Randomized Controlled Trial

. 2021 Jul 1;175(7):680-688.

doi: 10.1001/jamapediatrics.2021.0417.

Effect of a Scalable School-Based Intervention on Cardiorespiratory Fitness in Children: A Cluster Randomized Clinical Trial

Chris Lonsdale¹, Taren Sanders¹, Philip Parker¹, Michael Noetel², Timothy Hartwig³, Diego Vasconcellos¹, Jane Lee¹, Devan Antczak¹, Morwenna Kirwan⁴, Philip Morgan⁵, Jo Salmon⁶, Marj Moodie⁷, Heather McKay⁸, Andrew Bennie⁹, Ronald C Plotnikoff⁵, Renata Cinelli¹⁰, David Greene³, Louisa Peralta¹¹, Dylan Cliff¹², Gregory Kolt⁹, Jennifer Gore¹³, Lan Gao¹⁴, James Boyer¹⁵, Ross Morrison¹⁵, Charles Hillman¹⁶, Tatsuya T Shigeta¹⁶, Elise Tan⁷, David R Lubans⁵

Affiliations

¹ Institute for Positive Psychology and Education, Australian Catholic University, North Sydney, New South Wales, Australia.
² School of Behavioural and Health Sciences, Australian Catholic University, Banyo, Queensland, Australia.
³ School of Behavioural and Health Sciences, Australian Catholic University, Strathfield, New South Wales, Australia.
⁴ Faculty of Medicine and Health Sciences, Macquarie University, Macquarie Park, New South Wales, Australia.
⁵ Priority Research Centre for Physical Activity and Nutrition, Callaghan, University of Newcastle, New South Wales, Australia.
⁶ Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria, Australia.
⁷ Global Obesity Centre, Deakin University, Burwood, Victoria, Australia.
⁸ Centre for Hip Health and Mobility, University of British Columbia, Vancouver, British Columbia, Canada.
⁹ School of Health Sciences, Western Sydney University, Penrith, New South Wales, Australia.
¹⁰ National School of Education, Australian Catholic University, Strathfield, New South Wales, Australia.
¹¹ School of Education and Social Work, Sydney University, Camperdown, New South Wales, Australia.
¹² School of Education, University of Wollongong, Wollongong, New South Wales, Australia.
¹³ School of Education, University of Newcastle, Callaghan, New South Wales, Australia.
¹⁴ School of Health and Social Development, Deakin University, Burwood, Victoria, Australia.
¹⁵ New South Wales Department of Education, Turrella, New South Wales, Australia.
¹⁶ Bouve College of Health Sciences, Northeastern University, Boston, Massachusetts.

PMID: 33938946
PMCID: PMC8094033
DOI: 10.1001/jamapediatrics.2021.0417

Randomized Controlled Trial

Effect of a Scalable School-Based Intervention on Cardiorespiratory Fitness in Children: A Cluster Randomized Clinical Trial

Chris Lonsdale et al. JAMA Pediatr. 2021.

. 2021 Jul 1;175(7):680-688.

doi: 10.1001/jamapediatrics.2021.0417.

Authors

Affiliations

¹ Institute for Positive Psychology and Education, Australian Catholic University, North Sydney, New South Wales, Australia.
² School of Behavioural and Health Sciences, Australian Catholic University, Banyo, Queensland, Australia.
³ School of Behavioural and Health Sciences, Australian Catholic University, Strathfield, New South Wales, Australia.
⁴ Faculty of Medicine and Health Sciences, Macquarie University, Macquarie Park, New South Wales, Australia.
⁵ Priority Research Centre for Physical Activity and Nutrition, Callaghan, University of Newcastle, New South Wales, Australia.
⁶ Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria, Australia.
⁷ Global Obesity Centre, Deakin University, Burwood, Victoria, Australia.
⁸ Centre for Hip Health and Mobility, University of British Columbia, Vancouver, British Columbia, Canada.
⁹ School of Health Sciences, Western Sydney University, Penrith, New South Wales, Australia.
¹⁰ National School of Education, Australian Catholic University, Strathfield, New South Wales, Australia.
¹¹ School of Education and Social Work, Sydney University, Camperdown, New South Wales, Australia.
¹² School of Education, University of Wollongong, Wollongong, New South Wales, Australia.
¹³ School of Education, University of Newcastle, Callaghan, New South Wales, Australia.
¹⁴ School of Health and Social Development, Deakin University, Burwood, Victoria, Australia.
¹⁵ New South Wales Department of Education, Turrella, New South Wales, Australia.
¹⁶ Bouve College of Health Sciences, Northeastern University, Boston, Massachusetts.

