School-Based Multicomponent Intervention to Promote Physical Activity and Reduce Sedentary Time of Disadvantaged Children Aged 6-10 Years: Protocol for a Randomized Controlled Trial

Caroline Maite Marie Bernal, Lena Lhuisset, Nicolas Fabre, Julien Bois, Caroline Maite Marie Bernal, Lena Lhuisset, Nicolas Fabre, Julien Bois

Abstract

Background: In our modern society, physical activity (PA) is decreasing and sedentary time (ST) is increasing, especially for children from disadvantaged neighborhoods. School-based interventions to promote PA and decrease ST are therefore required among this population in order to change children's lifestyle habits. Moreover, attentional capacities and academic achievement can be enhanced by chronic PA during childhood. The relationships between these variables have been poorly studied with this population.

Objective: The objective of this study is to present the rationale and methods for a randomized controlled trial among 6-10-year-old children with low socioeconomic status that will (1) evaluate the effectiveness of a school-based intervention designed to promote PA and reduce ST and (2) study the relationships between PA, ST, motor skills, attentional capacities, and academic achievement.

Methods: A randomized controlled trial was conducted in 2 eligible primary schools. During academic year 2016-2017, 1 school was randomly assigned as the experiment one and the other was assigned as the control one. Five assessments times were used: baseline (T1 [November 2016] to T2 [June 2017]), follow-up (T3 [November 2017] to T4 [June 2018]), and final assessment (T5 [June 2019]). The school-based intervention included various components on different levels of the socioecological model: (1) curriculum-based program for children; (2) sensitization workshops and newsletters for parents; (3) training workshops for teachers; (4) environmental adaptation of playgrounds and reorganization of recess time; (5) time adaptation of lunch breaks; and (6) collaboration with political groups. PA, ST, motor skills, and attentional capacities were evaluated and academic achievement was recorded.

Results: The presented intervention and its different assessments have been successfully implemented. In order to achieve the 2 objectives of this randomized controlled trial, data analyses are about to be completed.

Conclusions: The implementation of this randomized controlled trial can help to determine effective strategies to promote PA in the context of increasing prevalence of physical inactivity among children with sedentary lifestyle which will be useful for researchers, stakeholders, and public policy makers.

Trial registration: ClinicalTrials.gov NCT03983447; https://ichgcp.net/clinical-trials-registry/NCT03983447.

International registered report identifier (irrid): RR1-10.2196/17815.

Keywords: academic achievement; attention; children; intervention; physical activity; promotion; school; sedentary time.

Conflict of interest statement

Conflicts of Interest: None declared.

©Caroline Maite Marie Bernal, Lena Lhuisset, Nicolas Fabre, Julien Bois. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 23.09.2020.

Figures

Figure 1
Figure 1
Flowchart of participants. PA: physical activity; ST: sedentary time.

References

    1. Lee I, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT, Lancet PASWG. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet. 2012 Jul 21;380(9838):219–29. doi: 10.1016/S0140-6736(12)61031-9.
    1. Warburton DER, Nicol CW, Bredin SSD. Health benefits of physical activity: the evidence. CMAJ. 2006 Mar 14;174(6):801–9. doi: 10.1503/cmaj.051351.
    1. World Health Organization . Global Action Plan on Physical Activity 2018–2030: More Active People for a Healthier World. Geneva, Switzerland: World Health Organization; 2018.
    1. World Health Organization . Global Strategy on Diet, Physical Activity and Health. Geneva, Switzerland: World Health Organization; 2004.
    1. Telama R, Yang X, Viikari J, Välimäki I, Wanne O, Raitakari O. Physical activity from childhood to adulthood: a 21-year tracking study. Am J Prev Med. 2005 Apr;28(3):267–73. doi: 10.1016/j.amepre.2004.12.003.
    1. Cooper AR, Goodman A, Page AS, Sherar LB, Esliger DW, van Sluijs EMF, Andersen LB, Anderssen S, Cardon G, Davey R, Froberg K, Hallal P, Janz KF, Kordas K, Kreimler S, Pate RR, Puder JJ, Reilly JJ, Salmon J, Sardinha LB, Timperio A, Ekelund U. Objectively measured physical activity and sedentary time in youth: the International children's accelerometry database (ICAD) Int J Behav Nutr Phys Act. 2015 Sep 17;12:113. doi: 10.1186/s12966-015-0274-5.
    1. Guinhouya BC, Samouda H, de Beaufort C. Level of physical activity among children and adolescents in Europe: a review of physical activity assessed objectively by accelerometry. Public Health. 2013 Apr;127(4):301–11. doi: 10.1016/j.puhe.2013.01.020.
    1. Konstabel K, Veidebaum T, Verbestel V, Moreno LA, Bammann K, Tornaritis M, Eiben G, Molnár D, Siani A, Sprengeler O, Wirsik N, Ahrens W, Pitsiladis Y, IDEFICS consortium Objectively measured physical activity in European children: the IDEFICS study. Int J Obes (Lond) 2014 Sep;38 Suppl 2:S135–43. doi: 10.1038/ijo.2014.144.
    1. Drenowatz C, Eisenmann JC, Pfeiffer KA, Welk G, Heelan K, Gentile D, Walsh D. Influence of socio-economic status on habitual physical activity and sedentary behavior in 8- to 11-year old children. BMC Public Health. 2010 Apr 27;10:214. doi: 10.1186/1471-2458-10-214.
    1. de Meij JSB, Chinapaw MJM, van Stralen MM, van der Wal MF, van Dieren L, van Mechelen W. Effectiveness of JUMP-in, a Dutch primary school-based community intervention aimed at the promotion of physical activity. Br J Sports Med. 2011 Oct;45(13):1052–7. doi: 10.1136/bjsm.2010.075531.
    1. Engelen L, Bundy AC, Naughton G, Simpson JM, Bauman A, Ragen J, Baur L, Wyver S, Tranter P, Niehues A, Schiller W, Perry G, Jessup G, van der Ploeg HP. Increasing physical activity in young primary school children--it's child's play: a cluster randomised controlled trial. Prev Med. 2013 May;56(5):319–25. doi: 10.1016/j.ypmed.2013.02.007.
    1. Haapala HL, Hirvensalo MH, Kulmala J, Hakonen H, Kankaanpää A, Laine K, Laakso L, Tammelin TH. Changes in physical activity and sedentary time in the Finnish Schools on the Move program: a quasi-experimental study. Scand J Med Sci Sports. 2017 Nov;27(11):1442–1453. doi: 10.1111/sms.12790.
    1. Kipping RR, Howe LD, Jago R, Campbell R, Wells S, Chittleborough CR, Mytton J, Noble SM, Peters TJ, Lawlor DA. Effect of intervention aimed at increasing physical activity, reducing sedentary behaviour, and increasing fruit and vegetable consumption in children: active for Life Year 5 (AFLY5) school based cluster randomised controlled trial. BMJ. 2014 May 27;348:g3256. doi: 10.1136/bmj.g3256.
    1. Magnusson KT, Sigurgeirsson I, Sveinsson T, Johannsson E. Assessment of a two-year school-based physical activity intervention among 7-9-year-old children. Int J Behav Nutr Phys Act. 2011 Dec 20;8:138. doi: 10.1186/1479-5868-8-138.
    1. Taylor SL, Noonan RJ, Knowles ZR, Owen MB, McGrane B, Curry WB, Fairclough SJ. Evaluation of a Pilot School-Based Physical Activity Clustered Randomised Controlled Trial-Active Schools: Skelmersdale. Int J Environ Res Public Health. 2018 May 17;15(5) doi: 10.3390/ijerph15051011.
    1. van SEMF, McMinn AM, Griffin SJ. Effectiveness of interventions to promote physical activity in children and adolescents: systematic review of controlled trials. BMJ. 2007 Oct 6;335(7622):703. doi: 10.1136/.
    1. Kriemler S, Meyer U, Martin E, van Sluijs EMF, Andersen LB, Martin BW. Effect of school-based interventions on physical activity and fitness in children and adolescents: a review of reviews and systematic update. Br J Sports Med. 2011 Sep;45(11):923–30. doi: 10.1136/bjsports-2011-090186.
    1. Sallis JF, Cervero RB, Ascher W, Henderson KA, Kraft MK, Kerr J. An ecological approach to creating active living communities. Annu Rev Public Health. 2006;27:297–322. doi: 10.1146/annurev.publhealth.27.021405.102100.
    1. Sallis JF, Owen N, Fisher EB. Ecological models of health behavior. In: Glanz K, Rimer BK, Viswanath K, editors. Health Behavior and Health Education: Theory, Research, and Practice (4th ed) San Francisco, CA: Jossey-Bass; 2008. pp. 465–485.
    1. Hamer M, Aggio D, Knock G, Kipps C, Shankar A, Smith L. Effect of major school playground reconstruction on physical activity and sedentary behaviour: Camden active spaces. BMC Public Health. 2017 Jun 07;17(1):552. doi: 10.1186/s12889-017-4483-5.
    1. Janssen X, Mann KD, Basterfield L, Parkinson KN, Pearce MS, Reilly JK, Adamson AJ, Reilly JJ. Development of sedentary behavior across childhood and adolescence: longitudinal analysis of the Gateshead Millennium Study. Int J Behav Nutr Phys Act. 2016 Aug 02;13:88. doi: 10.1186/s12966-016-0413-7.
    1. Ekelund U, Steene-Johannessen J, Brown WJ, Fagerland MW, Owen N, Powell KE, Bauman A, Lee I, Lancet Physical Activity Series 2 Executive Committe. Lancet Sedentary Behaviour Working Group Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women. Lancet. 2016 Sep 24;388(10051):1302–10. doi: 10.1016/S0140-6736(16)30370-1.
    1. Hinckson E, Salmon J, Benden M, Clemes SA, Sudholz B, Barber SE, Aminian S, Ridgers ND. Standing Classrooms: Research and Lessons Learned from Around the World. Sports Med. 2016 Jul;46(7):977–87. doi: 10.1007/s40279-015-0436-2.
    1. Mahar MT, Murphy SK, Rowe DA, Golden J, Shields AT, Raedeke TD. Effects of a classroom-based program on physical activity and on-task behavior. Med Sci Sports Exerc. 2006 Dec;38(12):2086–94. doi: 10.1249/01.mss.0000235359.16685.a3.
    1. Stamatakis E, Ekelund U, Ding D, Hamer M, Bauman AE, Lee I. Is the time right for quantitative public health guidelines on sitting? A narrative review of sedentary behaviour research paradigms and findings. Br J Sports Med. 2019 Mar;53(6):377–382. doi: 10.1136/bjsports-2018-099131.
    1. Kiefer M, Trumpp NM. Embodiment theory and education: The foundations of cognition in perception and action. Trends in Neuroscience and Education. 2012 Dec;1(1):15–20. doi: 10.1016/j.tine.2012.07.002.
    1. Tomporowski PD, Lambourne K, Okumura MS. Physical activity interventions and children's mental function: an introduction and overview. Prev Med. 2011 Jun;52 Suppl 1:S3–9. doi: 10.1016/j.ypmed.2011.01.028.
    1. Donnelly JE, Hillman CH, Castelli D, Etnier JL, Lee S, Tomporowski P, Lambourne K, Szabo-Reed AN. Physical Activity, Fitness, Cognitive Function, and Academic Achievement in Children: A Systematic Review. Med Sci Sports Exerc. 2016 Jun;48(6):1197–222. doi: 10.1249/MSS.0000000000000901.
    1. Pindus DM, Drollette ES, Scudder MR, Khan NA, Raine LB, Sherar LB, Esliger DW, Kramer AF, Hillman CH. Moderate-to-Vigorous Physical Activity, Indices of Cognitive Control, and Academic Achievement in Preadolescents. J Pediatr. 2016 Jun;173:136–42. doi: 10.1016/j.jpeds.2016.02.045.
