- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03397940
Role of Structured Days on Weight Gain
May 4, 2022 updated by: R. Glenn Weaver, University of South Carolina
Investigating the Role of Structured Days on Accelerated Weight Gain During Summer: A Natural Experiment
Summer vacation is a 3-month window of vulnerability for children from low-income households when health behaviors and academic learning decay.
The goal of this project is to collect information on where low-income children go during summer, what they do when they get there, and how their behaviors (physical activity, sedentary, sleep, and diet) differ between the summer (unstructured days) and school year (structured days).
This study is 1) significant because it will provide evidence on potential points of intervention that can reduce or reverse the excessive unhealthy weight gains that occur during summer and 2) innovative because it will be the first to identify changes in activity, sedentary, sleep, and dietary behaviors during prolonged and shorter periodic breaks from school and link these behaviors to changes in zBMI over time.
Study Overview
Status
Completed
Detailed Description
For children (5-12yrs) from low-income households, summer vacation is a "window of vulnerability" and represents an extended period of time (typically 9-10 weeks) in which declines in academic performance occur.
For 30 years, empirical evidence has indicated that children from low-income households experience greater declines in reading and math skills during the summer vacation than their middle-to-upper income peers.
Additionally, a growing body of evidence demonstrates that the amount of weight gained during summer vacation is 3-5 times greater than the amount of weight gained during the school year.
Moreover, this excessive weight gain during summer is more pronounced for low-income, minority children, the same children experiencing the greatest summer learning loss.
What children eat and drink, the types of physical activity opportunities, and the amount of screen-time and sleep (two important correlates of weight gain) they engage in during summer vacation is unknown.
However, a substantial body of literature indicates that children engage in a greater number of obesogenic behaviors during less-structured times (e.g., weekend days) compared to more-structured times (e.g., week/school days).
This phenomenon is refered to as the Structured Days Hypothesis.
These behaviors include 1) increased time spent sedentary, 2) reduced engagement in physical activity, 3) displaced sleep patterns, and 4) unhealthy dietary patterns.
This study hypothesizes that summer vacation is simply one long weekend where the effect of children's obesogenic behaviors on weight are compounded over a three month time period.
However, should children be involved in a structured program over the summer they would not engage in obesogenic behaviors and they would not experience unhealthy weight gains and fitness loss.
Recently, one school district in the Columbia, SC area adopted a year-round calendar for an elementary school.
This provides a unique opportunity to conduct a natural experiment examining the effects of shorter periodic breaks vs. one prolonged break from structured days (i.e., school days) on the obesogenic behaviors, weight gain, and fitness.
This study will use a two arm accelerated longitudinal cohort design to complete the following specific aims: Aim 1: Compare changes in BMI z-scores and fitness during the traditional 3-month summer and 9-month school year between children attending a school that follows a year-round school calendar to children attending match-paired schools that follow a traditional school calendar.
Aim 2: Compare changes in sleep, physical activity, sedentary behaviors, and diet during the traditional 3-month summer and 9-month school year between children attending a school that follows a year-round school calendar to children attending match-paired schools that follow a traditional school calendar.
This study is significant because the reason for children's weight gain and fitness loss during the summer is unknown.
This study is innovative because no studies have examined the effects of prolonged (9 weeks all at once) vs. periodic breaks (3 week breaks distributed throughout the year) from a structured environment on children's weight and fitness.
Study Type
Observational
Enrollment (Actual)
2279
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
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South Carolina
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Columbia, South Carolina, United States, 29205
- University of South Carolina
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
5 years to 9 years (CHILD)
Accepts Healthy Volunteers
N/A
Genders Eligible for Study
All
Sampling Method
Probability Sample
Study Population
Three schools (2 traditional and 1 year-round) enrolling 1,279 students have agreed to participate.
85.0% of children in these schools qualify for free and/or reduced price lunch, and 67.5% of children attending these schools are black, 28.5% are white, and 3.6% are Hispanic.
The first school was selected to participate because it operates on a year-round calendar.
The second and third schools were selected because their enrollment size and student demographics closely match the enrollment and student demographics of the first school.
All children in the participating schools will have their height/weight and cardiovascular fitness measured.
