative ease. However, schools are diverse settings, with unique challenges to ongoing delivery. Thus, planned adaptations, specific to each school's context, are likely necessary to sustain participation in the longer term and should be considered prior to implementation.
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Affiliation(s)
- Anna E. Chalkley
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE113TU, UK; (J.P.H.); (L.A.C.); (L.B.S.)
| | - Ash C. Routen
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester LE5 4PW, UK;
| | - Jo P. Harris
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE113TU, UK; (J.P.H.); (L.A.C.); (L.B.S.)
| | - Lorraine A. Cale
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE113TU, UK; (J.P.H.); (L.A.C.); (L.B.S.)
- Department of Physical Education and Sport Sciences, University of Limerick, Co Limerick V94 T9PX, Ireland
| | - Trish Gorely
- Department of Nursing and Midwifery, University of the Highlands and Islands, Inverness IV3 5SQ, UK;
| | - Lauren B. Sherar
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE113TU, UK; (J.P.H.); (L.A.C.); (L.B.S.)
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McMichael L, Farič N, Newby K, Potts HWW, Hon A, Smith L, Steptoe A, Fisher A. Parents of Adolescents Perspectives of Physical Activity, Gaming and Virtual Reality: Qualitative Study. JMIR Serious Games 2020; 8:e14920. [PMID: 32840487 PMCID: PMC7479580 DOI: 10.2196/14920] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 11/19/2019] [Accepted: 06/25/2020] [Indexed: 12/14/2022] Open
Abstract
Background Virtual reality (VR) exergaming may be a promising avenue to engage adolescents with physical activity. Since parental support is a consistent determinant of physical activity in adolescents, it is crucial to gather the views of parents of adolescents about this type of intervention. Objective This study aimed to interview parents of younger adolescents (13-17 years old) about physical activity, gaming, and VR as part of the larger vEngage study. Methods Semistructured interviews were conducted with 18 parents of adolescents. Data were synthesized using framework analysis. Results Parents believed that encouraging physical activity in adolescents was important, particularly for mental health. Most parents felt that their children were not active enough. Parents reported their adolescents regularly gamed, with mostly negative perceptions of gaming due to violent content and becoming addicted. Parents discussed an inability to relate to gaming due to “generational differences,” but an exception was exergaming, which they had played with their children in the past (eg, Wii Fit). Specific recommendations for promoting a VR exergaming intervention were provided, but ultimately parents strongly supported harnessing gaming for any positive purpose. Conclusions The current study suggests promise for a VR exergaming intervention, but this must be framed in a way that addresses parental concerns, particularly around addiction, violence, and safety, without actively involving their participation. While parents would rather their children performed “real-world” physical activity, they believed the key to engagement was through technology. Overall, there was the perception that harnessing gaming and sedentary screen time for a positive purpose would be strongly supported.
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Affiliation(s)
- Lucy McMichael
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Nuša Farič
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Katie Newby
- Department of Psychology and Sport Sciences, University of Hertfordshire, Hertfordshire, United Kingdom
| | - Henry W W Potts
- Institute of Health Informatics, University College London, London, United Kingdom
| | | | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Abi Fisher
- Department of Behavioural Science and Health, University College London, London, United Kingdom
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Romero-Pérez EM, Núñez Enríquez O, Gastélum-Cuadras G, Horta-Gim MA, González-Bernal JJ, de Paz JA. Assessment of Attitudes Toward Physical Education by the Implementation of an Extracurricular Program for Obese Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5300. [PMID: 32717868 PMCID: PMC7432097 DOI: 10.3390/ijerph17155300] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/11/2020] [Accepted: 07/18/2020] [Indexed: 11/21/2022]
Abstract
The World Health Organization (WHO) identifies the importance of implementing physical activity programs such as physical education (PE) classes in schools. This study identifies the attitudes of obese children toward PE, before and after participation in a vigorous-intensity physical exercise program without the participation of normal-weight peers using a questionnaire on Attitudes toward Physical Education (CAEF). 98 children between 8-11 years of age were randomized in an Experimental Group (GE) (n = 48) and a Control Group (CG) (n = 47). They were assessed using a questionnaire on Attitudes toward Physical Education (CAEF). All the study participants exhibited a BMI Z-score ≥ 2. Before the intervention, the only difference between boys and girls was "empathy to teacher and physical education subject" (p = 0.001, d de Cohen = 0.72, r = 0.34). The interaction between gender and training was only present in empathy for the teacher, with a medium effect size (η2 = 0.055). The implementation of PE with two hours per week elicits only a few effects over the attitude of obese children, even though with a certain engagement of gender through training in the adjustment of empathy for teachers and the PE class.
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Affiliation(s)
- Ena Monserrat Romero-Pérez
- Division of Biological Sciences and Health, University of Sonora, 83000 Hermosillo, Sonora, Mexico; (E.M.R.-P.); (M.A.H.-G.); (J.A.d.P.)
| | - Oscar Núñez Enríquez
- Faculty of Physical Culture Sciences, Autonomous University of Chihuahua, 31000 Chihuahua, Chih, Mexico;
| | - Gabriel Gastélum-Cuadras
- Faculty of Physical Culture Sciences, Autonomous University of Chihuahua, 31000 Chihuahua, Chih, Mexico;
| | - Mario Alberto Horta-Gim
- Division of Biological Sciences and Health, University of Sonora, 83000 Hermosillo, Sonora, Mexico; (E.M.R.-P.); (M.A.H.-G.); (J.A.d.P.)
| | | | - José Antonio de Paz
- Division of Biological Sciences and Health, University of Sonora, 83000 Hermosillo, Sonora, Mexico; (E.M.R.-P.); (M.A.H.-G.); (J.A.d.P.)