    1. Tomporowski PD, McCullick B, Pendleton DM, Pesce C. Exercise and children's cognition: The role of exercise characteristics and a place for metacognition. Journal of Sport and Health Science. 2015 Mar;4(1):47–55. doi: 10.1016/j.jshs.2014.09.003.
    1. Catellier DJ, Hannan PJ, Murray DM, Addy CL, Conway TL, Yang S, Rice JC. Imputation of missing data when measuring physical activity by accelerometry. Med Sci Sports Exerc. 2005 Nov;37(11 Suppl):S555–62. doi: 10.1249/01.mss.0000185651.59486.4e.
    1. Sirard JR, Pate RR. Physical activity assessment in children and adolescents. Sports Med. 2001;31(6):439–54.
    1. Lubans DR, Hesketh K, Cliff DP, Barnett LM, Salmon J, Dollman J, Morgan PJ, Hills AP, Hardy LL. A systematic review of the validity and reliability of sedentary behaviour measures used with children and adolescents. Obes Rev. 2011 Oct;12(10):781–99. doi: 10.1111/j.1467-789X.2011.00896.x.
    1. Ridgers ND, Fairclough S. Assessing free-living physical activity using accelerometry: Practical issues for researchers and practitioners. European Journal of Sport Science. 2011 May;11(3):205–213. doi: 10.1080/17461391.2010.501116.
    1. Trost SG, McIver KL, Pate RR. Conducting accelerometer-based activity assessments in field-based research. Med Sci Sports Exerc. 2005 Nov;37(11 Suppl):S531–43.
    1. Rowlands A, Powell S, Humphries R, Eston RG. The effect of accelerometer epoch on physical activity output measures. J Exerc Sci Fit. 2006;4(1):52–58.
    1. Ridley K, Ridgers ND, Salmon J. Criterion validity of the activPAL™ and ActiGraph for assessing children's sitting and standing time in a school classroom setting. Int J Behav Nutr Phys Act. 2016 Jul 07;13:75. doi: 10.1186/s12966-016-0402-x.
    1. Adam C, Klissouras V, Ravassolo M. Handbook for the EUROFIT test of Physical Fitness. Rome: Edigraf Editoriale Gráfica; 1988.
    1. Kemper H, Van Mechelen W. Physical fitness testing of children: a European perspective. Pediatr Exerc Sci. 1996;8(3):201–204. doi: 10.1123/pes.8.3.201.
    1. Artero EG, España-Romero V, Castro-Piñero J, Ortega FB, Suni J, Castillo-Garzon MJ, Ruiz JR. Reliability of field-based fitness tests in youth. Int J Sports Med. 2011 Mar;32(3):159–69. doi: 10.1055/s-0030-1268488.
    1. Cadenas-Sánchez C, Alcántara-Moral F, Sánchez-Delgado G, Mora-González J, Martínez-Téllez B, Herrador-Colmenero M, Jiménez-Pavón D, Femia P, Ruiz JR, Ortega FB. Assessment of cardiorespiratory fitness in preschool children: adaptation of the 20 metres shuttle run test. Nutr Hosp. 2014 Dec 01;30(6):1333–43. doi: 10.3305/nh.2014.30.6.7859.
    1. Léger LA, Mercier D, Gadoury C, Lambert J. The multistage 20 metre shuttle run test for aerobic fitness. J Sports Sci. 1988;6(2):93–101. doi: 10.1080/02640418808729800.
    1. Eriksen BA, Eriksen CW. Effects of noise letters upon the identification of a target letter in a nonsearch task. Perception & Psychophysics. 1974 Jan;16(1):143–149. doi: 10.3758/bf03203267.
    1. Have M, Nielsen JH, Gejl AK, Thomsen Ernst M, Fredens K, Støckel JT, Wedderkopp N, Domazet SL, Gudex C, Grøntved A, Kristensen PL. Rationale and design of a randomized controlled trial examining the effect of classroom-based physical activity on math achievement. BMC Public Health. 2016 Apr 11;16:304. doi: 10.1186/s12889-016-2971-7.
    1. Scudder MR, Lambourne K, Drollette ES, Herrmann SD, Washburn RA, Donnelly JE, Hillman CH. Aerobic capacity and cognitive control in elementary school-age children. Med Sci Sports Exerc. 2014;46(5):1025–35. doi: 10.1249/MSS.0000000000000199.
    1. Boyce W, Torsheim T, Currie C, Zambon A. The Family Affluence Scale as a Measure of National Wealth: Validation of an Adolescent Self-Report Measure. Soc Indic Res. 2006 Apr 20;78(3):473–487. doi: 10.1007/s11205-005-1607-6.
    1. Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol. 1986 Dec;51(6):1173–82. doi: 10.1037//0022-3514.51.6.1173.

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