TY - JOUR
T1 - Effect of a scalable school-based intervention on cardiorespiratory fitness in children : a cluster randomized clinical trial
AU - Lonsdale, Chris
AU - Sanders, Taren
AU - Parker, Philip
AU - Noetel, Michael
AU - Hartwig, Timothy
AU - Vasconcellos, Diego
AU - Lee, Jane
AU - Antczak, Devan
AU - Kirwan, Morwenna
AU - Morgan, Philip
AU - Salmon, Jo
AU - Moodie, Marj
AU - McKay, Heather
AU - Bennie, Andrew
AU - Plotnikoff, Ronald C.
AU - Cinelli, Renata
AU - Greene, David
AU - Peralta, Louisa
AU - Cliff, Dylan
AU - Kolt, Gregory
AU - Gore, Jennifer
AU - Gao, Lan
AU - Boyer, James
AU - Morrison, Ross
AU - Hillman, Charles
AU - Shigeta, Tatsuya T.
AU - Tan, Elise
AU - Lubans, David R.
PY - 2021
Y1 - 2021
N2 - IMPORTANCE: Cardiorespiratory fitness is an important marker of childhood health and low fitness levels are a risk factor for disease later in life. Levels of children's fitness have declined in recent decades. Whether school-based physical activity interventions can increase fitness at the population level remains unclear. OBJECTIVE: To evaluate the effect of an internet-based intervention on children’s cardiorespiratory fitness across a large number of schools. DESIGN, SETTING, AND PARTICIPANTS: In this cluster randomized clinical trial, 22 government-funded elementary schools (from 137 providing consent) including 1188 students stratified from grades 3 and 4 in New South Wales, Australia, were randomized. The other schools received the intervention but were not included in the analysis. Eleven schools received the internet-based intervention and 11 received the control intervention. Recruitment and baseline testing began in 2016 and ended in 2017. Research assistants, blinded to treatment allocation, completed follow-up outcome assessments at 12 and 24 months. Data were analyzed from July to August 2020. INTERVENTIONS: The internet-based intervention included standardized online learning for teachers and minimal in-person support from a project mentor (9-10 months). MAIN OUTCOMES AND MEASURES: Multistage 20-m shuttle run test for cardiorespiratory fitness. RESULTS: Of 1219 participants (49% girls; mean [SD] age, 8.85 [0.71] years) from 22 schools, 1188 students provided baseline primary outcome data. At 12 months, the number of 20-m shuttle runs increased by 3.32 laps (95% CI, 2.44-4.20 laps) in the intervention schools and 2.11 laps (95% CI, 1.38-2.85 laps) in the control schools (adjusted difference = 1.20 laps; 95% CI, 0.17-2.24 laps). By 24 months, the adjusted difference was 2.22 laps (95% CI, 0.89-3.55 laps). The cost per student was AUD33 (USD26). CONCLUSIONS AND RELEVANCE: In this study, a school-based intervention improved children's cardiorespiratory fitness when delivered in a large number of schools. The low cost and sustained effect over 24 months of the intervention suggests that it may have potential to be scaled at the population level.
AB - IMPORTANCE: Cardiorespiratory fitness is an important marker of childhood health and low fitness levels are a risk factor for disease later in life. Levels of children's fitness have declined in recent decades. Whether school-based physical activity interventions can increase fitness at the population level remains unclear. OBJECTIVE: To evaluate the effect of an internet-based intervention on children’s cardiorespiratory fitness across a large number of schools. DESIGN, SETTING, AND PARTICIPANTS: In this cluster randomized clinical trial, 22 government-funded elementary schools (from 137 providing consent) including 1188 students stratified from grades 3 and 4 in New South Wales, Australia, were randomized. The other schools received the intervention but were not included in the analysis. Eleven schools received the internet-based intervention and 11 received the control intervention. Recruitment and baseline testing began in 2016 and ended in 2017. Research assistants, blinded to treatment allocation, completed follow-up outcome assessments at 12 and 24 months. Data were analyzed from July to August 2020. INTERVENTIONS: The internet-based intervention included standardized online learning for teachers and minimal in-person support from a project mentor (9-10 months). MAIN OUTCOMES AND MEASURES: Multistage 20-m shuttle run test for cardiorespiratory fitness. RESULTS: Of 1219 participants (49% girls; mean [SD] age, 8.85 [0.71] years) from 22 schools, 1188 students provided baseline primary outcome data. At 12 months, the number of 20-m shuttle runs increased by 3.32 laps (95% CI, 2.44-4.20 laps) in the intervention schools and 2.11 laps (95% CI, 1.38-2.85 laps) in the control schools (adjusted difference = 1.20 laps; 95% CI, 0.17-2.24 laps). By 24 months, the adjusted difference was 2.22 laps (95% CI, 0.89-3.55 laps). The cost per student was AUD33 (USD26). CONCLUSIONS AND RELEVANCE: In this study, a school-based intervention improved children's cardiorespiratory fitness when delivered in a large number of schools. The low cost and sustained effect over 24 months of the intervention suggests that it may have potential to be scaled at the population level.
UR - http://hdl.handle.net/1959.7/uws:59919
U2 - 10.1001/jamapediatrics.2021.0417
DO - 10.1001/jamapediatrics.2021.0417
M3 - Article
SN - 2168-6203
VL - 175
SP - 680
EP - 688
JO - JAMA Pediatrics
JF - JAMA Pediatrics
IS - 7
ER -