- Institute of Biomedicine, University of León, 24071 León, Spain
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Saucedo-Araujo RG, Chillón P, Pérez-López IJ, Barranco-Ruiz Y. School-Based Interventions for Promoting Physical Activity Using Games and Gamification: A Systematic Review Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145186. [PMID: 32709132 PMCID: PMC7400426 DOI: 10.3390/ijerph17145186] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/29/2020] [Accepted: 07/14/2020] [Indexed: 12/22/2022]
Abstract
Games and/or gamification seem to be a promising area for educational and health research. These strategies are being increasingly used for improving health indicators, even in educational settings; however, there is little information about these terms within the school to promote physical activity (PA). Objective: the aim of this study is to describe a systematic review protocol of school-based interventions for promoting PA in pre-schoolers, children, and adolescent students using games and gamification. Methods: This review protocol is registered in International prospective register of systematic reviews (PROSPERO) (CRD42019123521). Scientific databases include PubMed, Web of Science, SportDiscus, Cochrane Library, ERIC, and PsycINFO. A standardized procedure will be executed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol (PRISMA-P) checklist for conducting systematic review protocols and the PICOS (Population, Interventions, Comparators, Outcomes, and Study design) tool to address an appropriate search strategy. Detailed information will be extracted, including a quantitative assessment using effect sizes to compare the interventions and a qualitative assessment using the Evaluation of Public Health Practice Projects (EPHPP) tool. Conclusion: This systematic review protocol contributes to establishing future systematic reviews using games and gamification strategies in school settings in order to examine their effect on PA outcomes among youth. Additionally, an update and clarification on the different terms in the school context have been included.
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Affiliation(s)
- Romina Gisele Saucedo-Araujo
- Department of Physical Education and Sports, PROFITH “PROmoting FITness and Health through Physical Activity” Research Group, Sport and Health University Research Institute (iMUDS), Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain;
- Correspondence: ; Tel.: +34-958-244374
| | - Palma Chillón
- Department of Physical Education and Sports, PROFITH “PROmoting FITness and Health through Physical Activity” Research Group, Sport and Health University Research Institute (iMUDS), Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain;
| | - Isaac J. Pérez-López
- Department of Physical Education and Sports, “Educación Física y Transformación Social”, SEJ546 Research Group, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain;
| | - Yaira Barranco-Ruiz
- Department of Physical Education and Sports, PROFITH “PROmoting FITness and Health through Physical Activity” Research Group, Sport and Health University Research Institute (iMUDS), Faculty of Education and Sport Sciences, University of Granada, 52071 Melilla, Spain;
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Mesman M, Onrust S, Verkerk R, Hendriks H, Van den Putte B. Effectiveness of the InCharge Prevention Program to Promote Healthier Lifestyles: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e17702. [PMID: 32673278 PMCID: PMC7381060 DOI: 10.2196/17702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 04/30/2020] [Accepted: 05/06/2020] [Indexed: 11/13/2022] Open
Abstract
Background InCharge is a newly developed school-based health intervention aimed at older adolescents. It aims to promote a healthier lifestyle by increasing self-regulation skills. After the InCharge program’s effectiveness was previously investigated in a pilot study, the content of the program was adapted. Objective This study describes the protocol of a cluster randomized controlled trial that aims to investigate the effectiveness of the InCharge program. Methods A cluster randomized controlled trial including 70 classes with older adolescents (aged 16 years or older) in the Netherlands will be conducted to test the effectiveness of the InCharge program. After schools are recruited, randomization occurs at the class level. The trial consists of the following two conditions: an experimental condition and a control condition. Participants in the experimental condition will be given the InCharge intervention, consisting of four lessons of 50 minutes, with each lesson containing three assignments of approximately 15 minutes. While participants in the experimental condition will receive InCharge, participants in the control condition will receive regular academic school courses. Surveys are administered 1 week before the intervention (baseline), 1 week after the intervention (posttest), and 12 weeks after the intervention (follow-up). Variables of interest include, but are not limited to, self-regulation; predictors of snack intake, physical activity, and alcohol use; and interpersonal communication regarding these health behaviors. In addition to surveys, observations will be conducted during the first and fourth lessons, teachers will be interviewed, and focus groups will be held with a selection of students from the intervention condition. Results Enrollment started in September 2017. As of June 2019, a total of 1216 participants were enrolled for this trial. Findings will be published in peer-reviewed journals and presented at conferences. The trial has been approved by the Ethics Review Board of the Faculty of Social and Behavioral Sciences of the University of Amsterdam (reference no.: 2017-PC-8244). Conclusions In this study protocol, the design of a cluster randomized controlled trial is described, which assesses how effectively the school-based intervention InCharge stimulates healthier lifestyles in late adolescents. We hypothesize that participants in the experimental condition will consume less alcohol, eat fewer unhealthy snacks, and be more physically active compared with participants in the control condition. Trial Registration Netherlands Trial Register (NL6654); https://www.trialregister.nl/trial/6654 International Registered Report Identifier (IRRID) RR1-10.2196/17702
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Affiliation(s)
- Mathijs Mesman
- Amsterdam School of Communication Research, University of Amsterdam, Amsterdam, Netherlands
| | | | | | - Hanneke Hendriks
- Amsterdam School of Communication Research, University of Amsterdam, Amsterdam, Netherlands
| | - Bas Van den Putte
- Amsterdam School of Communication Research, University of Amsterdam, Amsterdam, Netherlands
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Grüne E, Popp J, Carl J, Pfeifer K. What do we know about physical activity interventions in vocational education and training? A systematic review. BMC Public Health 2020; 20:978. [PMID: 32571295 PMCID: PMC7309979 DOI: 10.1186/s12889-020-09093-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 06/12/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Although the health benefits of physical activity (PA) are well known, young people's level of PA is often insufficient and tends to decline in adolescence. Numerous studies have investigated the effectiveness of PA-promoting interventions among young people, but none have reviewed the effectiveness of PA interventions in the vocational education and training (VET) setting. This systematic review aims to (1) synthesize and review the available literature on PA-promoting interventions in VET and (2) examine the effects of these interventions on PA-related outcomes such as PA level, physical fitness, physiological parameters, or psychological factors. METHODS Five electronic databases were searched for studies involving adolescents aged 15 to 20 years that took place in VET settings and evaluated the effects of interventions with a PA component on PA-related outcomes such as PA level, physical fitness, physiological parameters, or psychological factors. The screening process and the quality assessment were conducted by two independent reviewers; data extraction was conducted by one reviewer and verified by another. RESULTS The literature search identified 18,959 articles and 11,282 unique records. After the screening process, nine studies, all coming from European or Asian countries, met the pre-defined eligibility criteria and were included in qualitative analyses. All but two studies reported significant improvements for at least one PA-related outcome. The interventions substantially differed in their development approaches (top-down vs. bottom-up approaches), complexity (multi- vs. single-component), and addressed behavior (multi-behavioral vs. single-behavioral). The most conspicuous finding was that bottom-up approaches tend to improve outcomes at the psychological level and top-down approaches at the physical level. Regarding the interventions' complexity and addressed behavior, we did not reveal any conclusive results. CONCLUSION This systematic review highlights the varying effects of PA-promoting interventions in VET. Nevertheless, heterogeneous effects, overall weak study quality and availability of studies only from two continents limited our ability to draw clear conclusions about the potentially most effective intervention strategies. Therefore, future research should focus on high-quality studies with long-term follow-ups to make recommendations for practical use. TRIAL REGISTRATION PROSPERO CRD42018109845.
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Affiliation(s)
- Eva Grüne
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg, Gebbertstraße 123b, 91058, Erlangen, Germany.
| | - Johanna Popp
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg, Gebbertstraße 123b, 91058, Erlangen, Germany
| | - Johannes Carl
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg, Gebbertstraße 123b, 91058, Erlangen, Germany
| | - Klaus Pfeifer
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg, Gebbertstraße 123b, 91058, Erlangen, Germany
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O'Kane SM, Carlin A, Gallagher AM, Lahart IM, Jago R, Faulkner M, Murphy MH. A study protocol for a clustered randomised controlled trial to evaluate the effectiveness of a peer-led school-based walking intervention on adolescent girls' physical activity: the Walking In ScHools (WISH) study. BMC Public Health 2020; 20:541. [PMID: 32316957 PMCID: PMC7171742 DOI: 10.1186/s12889-020-08600-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 03/26/2020] [Indexed: 12/20/2022] Open
Abstract
Background Adolescent girls in the UK and Ireland are failing to meet current physical activity guidelines. Physical activity behaviours track from childhood to adulthood and it is important that adolescent girls are provided with opportunities to be physically active. Walking has been a central focus for physical activity promotion in adults and may effectively increase physical activity levels among younger people. Following on from a pilot feasibility trial, the purpose of this cluster randomised controlled trial (c-RCT) is to evaluate the effectiveness of a novel, low-cost, peer-led school-based walking intervention delivered across the school year at increasing physical activity levels of adolescent girls. Methods The Walking In ScHools (WISH) Study is a school-based c-RCT conducted with girls aged 12–14 years from eighteen schools across the Border Region of Ireland / Northern Ireland. Following baseline data collection, schools will be randomly allocated to intervention or control group. In intervention schools, female pupils aged 15–18 years will be invited to train as walk leaders and will lead younger pupils in 10–15 min walks before school, at break and lunch recess. All walks will take place in school grounds and pupils will be encouraged to participate in as many walks as possible each week. The intervention will be delivered for the whole school year (minimum 20–22 weeks). The primary outcome measure is accelerometer-measured total physical activity (counts per minute) (end of intervention). Secondary outcomes will include time spent in sedentary behaviour, light, moderate and vigorous intensity physical activity, anthropometry measures, social media usage and sleep. A mixed-methods process evaluation will also be undertaken. Discussion The WISH Study will examine the effectiveness of a low-cost, school-based, peer-led walking intervention in increasing physical activity in adolescent girls when delivered across the school year. If the intervention increases physical activity, it would benefit adolescent girls in the defined target area with potential for wider adoption by schools across the UK and Ireland. Trial registration ISRCTN; ISRCTN12847782; Registered 2nd July 2019.
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Affiliation(s)
- S Maria O'Kane
- Centre for Exercise Medicine, Physical Activity and Health, Sports and Exercise Sciences Research Institute, University of Ulster, Jordanstown Campus, Newtownabbey, BT37 0QB, UK.
| | - Angela Carlin
- Centre for Exercise Medicine, Physical Activity and Health, Sports and Exercise Sciences Research Institute, University of Ulster, Jordanstown Campus, Newtownabbey, BT37 0QB, UK
| | - Alison M Gallagher
- Nutrition Innovation Centre for Food and Health (NICHE), Biomedical Sciences Research Institute, University of Ulster, Coleraine Campus, Coleraine, BT52 1SA, UK
| | - Ian M Lahart
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Walsall Campus, Gorway Road, Walsall, WS1 3BD, UK
| | - Russell Jago
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, BS8 1TZ, UK
| | - Maria Faulkner
- Department of Law and Humanities, Letterkenny Institute of Technology, Port Road, Letterkenny, Ireland
| | - Marie H Murphy
- Centre for Exercise Medicine, Physical Activity and Health, Sports and Exercise Sciences Research Institute, University of Ulster, Jordanstown Campus, Newtownabbey, BT37 0QB, UK
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Kühr P, Lima RA, Grøntved A, Wedderkopp N, Klakk H. Three times as much physical education reduced the risk of children being overweight or obese after 5 years. Acta Paediatr 2020; 109:595-601. [PMID: 31509297 PMCID: PMC7028115 DOI: 10.1111/apa.15005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 09/03/2019] [Accepted: 09/06/2019] [Indexed: 11/29/2022]
Abstract
AIM We evaluated the effect that increasing physical education lessons from 1.5 to 4.5 hours per week for 5 years had on the body mass index (BMI) and waist circumferences of children aged 5-11 years at inclusion. METHODS From 2008 to 2013, six intervention schools in Svendborg, Denmark, delivered 4.5 hours of physical education lessons per week to 750 children. Meanwhile, four matched control schools gave 549 children the standard 1.5 hours of physical education lessons per week. Measurements were taken at baseline and yearly for 5 years. Of the 1299 children, 81 joined the schools after 2008. RESULTS At baseline, the percentage of overweight children was 12% in the intervention schools and 13% in the control schools, whereas 15% and 19% were abdominal obese, respectively. After 5 years, the respective risks of remaining abdominal obese or overweight were 43% and 51% in the intervention schools and 78% and 84% in the control schools. Mean BMI increased 0.450 kg/m2 more in the control group over the five-year period. The intervention was not effective in decreasing the average waist circumference. CONCLUSION Three times as much physical education lessons per week, for 5 years, effectively decreased BMI and the likelihood of remaining overweight or obese.
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Affiliation(s)
- Petra Kühr
- Department of Sport Science and Clinical Biomechanics Research Unit for Exercise Epidemiology Centre of Research in Childhood Health Faculty of Health University of Southern Denmark Odense Denmark
- Faculty of Sport and Exercise Sciences University of Rome Rome Italy
| | - Rodrigo Antunes Lima
- Ministry of Education of Brazil CAPES Foundation Brasília – DF Brazil
- Institute of Sport Science University of Graz Graz Austria
| | - Anders Grøntved
- Department of Sport Science and Clinical Biomechanics Research Unit for Exercise Epidemiology Centre of Research in Childhood Health Faculty of Health University of Southern Denmark Odense Denmark
| | - Niels Wedderkopp
- Department of Sport Science and Clinical Biomechanics Research Unit for Exercise Epidemiology Centre of Research in Childhood Health Faculty of Health University of Southern Denmark Odense Denmark
- Institute of Regional Health Research University of Southern Denmark Odense M Denmark
- University of New Brunswick Fredericton NB Canada
- Orthopedic Department Hospital of Southwestern Jutland Esbjerg Denmark
| | - Heidi Klakk
- Department of Sport Science and Clinical Biomechanics Research Unit for Exercise Epidemiology Centre of Research in Childhood Health Faculty of Health University of Southern Denmark Odense Denmark
- Faculty of Applied Health Science University College Lillebaelt Odense Denmark
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Podstawski R, Markowski P, Choszcz D, Boraczyński M, Gronek P. Socioeconomic Determinants of the Anthropometric Characteristics and Motor Abilities of Polish Male University Students: A Cross-Sectional Study Conducted in 2000-2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041300. [PMID: 32085539 PMCID: PMC7068552 DOI: 10.3390/ijerph17041300] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 02/12/2020] [Accepted: 02/13/2020] [Indexed: 11/16/2022]
Abstract
Aim: The aim of this study was to determine the relationships between socioeconomic factors, anthropometric characteristics and motor abilities of male university students. Materials and Methods: The study was conducted from 2000 to 2018 on 2691 male university students aged 19.98 ± 1.05 years, who were randomly selected from students attending obligatory physical education (PE) classes. The participants’ body mass and height were measured, and students participated in 13 motor ability tests that assessed their speed/agility, flexibility, strength and endurance abilities. Multiple independent samples were compared with the Kruskal–Wallis test or the mean-ranks post-hoc test when significant differences were observed in the participants’ motor abilities. Results: Factors such as the place of permanent residence, students’ monthly budget, and mother’s and father’s educational background, significantly (p < 0.05) influenced the body mass, BMI and motor abilities of first-year university students. The participants’ motor abilities (speed/agility, flexibility—partly, strength, strength endurance, and endurance) were most frequently and most significantly determined by their monthly budgets, and were least frequently and least significantly determined by their place of permanent residence. Conclusions: The students’ body height, BMI and motor abilities generally increased with a rise in population in the place of permanent residence, monthly budget, and the parents’ educational attainment.
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Affiliation(s)
- Robert Podstawski
- Department of Tourism, Recreation and Ecology, Faculty of Geoengineering, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland
- Correspondence:
| | - Piotr Markowski
- Department of Heavy Duty Machines and Research Methodology, Faculty of Technical Sciences, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland; (P.M.); (D.C.)
| | - Dariusz Choszcz
- Department of Heavy Duty Machines and Research Methodology, Faculty of Technical Sciences, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland; (P.M.); (D.C.)
| | - Michał Boraczyński
- Faculty of Health Sciences, Olsztyn University College, 10-283 Olsztyn, Poland;
| | - Piotr Gronek
- Department of Dance and Gymnastics, University of Physical Education in Poznan, 61-871 Poznań, Poland;
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Van Woudenberg TJ, Bevelander KE, Burk WJ, Smit CR, Buijs L, Buijzen M. Testing a Social Network Intervention Using Vlogs to Promote Physical Activity Among Adolescents: A Randomized Controlled Trial. Front Psychol 2020; 10:2913. [PMID: 31998181 PMCID: PMC6967297 DOI: 10.3389/fpsyg.2019.02913] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 12/10/2019] [Indexed: 12/21/2022] Open
Abstract
There is a need to stimulate physical activity among adolescents, but unfortunately, they are hard to reach with traditional mass media interventions. A promising alternative is to carry out social network interventions. In social network interventions, a small group of individuals (influence agents) is selected to promote health-related behaviors within their social network. This study investigates whether a social network intervention is more effective to promote physical activity, compared to a mass media intervention and no intervention. Adolescents (N = 446; Mage = 11.35, SDage = 1.34; 47% male) were randomly allocated by classroom (N = 26, in 11 schools) to one of three conditions: social network intervention, mass media intervention, or control condition. In the social network intervention, 15% of the participants (based on peer nominations) was approached to become an influence agent, who created vlogs about physical activity that were shown during the intervention. In the mass media intervention, participants were exposed to vlogs made by unfamiliar peers (i.e., vlogs of the social network intervention). The control condition did not receive vlogs about physical activity. All participants received a research smartphone to complete questionnaires and a wrist-worn accelerometer to measure physical activity. The trial was registered a priori in the Dutch Trial Registry (NTR6903). There were no differences in objectively measured physical activity between this social network intervention and the control condition in the short-term, but there was an unexpected increase in the control condition compared to the social network intervention in the long-term. No differences between the social network intervention and mass media intervention were observed. The current study does not provide evidence that this social network intervention is effective in increasing physical activity in adolescents. Exploratory analyses suggest that this social network intervention increased the perceived social norm toward physical activity and responses to the vlogs were more positive in the social network intervention than in the mass media intervention. These initial results warrant further research to investigate the role of the social norms and the added benefit of using influence agents for social network interventions. Clinical Trial Registration:https://www.trialregister.nl/, identifier NTR6903.
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Affiliation(s)
| | - Kirsten E Bevelander
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands.,Radboud Institute for Health Sciences, Primary and Community Care, Radboud University and Medical Centre, Nijmegen, Netherlands
| | - William J Burk
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Crystal R Smit
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Laura Buijs
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Moniek Buijzen
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands.,Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, Netherlands
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41
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Yuksel HS, Şahin FN, Maksimovic N, Drid P, Bianco A. School-Based Intervention Programs for Preventing Obesity and Promoting Physical Activity and Fitness: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E347. [PMID: 31947891 PMCID: PMC6981629 DOI: 10.3390/ijerph17010347] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 12/16/2019] [Accepted: 12/23/2019] [Indexed: 01/08/2023]
Abstract
With the significant decrease in physical activity rates, the importance of intervention programs in the schools, where children spend a significant part of the day, has become indisputable. The purpose of this review is to systematically examine the possibility of school-based interventions on promoting physical activity and physical fitness as well as preventing obesity. A systematic approach adopting PRISMA statement was implemented in this study. Three different databases (2010-2019) were screened and primary and secondary school-based intervention programs measuring at least one variable of obesity, physical activity, or physical fitness were included. The risk of bias was assessed using the validated quality assessment tool for quantitative studies. Among 395 potentially related studies, 19 studies were found to meet the eligibility criteria. A general look at the studies examined reveals that among the outcomes, of which most (18/19) were examined, a significant improvement was provided in at least one of them. When the program details are examined, it can be said that the success rate of the physical activity-oriented programs is higher in all variables. School-based interventions can have important potential for obesity prevention and promotion of physical activity and fitness if they focus more on the content, quality, duration and priority of the physical activity.