PMID: 33938946
PMCID: PMC8094033
DOI: 10.1001/jamapediatrics.2021.0417

Abstract

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.

Trial registration: http://anzctr.org.au Identifier: ACTRN12616000731493.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Lonsdale reported receiving grants from the Department of Health, Australian Government/National Health and Medical Research Council (NHMRC) and grants from the New South Wales (NSW) Department of Education during the conduct of the study. Dr Sanders reported receiving grants from the NSW Department of Education and grants from the National Health and Medical Research Council during the conduct of the study; grants from the NSW Department of Education and grants from Sport Australia outside the submitted work. Dr Parker reported receiving grants from the Department of Health, Australian Government/NHMRC and grants from the NSW Department of Education during the conduct of the study. Dr Noetel reported receiving grants from the Department of Health, Australian Government | NHMRC (grant APP1114281) and grants from the NSW Department of Education during the conduct of the study; and grants from Sport Australia outside the submitted work. Dr Hartwig reported receiving grants from the Department of Health, Australian Government/NHMRC and grants from NSW Department of Education grants during the conduct of the study. Dr Vasconcellos reported receiving grants from the Department of Health, Australian Government/NHMRC and grants from NSW Department of Education during the conduct of the study. Dr Lee reported receiving grants from the Department of Health, Australian Government/National Health and NHMRC and grants from NSW Department of Education during the conduct of the study. Dr Antczak reported receiving grants from the Department of Health, Australian Government/NHMRC and grants from NSW Department of Education during the conduct of the study. Dr Morgan reported receiving grants from the NHMRC Partnership Grant funding (2016 - 2021) (grant APP1114281) during the conduct of the study. Dr Salmon reported receiving grants from the National Health & Medical Research Council funding outside the submitted work. Dr Moodie reported receiving grants from the Department of Health, Australian Government, NHMRC during the conduct of the study. Dr Plotnikoff reported receiving grants from the National Health & Medical Research Council of Australia during the conduct of the study. Dr Cinelli reported receiving grants from the Department of Health, Australian Government/NHMRC and grants from NSW Department of Education during the conduct of the study. Dr Greene reported receiving grants from the Department of Health, Australian Government/NHMRC and grants from NSW Department of Education during the conduct of the study. Dr Gore reported receiving grants from NHMRC during the conduct of the study. Dr Gao reported receiving grants from the Department of Health, Australian Government/NHMRC during the conduct of the study. Dr Boyer reported being a staff member at the NSW Department of Education (ie, one of the funders) Dr Morrison reported being Manager, School Sport Unit, at the NSW Department of Education (ie, one of the funders). Dr Tan reported receiving grants from the NHMRC during the conduct of the study. Dr Lubans reported receiving grants from NHMRC and funding from the NSW Department of Education during the conduct of the study. No other disclosures were reported.

Figures

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References

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Effect of a Scalable School-Based Intervention on Cardiorespiratory Fitness in Children: A Cluster Randomized Clinical Trial

Affiliations

Effect of a Scalable School-Based Intervention on Cardiorespiratory Fitness in Children: A Cluster Randomized Clinical Trial

Authors

Affiliations

Abstract

Conflict of interest statement

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References

Publication types

MeSH terms

Associated data

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical