Active Smarter Kids (ASK): Rationale and design of a cluster-randomized controlled trial investigating the effects of daily physical activity on children's academic performance and risk factors for non-communicable diseases

Geir K Resaland, Vegard Fusche Moe, Eivind Aadland, Jostein Steene-Johannessen, Øyvind Glosvik, John R Andersen, Olav M Kvalheim, Heather A McKay, Sigmund A Anderssen, ASK study group, Geir K Resaland, Vegard Fusche Moe, Eivind Aadland, Jostein Steene-Johannessen, Øyvind Glosvik, John R Andersen, Olav M Kvalheim, Heather A McKay, Sigmund A Anderssen, ASK study group

Abstract

Background: Evidence is emerging from school-based studies that physical activity might favorably affect children's academic performance. However, there is a need for high-quality studies to support this. Therefore, the main objective of the Active Smarter Kids (ASK) study is to investigate the effect of daily physical activity on children's academic performance. Because of the complexity of the relation between physical activity and academic performance it is important to identify mediating and moderating variables such as cognitive function, fitness, adiposity, motor skills and quality of life (QoL). Further, there are global concerns regarding the high prevalence of lifestyle-related non-communicable diseases (NCDs). The best means to address this challenge could be through primary prevention. Physical activity is known to play a key role in preventing a host of NCDs. Therefore, we investigated as a secondary objective the effect of the intervention on risk factors related to NCDs. The purpose of this paper is to describe the design of the ASK study, the ASK intervention as well as the scope and details of the methods we adopted to evaluate the effect of the ASK intervention on 5 (th) grade children.

Methods & design: The ASK study is a cluster randomized controlled trial that includes 1145 fifth graders (aged 10 years) from 57 schools (28 intervention schools; 29 control schools) in Sogn and Fjordane County, Norway. This represents 95.3 % of total possible recruitment. Children in all 57 participating schools took part in a curriculum-prescribed physical activity intervention (90 min/week of physical education (PE) and 45 min/week physical activity, in total; 135 min/week). In addition, children from intervention schools also participated in the ASK intervention model (165 min/week), i.e. a total of 300 min/week of physical activity/PE. The ASK study was implemented over 7 months, from November 2014 to June 2015. We assessed academic performance in reading, numeracy and English using Norwegian National tests delivered by The Norwegian Directorate for Education and Training. We assessed physical activity objectively at baseline, midpoint and at the end of the intervention. All other variables were measured at baseline and post-intervention. In addition, we used qualitative methodologies to obtain an in-depth understanding of children's embodied experiences and pedagogical processes taking place during the intervention.

Discussion: If successful, ASK could provide strong evidence of a relation between physical activity and academic performance that could potentially inform the process of learning in elementary schools. Schools might also be identified as effective settings for large scale public health initiatives for the prevention of NCDs.

Trial registration: Clinicaltrials.gov ID nr: NCT02132494 . Date of registration, 6(th) of May, 2014.

References

    1. Singh A, Uijtdewilligen L, Twisk JW, van Mechelen W, Chinapaw MJ. Physical activity and performance at school: a systematic review of the literature including a methodological quality assessment. Arch Pediatr Adolesc Med. 2012;166(1):49–55. doi: 10.1001/archpediatrics.2011.716.
    1. Hillman CH, Kamijo K, Scudder M. A review of chronic and acute physical activity participation on neuroelectric measures of brain health and cognition during childhood. Prev Med. 2011;52(Suppl 1):21–28. doi: 10.1016/j.ypmed.2011.01.024.
    1. Pate RR, Davis MG, Robinson TN, Stone EJ, McKenzie TL, American Heart Association Council on Nutrition PA, Metabolism, Council on Cardiovascular Disease in the Y, Council on Cardiovascular N Promoting physical activity in children and youth: a leadership role for schools: a scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism (Physical Activity Committee) In Collaboration With the Councils on Cardiovascular Disease In the Young and Cardiovascular Nursing. Circulation. 2006;114(11):1214–1224. doi: 10.1161/CIRCULATIONAHA.106.177052.
    1. Naylor PJ, McKay HA. Prevention in the first place: schools a setting for action on physical inactivity. Br J Sports Med. 2009;43(1):10–13. doi: 10.1136/bjsm.2008.053447.
    1. Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet. 2012;380(9838):219–229. doi: 10.1016/S0140-6736(12)61031-9.
    1. World Health Organization . Prevention and control of noncommunicable diseases: implementation of the global strategy. Geneva: WHO; 2008.
    1. Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, Amann M, Anderson HR, Andrews KG, Aryee M, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2224–2260. doi: 10.1016/S0140-6736(12)61766-8.
    1. World Health Organization: . In.: WHO; 2011.
    1. McLeroy KR, Bibeau D, Steckler A, Glanz K. An ecological perspective on health promotion programs. Health Educ Q. 1988;15(4):351–377. doi: 10.1177/109019818801500401.
    1. Harter S. Effectance motivation reconsidered: toward a developmental model. Hum Dev. 1978;21:34–64. doi: 10.1159/000271574.
    1. Nicholls JG. The competitive ethos and democratic education. Cambridge, Mass: Harvard University Press; 1989.
    1. Ryan RM. Overview of self-determination theory. An organismic dialectical perspective. Rochester NY: The University of Rochester Press; 2002.
    1. The Norwegian Directorate for Education and Training. Information about national tests. .
    1. Miyake A, Friedman NP, Emerson MJ, Witzki AH, Howerter A, Wager TD. The unity and diversity of executive functions and their contributions to complex "frontal lobe" tasks: A latent variable analysis. Cogn Psychol. 2000;41(1):49–100. doi: 10.1006/cogp.1999.0734.
    1. Golden CJ. Stroop Color and Word Test. Chicago: Stoelting; 1978.
    1. Lezak MD, Howieson DB, Bigler ED, Tranel D. Neuropsychological Assessment. USA: OUP; 2012.
    1. Spreen O, Strauss E. A compendium of neuropsychological tests. 2. New York: Oxford University Press; 1998.
    1. Brage S, Wedderkopp N, Franks PW, Andersen LB, Froberg K. Reexamination of validity and reliability of the CSA monitor in walking and running. Med Sci Sports Exerc. 2003;35(8):1447–1454. doi: 10.1249/.
    1. Esliger DW, Copeland JL, Barnes JD, Tremblay MS. Standardizing and Optimizing the Use of Accelerometer Data for Free-Living Physical Activity Monitoring. J Phys Act & Health. 2005;2(3):366.
    1. Evenson KR, Catellier DJ, Gill K, Ondrak KS, McMurray RG. Calibration of two objective measures of physical activity for children. J Sport Sci. 2008;26(14):1557–1565. doi: 10.1080/02640410802334196.
    1. Trost SG, Loprinzi PD, Moore R, Pfeiffer KA. Comparison of Accelerometer Cut Points for Predicting Activity Intensity in Youth. Med Sci Sports Exerc. 2011;43(7):1360–1368. doi: 10.1249/MSS.0b013e318206476e.
    1. Andersen LB, Andersen TE, Andersen E, Anderssen SA. An intermittent running test to estimate maximal oxygen uptake: the Andersen test. J Sports Med Phys Fitness. 2008;48(4):434–437.
    1. Aadland E, Terum T, Mamen A, Andersen LB, Resaland GK. The Andersen aerobic fitness test: reliability and validity in 10-year-old children. Plos One. 2014;9(10):e110492–2. doi: 10.1371/journal.pone.0110492.
    1. COE . Eurofit: handbook for the Eurofit test on physical fitness. Strasbourg: Council of Europe. 1993.