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Affiliation(s)
| | - Fatma Neşe Şahin
- Faculty of Sport Sciences, Ankara University, 06830 Ankara, Turkey
| | - Nebojsa Maksimovic
- Faculty of Sport and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Patrik Drid
- Faculty of Sport and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Antonino Bianco
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90144 Palermo, Italy
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42
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Schienkiewitz A, Truthmann J, Ernert A, Wiegand S, Schwab KO, Scheidt-Nave C. Age, maturation and serum lipid parameters: findings from the German Health Survey for Children and Adolescents. BMC Public Health 2019; 19:1627. [PMID: 31796007 PMCID: PMC6891966 DOI: 10.1186/s12889-019-7901-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 11/05/2019] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND Recommendations on preventive lipid screening among children and adolescents remain controversial. The aim of the study was to assess age and puberty-related changes in serum lipids, including total cholesterol (TC), and high-density (HDL-C) and non-high-density lipoprotein cholesterol (Non-HDL-C). METHODS Using cross-sectional data from the National Health Interview and Examination Survey for Children and Adolescents in Germany (KiGGS 2003-2006; N = 13,676; 1-17 years), changes in distributions of serum lipids were visualized according to sex, age and maturation. Youth aged 10-17 years were classified as prepubescent, early/mid-puberty, and mature/advanced puberty. Multiple linear regressions were used to quantify the impact of pubertal stage on serum lipid levels, adjusted for potential confounding factors. RESULTS Among children 1-9 years mean serum lipid measures increased with age, with higher mean TC and Non-HDL-C among girls than boys. Among children 10-17 years, advanced pubertal stage was independently related to lower lipid measures. Adjusted mean TC, HDL-C and Non-HDL-C was 19.4, 5.9 and 13.6 mg/dL lower among mature/advanced puberty compared to prepubescent boys and 11.0, 4.0 and 7.0 mg/dL lower in mature/advanced puberty compared to prepubescent girls. CONCLUSIONS Lipid concentrations undergo considerable and sex-specific changes during physical growth and sexual maturation and significantly differ between pubertal stages. Screening recommendations need to consider the fluctuations of serum lipids during growth and sexual maturation.
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Affiliation(s)
- Anja Schienkiewitz
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Berlin, Germany
| | - Julia Truthmann
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Berlin, Germany
| | - Andrea Ernert
- Institute for Biostatistics and Clinical Epidemiology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Susanna Wiegand
- Institute for Experimental Pediatric Endocrinology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Karl Otfried Schwab
- Department of Pediatrics and Adolescent Medicine, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Christa Scheidt-Nave
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Berlin, Germany
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43
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Di Cesare M, Sorić M, Bovet P, Miranda JJ, Bhutta Z, Stevens GA, Laxmaiah A, Kengne AP, Bentham J. The epidemiological burden of obesity in childhood: a worldwide epidemic requiring urgent action. BMC Med 2019; 17:212. [PMID: 31760948 PMCID: PMC6876113 DOI: 10.1186/s12916-019-1449-8] [Citation(s) in RCA: 491] [Impact Index Per Article: 98.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 10/23/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND In recent decades, the prevalence of obesity in children has increased dramatically. This worldwide epidemic has important consequences, including psychiatric, psychological and psychosocial disorders in childhood and increased risk of developing non-communicable diseases (NCDs) later in life. Treatment of obesity is difficult and children with excess weight are likely to become adults with obesity. These trends have led member states of the World Health Organization (WHO) to endorse a target of no increase in obesity in childhood by 2025. MAIN BODY Estimates of overweight in children aged under 5 years are available jointly from the United Nations Children's Fund (UNICEF), WHO and the World Bank. The Institute for Health Metrics and Evaluation (IHME) has published country-level estimates of obesity in children aged 2-4 years. For children aged 5-19 years, obesity estimates are available from the NCD Risk Factor Collaboration. The global prevalence of overweight in children aged 5 years or under has increased modestly, but with heterogeneous trends in low and middle-income regions, while the prevalence of obesity in children aged 2-4 years has increased moderately. In 1975, obesity in children aged 5-19 years was relatively rare, but was much more common in 2016. CONCLUSIONS It is recognised that the key drivers of this epidemic form an obesogenic environment, which includes changing food systems and reduced physical activity. Although cost-effective interventions such as WHO 'best buys' have been identified, political will and implementation have so far been limited. There is therefore a need to implement effective programmes and policies in multiple sectors to address overnutrition, undernutrition, mobility and physical activity. To be successful, the obesity epidemic must be a political priority, with these issues addressed both locally and globally. Work by governments, civil society, private corporations and other key stakeholders must be coordinated.
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Affiliation(s)
| | - Maroje Sorić
- University of Zagreb, Trg Republike Hrvatske 14, 10000, Zagreb, Croatia.,University of Ljubljana, Kongresni trg 12, 1000, Ljubljana, Slovenia
| | - Pascal Bovet
- Center for Primary Care and Public Health, Secteur Croisettes/Bâtiment SC-B, Route de la Corniche 2, 1066 Epalinges, Lausanne, Switzerland.,Ministry of Health, Hospital Road, Victoria, Republic of Seychelles
| | - J Jaime Miranda
- Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martín de Porres, 15102, Lima, Peru
| | - Zulfiqar Bhutta
- Aga Khan University, National Stadium Rd, Karachi, 74800, Pakistan
| | - Gretchen A Stevens
- Independent consultant, Los Angeles, USA.,c/o: School of Mathematics, Statistics and Actuarial Science, University of Kent, Giles Lane, Canterbury, CT2 7NZ, UK
| | - Avula Laxmaiah
- ICMR-National Institute of Nutrition, Beside Tarnaka Metro Station, Osmania University PO, Hyderabad, Telangana, 500007, India
| | - Andre-Pascal Kengne
- South African Medical Research Council, Francie Van Zijl Dr, Parow Valley, Cape Town, 7501, South Africa
| | - James Bentham
- University of Kent, Giles Lane, Canterbury, CT2 7NZ, UK.
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Sebire SJ, Banfield K, Campbell R, Edwards MJ, Kipping R, Kadir B, Garfield K, Matthews J, Blair PS, Lyons RA, Hollingworth W, Jago R. A peer-led physical activity intervention in schools for adolescent girls: a feasibility RCT. PUBLIC HEALTH RESEARCH 2019. [DOI: 10.3310/phr07160] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Background
Girls are less active than boys and few adolescent girls meet physical activity (PA) guidelines. Peers are an important influence on the views and behaviours of adolescent girls, yet many PA interventions involving peers use formal approaches that may not harness the power of peer groups. More informal peer-led PA interventions, which work within proximal peer groups, may hold promise for increasing girls’ PA.
Objectives
To examine the feasibility, evidence of promise and cost of the Peer-Led physical Activity iNtervention for Adolescent girls (PLAN-A), a peer-led PA intervention.
Design
Phase 1 comprised formative work and a pilot study conducted in one secondary school. Phase 2 was a feasibility study comprising a pilot randomised controlled trial in six secondary schools, including process and economic evaluations.
Setting
Six secondary schools in South Gloucestershire and Wiltshire, recruited from schools above the median local Pupil Premium (i.e. more deprived).
Participants
Year 8 girls (aged 12–13 years).
Intervention
Year 8 girls nominated other girls in their year who are likely to be influential (e.g. who they look up to, are good listeners); the 18% most nominated were invited to be peer supporters (PSs). PSs attended 2 consecutive days of training (plus a top-up day 5 weeks later) outside the school site, led by pairs of PS trainers, to increase their knowledge about PA and their capabilities and confidence to promote PA in their friendship group.
Main outcome measures
Measures focused on establishing evidence for feasibility and promise: recruitment and retention of Year 8 girls and PSs, data provision rates [accelerometer and questionnaire collected pre randomisation/beginning of Year 8 (T0), end of Year 8 (T1) and beginning of Year 9 (T2)], intervention acceptability, PS training attendance, intervention cost, and the between-arm difference in weekday minutes of moderate to vigorous PA (MVPA). A process evaluation was conducted.
Results
Six schools were recruited: four PLAN-A (n = 269) and two control (n = 158). In total, 94.7% of Year 8 girls participated. A total of 55 (17–24% of Year 8 girls) PSs were trained (attendance rate 91–100%). Five girls were trained as PS trainers. Questionnaire data provision exceeded 92% at all time points. Accelerometer return rates were > 85% and wear-time criteria were met by 83%, 71% and 62% of participants at T0, T1 and T2, respectively. Mean weekday MVPA did not differ between intervention arms at T1 (1.1 minutes, 95% CI –4.3 to 6.5 minutes) but did at T2 (6.1 minutes, 95% CI 1.4 to 10.8 minutes), favouring PLAN-A. The mean cost of intervention delivery was £2685 per school or £37 per Year 8 girl. Process evaluation identified good fidelity, engagement and enjoyment of the PS training and peer-support strategies. PSs needed more guidance on how to start conversations.
Limitations
Accelerometer data provision was lowest at T2, suggesting a need for strategies to increase compliance.
Conclusions
Informal peer-led intervention approaches, such as PLAN-A, hold promise as a means of promoting PA to adolescent girls.
Future work
A definitive randomised controlled trial of PLAN-A is warranted.
Trial registration
Current Controlled Trials ISRCTN12543546.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 7, No. 16. See the NIHR Journals Library website for further project information. The work was undertaken with the support of the Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), a UK Clinical Research Collaboration (UKCRC) Public Health Research Centre of Excellence. Joint funding (MR/KO232331/1) from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, the Welsh Government and the Wellcome Trust, under the auspices of the UKCRC, is gratefully acknowledged. This study was designed and delivered in collaboration with the Bristol Randomised Trials Collaboration (BRTC), a UK CRC-registered clinical trials unit in receipt of NIHR clinical trials unit support funding. The intervention costs were jointly funded by South Gloucestershire Council and Wiltshire Council.
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Affiliation(s)
- Simon J Sebire
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Kathryn Banfield
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Rona Campbell
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement, Cardiff University, Cardiff, Wales
| | - Mark J Edwards
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Ruth Kipping
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Bryar Kadir
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Bristol Randomised Trials Collaboration, University of Bristol, Bristol, UK
| | - Kirsty Garfield
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Bristol Randomised Trials Collaboration, University of Bristol, Bristol, UK
| | - Joe Matthews
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Peter S Blair
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Bristol Randomised Trials Collaboration, University of Bristol, Bristol, UK
| | - Ronan A Lyons
- Farr Institute, Swansea University Medical School, Swansea, UK
| | - William Hollingworth
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Russell Jago
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West at University Hospitals Bristol NHS Foundation Trust, Bristol, UK
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Lucas IR, Harris C, Lee S, Wargo J, Barnes SP, Kauh TJ, Iachan R. Teacher Physical Education Practices and Student Outcomes in a Sample of Middle Schools Participating in the Presidential Youth Fitness Program. Prev Chronic Dis 2019; 16:E104. [PMID: 31400098 PMCID: PMC6716461 DOI: 10.5888/pcd16.180627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Obesity and lack of physical activity among children and adolescents are public health problems in the United States. This Presidential Youth Fitness Program (PYFP) evaluation measured program implementation in 13 middle schools and its effect on physical education practices, student fitness knowledge, and student physical activity and fitness levels. PYFP, a free program with the potential to positively affect student health and fitness outcomes, was designed to improve fitness education practices that are easily integrated into existing physical education programs. We used a 2-group (13 PYFP and 13 comparison schools) quasi-experimental design to collect FitnessGram assessments, accelerometry data, and surveys of students, physical education teachers, and administrators. Although the program was positively associated with student cardiovascular endurance and physical activity gains during the semester, schools underused professional development courses and fitness recognition resources.