Description
Inclusion Criteria:
K, 1st, 2nd, and 3rd grade students without any physical and/or medical conditions that would limit their ability to take part in measurements.
Exclusion Criteria:
Children in the 4th and 5th grade will be excluded from participation in the obesogenic behavior assessments because they will move out of elementary school over the two-year study.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
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Year Round School
Children attending year round school
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Traditional School
Children attending a traditional school with a traditional calendar school year
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Body Mass Index
Time Frame: Baseline and will follow up at 4 months, 12 months, 16 months, and 24 months
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All students enrolled in the partnering schools will have their height and weight measured using standard procedures, as part of their routine PE class.
Height and weight will be collected prior to and following every break lasting 3 weeks or longer.
These measures will be collected with the help of trained research staff during regularly scheduled PE classes to ensure data quality.
This information will be used to compare the BMI (translated into age/sex z-scores [zBMI] for analytical modeling) over time and between students attending a year-round school and traditional schools.
These tests are valid and reliable for this age group.
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Baseline and will follow up at 4 months, 12 months, 16 months, and 24 months
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Change in Cardiorespiratory Fitness:
Time Frame: Baseline and will follow up at 4 months, 12 months, 16 months, and 24 months
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All students enrolled in the partnering schools will take part in the cardiovascular fitness (CVF) test (i.e., PACER) as part of their routine PE class.
These tests are administered to this age group and occur as part of regular PE class as part of a South Carolina statewide assessment system.This information will be used to compare the CVF over time and between students attending a year-round school and traditional schools.
These tests are valid and reliable for this age group.
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Baseline and will follow up at 4 months, 12 months, 16 months, and 24 months
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Sleep
Time Frame: Baseline and follow up at 3 months, 12 months, and 15 months
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Children's sleep will be assessed via wrist-placed Actigraph Links.
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Baseline and follow up at 3 months, 12 months, and 15 months
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Change in Dietary Behavior
Time Frame: Baseline and follow up at 3 months, 12 months, and 15 months
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Dietary patterns rather than individual foods will be assessed.
For the current study, the intent is to estimate less healthful/more healthful foods and beverages consumed and compare these between summer and school.
The study will assess child dietary patterns using two approaches.
First, a modified dietary screener questionnaire will be completed by a parent/guardian at each measurement (traditional school and summer vacation) each year.
Screener items were selected from multiple screeners developed for use in this age group and have been widely used in research.
The screeners are the 26-item Dietary Screener Questionnaire,16 items from the National Youth Physical Activity and Nutrition Study, and items from several additional food/beverage validated screeners.
These dietary screeners provide accurate estimates of food groups and dietary patterns, to allow for examination of relationships between diet and other variables in this study.
These screeners have been tested for validity
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Baseline and follow up at 3 months, 12 months, and 15 months
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Change in Physical Activity
Time Frame: Baseline and follow up at 3 months, 12 months, and 15 months
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Time (minutes per day) spent sedentary, and in light, moderate, and vigorous physical activity will be collected using a non-dominant wrist-placed ActiGraph Link for 9-days (common timeframe to collect physical activity data).
Non-dominant wrist-placement provides an advantage over waist placement by improving compliance and the ability to collect information regarding sleep.
The device is water-proof, allowing us to capture water activities during summer.
A calibration/validation study was recently published to establish methodology to distill activity-intensities from wrist-placed ActiGraph in children.
The widely accepted protocols for a valid day of data will be used.
Each parent with receive a logbook to complete each night to report non-wear time.
Logs will be cross-referenced with the accelerometer data for quality assurance.
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Baseline and follow up at 3 months, 12 months, and 15 months
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (ACTUAL)
March 1, 2018
Primary Completion (ACTUAL)
October 1, 2021
Study Completion (ACTUAL)
October 1, 2021
Study Registration Dates
First Submitted
November 10, 2017
First Submitted That Met QC Criteria
January 5, 2018
First Posted (ACTUAL)
January 12, 2018
Study Record Updates
Last Update Posted (ACTUAL)
May 5, 2022
Last Update Submitted That Met QC Criteria
May 4, 2022
Last Verified
May 1, 2022
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- Pro00065211
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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