    1. Henderson SE, Sugden DA, Barnett A. The Movement Assessment Battery for Children 2. London: Pearson Assessment; 2007.
    1. Kemper HC, Van Mechelen W. Physical fitness testing of children: A European perspective. Pediatr Exerc Sci. 1996;8:201–214.
    1. Schulz J, Henderson SE, Sugden DA, Barnett AL. Structural validity of the Movement ABC-2 test: Factor structure comparisons across three age groups. Res Dev Disabil. 2011;32(4):1361–1369. doi: 10.1016/j.ridd.2011.01.032.
    1. Wuang Y-P, Su J-H, Su C-Y. Reliability and responsiveness of the Movement Assessment Battery for Children. Second Edition Test in children with developmental coordination disorder. Dev Med Child Neurol. 2012;54(2):160–165. doi: 10.1111/j.1469-8749.2011.04177.x.
    1. Wagner MO, Kastner J, Petermann F, Bös K. Factorial validity of the Movement Assessment Battery for Children-2 (age band 2) Res Dev Disabil. 2011;32(2):674–680. doi: 10.1016/j.ridd.2010.11.016.
    1. van Waelvelde H, Peersman W, Lenoir M, Engelsman BCMS. The reliability of the Movement Assessment Battery for Children for preschool children with mild to moderate motor impairment. Clin Rehabil. 2007;21(5):465–470. doi: 10.1177/0269215507074052.
    1. Croce RV, Horvat M, McCarthy E. Reliability and concurrent validity of the movement assessment battery for children. Percept Mot Skills. 2001;93(1):275. doi: 10.2466/pms.2001.93.1.275.
    1. Lohman TG, Roche AFM, Martorell R. Anthropometric standardization reference manual. Illinois: Champaign, IL: Human Kinetics Books; 1991.
    1. Yeung DC, Hui SS. Validity and reliability of skinfold measurement in assessing body fatness of Chinese children. Asia Pac J Clin Nutr. 2010;19(3):350–357.
    1. Tanner JM. Growth at Adolescence. Oxford, United Kingdom: Blackwell; 1962.
    1. Carel JC, Leger J. Precocious puberty. New Engl J Med. 2008;358(22):2366–2377. doi: 10.1056/NEJMcp0800459.
    1. A clinical evaluation report of professional blood pressure monitor HBP-1300.
    1. Soininen P, Kangas AJ, Würtz P, Tukiainen T, Tynkkynen T, Laatikainen R, Järvelin M-R, Kähönen M, Lehtimäki T, Viikari J, et al. High-throughput serum NMR metabonomics for cost-effective holistic studies on systemic metabolism. Analyst. 2009;134(9):1781–1785. doi: 10.1039/b910205a.
    1. Mihaleva VV, van Schalkwijk DB, de Graaf AA, van Duynhoven J, van Dorsten FA, Vervoort J, Smilde A, Westerhuis JA, Jacobs DM. A systematic approach to obtain validated partial least square models for predicting lipoprotein subclasses from serum NMR spectra. Anal Chem. 2014;86(1):543–50.
    1. Meier S, Mjos SA, Joensen H, Grahl-Nielsen O: Validation of a one-step extraction/methylation method for determination of fatty acids and cholesterol in marine tissues. Journal of Chromatography 2006, 1104: 291-298.
    1. Gudbrandsen OA, Kodama Y, Mjos SA, Zhao C-M, Johannessen H, Brattbakk H-R et al: Effects of duodenal switch alone or in combination with sleeve gastrectomy on body weight and lipid metabolism in rats. Nutrition & Diabetes 2014, 4, e124.
    1. Ostergaard L, Kolle E, Steene-Johannessen J, Anderssen SA, Andersen LB. Cross sectional analysis of the association between mode of school transportation and physical fitness in children and adolescents. Int J Behav Nutr Phys Act. 2013;10:91–1. doi: 10.1186/1479-5868-10-91.
    1. The Norwegian Directorate of Health. Physical activity among 6, 9 and 16 year olds. Results from surveillance in 2011. IS-2002, 06/2012. Oslo
    1. Ravens-Sieberer U, Auquier P, Erhart M, Gosch A, Rajmil L, Bruil J, Power M, Duer W, Cloetta B, Czemy L, et al. The KIDSCREEN-27 quality of life measure for children and adolescents: psychometric results from a cross-cultural survey in 13 European countries. Qual Life Res. 2007;16(8):1347–56.
    1. Andersen JR, Natvig GK, Haraldstad K, Skrede T, Aadland E, Resaland GK. Is the Kidscreen-27 a valid measure of health-related quality of life in 10-year-old Norwegian children? Peer J PrePrints. 2015;3:e1383.
    1. Haraldstad K, Christophersen KA, Eide H, Nativg GK, Helseth S. Health related quality of life in children and adolescents: reliability and validity of the Norwegian version of KIDSCREEN-52 questionnaire, a cross sectional study. Int J Nurs Stud. 2011;48(5):573–581. doi: 10.1016/j.ijnurstu.2010.10.001.