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Affiliation(s)
| | | | - Sarah Lee
- Centers for Disease Control and Prevention, Division of Population Health, School Health Branch, Atlanta, Georgia
| | - Jane Wargo
- National Fitness Foundation, Washington, DC
| | - Seraphine Pitt Barnes
- Centers for Disease Control and Prevention, Division of Population Health, School Health Branch, Atlanta, Georgia
| | - Tina J Kauh
- Robert Wood Johnson Foundation, Princeton, New Jersey
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46
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Joyner D, Wengreen H, Aguilar S, Madden G. Effects of the FIT Game on Physical Activity in Sixth Graders: A Pilot Reversal Design Intervention Study. JMIR Serious Games 2019; 7:e13051. [PMID: 31215508 PMCID: PMC6604505 DOI: 10.2196/13051] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 05/08/2019] [Accepted: 05/17/2019] [Indexed: 12/02/2022] Open
Abstract
Background The FIT Game is a low-cost intervention that increases fruit and vegetable consumption in elementary school children. For this study, the FIT Game was adapted into an intervention designed to increase children’s physical activity at school. Objective We aimed to evaluate if the FIT Game could increase children’s physical activity relative to their baseline levels. Methods A total of 29 participants were recruited from a sixth-grade classroom. An ABAB reversal design was used. Participants wore an accelerometer while at school during pre/postintervention baseline (A) and intervention (B) phases. During the FIT Game intervention, daily physical activity goals encouraged the class to increase their median daily step count above the 60th percentile of the previous 10 days. When daily goals were met, game-based accomplishments were realized. Results Children met their activity goals 80% of the time during the intervention phases. Physical activity at school increased from a median of 3331 steps per day during the baseline to 4102 steps during the FIT Game phases (P<.001, Friedman test). Conclusions Preliminary evidence showed that playing the FIT Game could positively influence children’s physical activity at school.
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Affiliation(s)
- Damon Joyner
- Weber State University, Ogden, UT, United States
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47
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Love R, Adams J, van Sluijs EMF. Are school-based physical activity interventions effective and equitable? A meta-analysis of cluster randomized controlled trials with accelerometer-assessed activity. Obes Rev 2019; 20:859-870. [PMID: 30628172 PMCID: PMC6563481 DOI: 10.1111/obr.12823] [Citation(s) in RCA: 189] [Impact Index Per Article: 37.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 10/26/2018] [Accepted: 11/21/2018] [Indexed: 12/30/2022]
Abstract
The prevalence of childhood obesity is increasing at epidemic rates globally, with widening inequalities between advantaged and disadvantaged groups. Despite the promise of schools as a universal context to access and influence all children, the potential of school-based interventions to positively impact children's physical activity behaviour, and obesity risk, remains uncertain. We searched six electronic databases to February 2017 for cluster randomized trials of school-based physical activity interventions. Following data extraction, authors were sent re-analysis requests. For each trial, a mean change score from baseline to follow-up was calculated for daily minutes of accelerometer-assessed moderate-to-vigorous physical activity (MVPA), for the main effect, by gender, and by socio-economic position (SEP). Twenty-five trials met the inclusion criteria; 17 trials provided relevant data for inclusion in the meta-analyses. The pooled main effect for daily minutes of MVPA was nonexistent and nonsignificant. There was no evidence of differential effectiveness by gender or SEP. This review provides the strongest evidence to date that current school-based efforts do not positively impact young people's physical activity across the full day, with no difference in effect across gender and SEP. Further assessment and maximization of implementation fidelity is required before it can be concluded that these interventions have no contribution to make.
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Affiliation(s)
- Rebecca Love
- Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Jean Adams
- Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Esther M F van Sluijs
- Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
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48
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Willis K, Tibbitts B, Sebire SJ, Reid T, MacNeill SJ, Sanderson E, Hollingworth W, Kandiyali R, Campbell R, Kipping RR, Jago R. Protocol for a cluster randomised controlled trial of a Peer-Led physical Activity iNtervention for Adolescent girls (PLAN-A). BMC Public Health 2019; 19:644. [PMID: 31138171 PMCID: PMC6537278 DOI: 10.1186/s12889-019-7012-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 05/20/2019] [Indexed: 01/07/2023] Open
Abstract
Background Adolescent girls are less physically active than recommended for health, and levels decline further as they approach adulthood. Peers can influence adolescent girls’ physical activity. Interventions capitalising on peer support could positively impact physical activity behaviour in this group. Building on promising feasibility work, the purpose of this cluster randomised controlled trial is to assess whether the Peer-Led physical Activity iNtervention for Adolescent girls (PLAN-A) increases adolescent girls’ physical activity and is cost effective. Methods PLAN-A is a two-arm secondary school-based cluster randomised controlled trial, conducted with girls aged 13–14 years from twenty schools in the south west of England. The intervention requires participants to nominate influential girls within their year group to become peer supporters. The top 15% of girls nominated in each school receive three days of training designed to prepare them to support their peers to be more physically active during a ten-week intervention period. Data will be collected at two time points, at baseline (T0) and 5–6 months post-intervention (T1). Schools will be randomly allocated to the intervention (n = 10) or control (n = 10) arm after T0. At each time point, all consenting participants will wear an accelerometer for seven days to assess the primary outcome of mean weekday minutes of moderate-to-vigorous physical activity. Multivariable mixed effects linear regression will be used to estimate differences in the primary outcome between the two arms and will be examined on an Intention-to-Treat (ITT) basis. A self-report psychosocial questionnaire will be completed by participants to assess self-esteem and physical activity motivation. Resource use and quality of life will be measured for the purposes of an economic evaluation. A mixed-methods process evaluation will be conducted to explore intervention fidelity, acceptability and sustainability. Analysis of quantitative process evaluation data will be descriptive, and the framework method will be used to analyse qualitative data. Discussion This paper describes the protocol for the PLAN-A cluster randomised controlled trial, a novel approach to increasing adolescent girls’ physical activity levels through peer support. Trial registration ISRCTN14539759–31 May, 2018. Electronic supplementary material The online version of this article (10.1186/s12889-019-7012-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kathryn Willis
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK.
