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Randomized Controlled Trial
. 2020 Apr 29;17(1):55.
doi: 10.1186/s12966-020-00958-z.

Stand Out in Class: restructuring the classroom environment to reduce sitting time - findings from a pilot cluster randomised controlled trial

Stacy A Clemes  1   2 , Daniel D Bingham  3 , Natalie Pearson  4 , Yu-Ling Chen  4 , Charlotte L Edwardson  5   6 , Rosemary R C McEachan  3 , Keith Tolfrey  4   5 , Lorraine Cale  4 , Gerry Richardson  7 , Mike Fray  8 , James Altunkaya  7 , Stephan Bandelow  4   9 , Nishal Bhupendra Jaicim  10 , Jo Salmon  11 , David W Dunstan  12   13 , Sally E Barber  3
Affiliations
Randomized Controlled Trial

Stand Out in Class: restructuring the classroom environment to reduce sitting time - findings from a pilot cluster randomised controlled trial

Stacy A Clemes et al. Int J Behav Nutr Phys Act. .

Abstract

Background: Excessive sedentary behaviour (sitting) is a risk factor for poor health in children and adults. Incorporating sit-stand desks in the classroom environment has been highlighted as a potential strategy to reduce children's sitting time. The primary aim of this study was to examine the feasibility of conducting a cluster randomised controlled trial (RCT) of a sit-stand desk intervention within primary school classrooms.

Methods: We conducted a two-armed pilot cluster RCT involving 8 primary schools in Bradford, United Kingdom. Schools were randomised on a 1:1 basis to the intervention or usual practice control arm. All children (aged 9-10 years) in participating classes were eligible to take part. Six sit-stand desks replaced three standard desks (sitting 6 children) in the intervention classrooms for 4.5-months. Teachers were encouraged to use a rotation system to ensure all pupils were exposed to the sit-stand desks for > 1 h/day on average. Trial feasibility outcomes (assessed using quantitative and qualitative measures) included school and participant recruitment and attrition, intervention and outcome measure completion rates, acceptability, and preliminary effectiveness of the intervention for reducing sitting time. A weighted linear regression model compared changes in weekday sitting time (assessed using the activPAL accelerometer) between trial arms.

Results: School and child recruitment rates were 33% (n = 8) and 75% (n = 176). At follow-up, retention rates were 100% for schools and 97% for children. Outcome measure completion rates ranged from 63 to 97%. A preliminary estimate of intervention effectiveness revealed a mean difference in change in sitting of - 30.6 min/day (95% CI: - 56.42 to - 4.84) in favour of the intervention group, after adjusting for baseline sitting and wear time. Qualitative measures revealed the intervention and evaluation procedures were acceptable to teachers and children, except for some problems with activPAL attachment.

Conclusion: This study provides evidence of the acceptability and feasibility of a sit-stand desk intervention and evaluation methods. Preliminary evidence suggests the intervention showed potential in reducing children's weekday sitting but some adaptations to the desk rotation system are needed to maximize exposure. Lessons learnt from this trial will inform the planning of a definitive trial.

Trial registration: ISRCTN12915848 (registered: 09/11/16).

Keywords: Bradford; Children; Health inequalities; Primary/elementary school; Sedentary behaviour; Sit-stand desks; South Asian; Standing desks.

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Conflict of interest statement

The sit-stand desks used in this study were supplied via an in-kind donation from Ergotron Inc., USA. The company played no role in the study design, data collection or data analyses, or in the preparation of this paper. The company have no relevant interests/rights in terms of project outcomes and uses. JS notes that she has a potential conflict of interest as her husband owns a business to manufacture height-adjustable desks for schools. These desks were not used in this research, and she was not involved in the data analysis. The remaining authors declare no other competing interests.

Figures

Fig. 1
Fig. 1
A Logic model for the Stand Out in Class intervention, applicable for a definitive trial
Fig. 2
Fig. 2
A CONSORT Diagram for the Stand Out in Class pilot cluster RCT
See this image and copyright information in PMC

References

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