    1. Torsheim T, Wold B, Samdal O. The teacher and classmate support scale: factor structure, test retest reability and validity in samples of 13–15 year old adolecents. Sch Psychol Int. 2000;21:195–212. doi: 10.1177/0143034300212006.
    1. Bronson MB, Goodson BD, Layzer JI, Love JM. Child Behavior Rating Scale. Cambridge: MA: Abt Associates; 1990.
    1. Bronson MB, Tivnan T, Seppanen PS. Relations between teacher and classroom activity variables and the classroom behaviors of prekindergarten children in Chapter 1 funded programs. J Appl Dev Psychol. 1995;16(2):253–282. doi: 10.1016/0193-3973(95)90035-7.
    1. Matthews JS, Ponitz CC, Morrison FJ. Early gender differences in self-regulation and academic achievement. J Educ Psychol. 2009;101(3):689–704. doi: 10.1037/a0014240.
    1. von Suchodoletz A, Gestsdottir S, Wanless SB, McClelland MM, Birgisdottir F, Gunzenhauser C, Ragnarsdottir H. Behavioral self-regulation and relations to emergent academic skills among children in Germany and Iceland. Early Child Res Q. 2013;28(1):62–73.
    1. Lim SM, Rodger S, Brown T. Validation of child behavior rating scale in Singapore (Part 1): Rasch analysis. Hong Kong J Occup Ther. 2010;20(2):52–62. doi: 10.1016/S1569-1861(11)70004-3.
    1. Christensen P. Childhood and the cultural constitution of vulnerable bodies. In: Prout A, Campling J, editors. The body, childhood and society. Houndmills: Macmillan Press Ltd.; 2000.
    1. Christensen P, Prout A. Working with ethical symmetry in social research with children. Childhood. 2002;9(4):477–497. doi: 10.1177/0907568202009004007.
    1. Alvesson M, Kärreman D. Qualitative Research and Theory Development. London: SAGE Publications; 2011.
    1. Donnelly JE, Greene JL, Gibson CA, Sullivan DK, Hansen DM, Hillman CH, et al. Physical activity and academic achievement across the curriculum (A + PAAC): rationale and design of a 3-year, cluster-randomized trial. BMC Public Health. 2013;13:307–7. doi: 10.1186/1471-2458-13-307.
    1. Kriemler S, Zahner L, Schindler C, Meyer U, Hartmann T, Hebestreit H, Brunner-La Rocca HP, van Mechelen W, Puder JJ. Effect of school based physical activity programme (KISS) on fitness and adiposity in primary school children: cluster randomised controlled trial. Br Med J. 2010;340:c785.
    1. Hollis S, Campbell F. What is meant by intention to treat analysis? Survey of published randomised controlled trials. Br Med J. 1999;319(7211):670–674. doi: 10.1136/bmj.319.7211.670.
    1. Polit DF, Gillespie BM. Intention-to-treat in randomized controlled trials: recommendations for a total trial strategy. Res Nurs Health. 2010;33(4):355–368. doi: 10.1002/nur.20386.
    1. Donnelly JE, Greene JL, Gibson CA, Smith BK, Washburn RA, Sullivan DK, DuBose K, Mayo MS, Schmelzle KH, Ryan JJ et al. Physical Activity Across the Curriculum (PAAC): A randomized controlled trial to promote physical activity and diminish overweight and obesity in elementary school children. Prev Med. 2009;49(4):336–41.
    1. Campbell MK, Piaggio G, Elbourne DR, Altman DG, Grp C. Consort 2010 statement: extension to cluster randomised trials. Br Med J. 2012;345:e5661. doi: 10.1136/bmj.e5661.
    1. Rajalahti T, Arneberg R, Berven FS, Myhr KM, Ulvik RJ, Kvalheim OM. Biomarker discovery in mass spectral profiles by means of selectivity ratio plot. Chemometr Intell Lab Syst. 2009;95(1):35–48. doi: 10.1016/j.chemolab.2008.08.004.
    1. Rajalahti T, Kvalheim OM. Multivariate data analysis in pharmaceutics: a tutorial review. Int J Pharm. 2011;417(1–2):280–290. doi: 10.1016/j.ijpharm.2011.02.019.
    1. Durlak JA, DuPre EP. Implementation matters: a review of research on the influence of implementation on program outcomes and the factors affecting implementation. Am J Community Psychol. 2008;41(3–4):327–350. doi: 10.1007/s10464-008-9165-0.
    1. McKay HA, Macdonald HM, Nettlefold L, Masse LC, Day M, Naylor P-J. Action Schools! BC implementation: from efficacy to effectiveness to scale-up. Br J Sports Med. 2015;49(4):210–218. doi: 10.1136/bjsports-2013-093361.
    1. WMA . Ethical principles for medical research involving human subjects. Helsinki: World Medical Association General Assembly. 1964.
    1. Story M, Nanney MS, Schwartz MB. Schools and obesity prevention: creating school environments and policies to promote healthy eating and physical activity. Milbank Q. 2009;87(1):71–100. doi: 10.1111/j.1468-0009.2009.00548.x.

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