| | - Byron Tibbitts
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK
| | - Simon J Sebire
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK
| | - Tom Reid
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK
| | - Stephanie J MacNeill
- Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK.,Bristol Randomised Trials Collaboration, Bristol Trials Centre, University of Bristol, Bristol, UK
| | - Emily Sanderson
- Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK
| | - William Hollingworth
- Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK
| | - Rebecca Kandiyali
- Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK
| | - Rona Campbell
- Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK
| | - Ruth R Kipping
- Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK
| | - Russell Jago
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK
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Aittasalo M, Jussila AM, Tokola K, Sievänen H, Vähä-Ypyä H, Vasankari T. Kids Out; evaluation of a brief multimodal cluster randomized intervention integrated in health education lessons to increase physical activity and reduce sedentary behavior among eighth graders. BMC Public Health 2019; 19:415. [PMID: 30995905 PMCID: PMC6472104 DOI: 10.1186/s12889-019-6737-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 04/02/2019] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Most Finnish adolescents are not sufficiently physically active. Health education (HE) provides beneficial starting point for physical activity (PA) promotion in schools. This study evaluates an intervention integrated into three HE lessons to increase PA and reduce sedentary behavior (SB) among eighth graders. METHODS All public secondary schools in Tampere, Finland participated and were randomized to intervention (INT, n = 7) and comparison group (COM, n = 7). In INT (690 students, 36 classes) the teachers (n = 14) implemented behavioral theory-driven content during three HE lessons. In COM (860 students, 41 classes) the teachers (n = 14) carried out standard lessons. The evaluation was based on RE-AIM: Effectiveness was assessed from baseline to 4 weeks (Follow-up 1) and Maintenance from 4 weeks to 7 months (Follow-up 2) with change in students' PA and SB and related psychosocial and parental factors. Methods included questionnaire, accelerometer and activity diary. Linear mixed models with baseline adjustments and random effect correction were used to compare the difference in change between INT and COM. Data on Reach, Adoption and Implementation were collected during the process. RESULTS Intervention effects were only seen in the self-reported data favoring INT in the weekly number of days with at least 1 h of brisk leisure PA (0.3 [95%CI 0.1 to 0.6]), proportion of students meeting PA recommendations (4.1 [95%CI 2.5 to 5.7]), proportion of students reporting that their family sets limitations for screen time (5.4 [95%CI 3.3 to 7.4]) and in the number of days on which the students intended to do leisure PA in the following week (0.3 [95%CI 0.1 to 0.6]). The effects on PA were still beneficial for INT at Follow-up 2. The intervention reached 96% of the students, was adopted in all 7 schools and was implemented by 13/14 teachers in 35/36 classes. CONCLUSIONS The intervention was feasible and had small favorable effects on students' self-reported PA, intention to do PA and family norm in screen time. The effects on PA persisted until Follow-up 2. It is likely that for greater impacts the HE lessons should have been supported with other actions without compromising feasibility. TRIAL REGISTRATION NCT01633918 (June 27th, 2012).
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Affiliation(s)
- M. Aittasalo
- UKK Institute for Health Promotion Research, PO Box 30, 33501 Tampere, Finland
| | - A-M Jussila
- UKK Institute for Health Promotion Research, PO Box 30, 33501 Tampere, Finland
| | - K. Tokola
- UKK Institute for Health Promotion Research, PO Box 30, 33501 Tampere, Finland
| | - H. Sievänen
- UKK Institute for Health Promotion Research, PO Box 30, 33501 Tampere, Finland
| | - H. Vähä-Ypyä
- UKK Institute for Health Promotion Research, PO Box 30, 33501 Tampere, Finland
| | - T. Vasankari
- UKK Institute for Health Promotion Research, PO Box 30, 33501 Tampere, Finland
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Breslin G, Shannon S, Rafferty R, Fitzpatrick B, Belton S, O’Brien W, Chambers FC, Haughey T, Hanna D, Gormley R, McCullagh D, Brennan D. The effect of sport for LIFE: all island in children from low socio-economic status: a clustered randomized controlled trial. Health Qual Life Outcomes 2019; 17:66. [PMID: 30992012 PMCID: PMC6469044 DOI: 10.1186/s12955-019-1133-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 03/29/2019] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND School-based interventions offer the opportunity to increase physical activity, health-related quality of life (HRQOL) and nutritional behaviours, yet methodological limitations hinder current research, particularly among under-represented children from low socio-economic status (SES). The aim was to determine the effect of a 12-week physical activity programme, Sport for LIFE: All Island (SFL:AI), on physical activity levels, HRQOL, and nutritional attitudes and behaviours in children of low SES across the island of Ireland. METHODS A 2 (groups) × 4 (data collection points) clustered randomised controlled trial was conducted comprising an intervention group who received SFL:AI for 12 weeks, and a waiting-list control condition. In total 740 children (381 boys, 359 girls) aged 8-9 years (mean = 8.7; SD = .50) from 27 schools across four regions of Ireland (Ulster, Leinster, Connacht and Munster) took part. Physical activity was measured by accelerometers, and children completed a validated questionnaire at baseline, mid (i.e. 6-weeks), post-intervention (i.e. 12 weeks) and follow-up (i.e. 3 months post-intervention). RESULTS No significant interaction effects for the intervention were found on any of the study outcomes. Main effects were reported for physical well-being, parental relations and autonomy and financial resources, as well as sweetened beverages, environment and intake, and attitude to vegetables. However, these changes were not statistically attributable to the intervention. CONCLUSIONS It remains unclear if school-based physical activity interventions can improve HRQOL through physical activity with children from low SES. Logistical and methodological considerations are outlined to explore the null effect of the programme, and to provide suggestions for future research and practice. TRIAL REGISTRATION Trial registration number: ISRCTN76261698 . Name of registry: ICRCTN. Date of registration: 23/08/2017. Date of enrolment: September 2014.
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Affiliation(s)
- Gavin Breslin
- Sport and Exercise Sciences Research Institute, Ulster University, Jordanstown, Newtownabbey, Northern Ireland, UK
| | - Stephen Shannon
- Sport and Exercise Sciences Research Institute, Ulster University, Jordanstown, Newtownabbey, Northern Ireland, UK
| | - Ruth Rafferty
- Sport and Exercise Sciences Research Institute, Ulster University, Jordanstown, Newtownabbey, Northern Ireland, UK
| | - Ben Fitzpatrick
- Sport and Exercise Sciences Research Institute, Ulster University, Jordanstown, Newtownabbey, Northern Ireland, UK
| | - Sarahjane Belton
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Wesley O’Brien
- School of Education, Sports Studies and Physical Education Department, University College Cork, Cork, Ireland
| | - Fiona C. Chambers
- School of Education, Sports Studies and Physical Education Department, University College Cork, Cork, Ireland
| | - Tandy Haughey
- Sport and Exercise Sciences Research Institute, Ulster University, Jordanstown, Newtownabbey, Northern Ireland, UK
| | - Donncha Hanna
- School of Psychology, Queen’s University Belfast, Belfast, Northern Ireland, UK
| | - Richard Gormley
- Sport and Exercise Sciences Research Institute, Ulster University, Jordanstown, Newtownabbey, Northern Ireland, UK
| | - Darryl McCullagh
- Sport and Exercise Sciences Research Institute, Ulster University, Jordanstown, Newtownabbey, Northern Ireland, UK
| | - Deirdre Brennan
- Sport and Exercise Sciences Research Institute, Ulster University, Jordanstown, Newtownabbey, Northern Ireland, UK
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