Transform-Us! cluster RCT: 18-month and 30-month effects on children's physical activity, sedentary time and cardiometabolic risk markers

doi:10.1136/bjsports-2022-105825

Randomized Controlled Trial

. 2023 Mar;57(5):311-319.

doi: 10.1136/bjsports-2022-105825. Epub 2022 Nov 25.

Transform-Us! cluster RCT: 18-month and 30-month effects on children's physical activity, sedentary time and cardiometabolic risk markers

Jo Salmon¹, Lauren Arundell², Ester Cerin³, Nicola Dawn Ridgers⁴, Kylie D Hesketh², Robin M Daly², David Dunstan^{2

5}, Helen Brown⁶, Jacqui Della Gatta⁷, Paul Della Gatta², Mai J M Chinapaw⁸, Lauren Shepphard⁹, Marj Moodie¹⁰, Clare Hume¹¹, Vicki Brown¹⁰, Kylie Ball², David Crawford²

Affiliations

¹ School of Exercise and Nutrition Sciences, Deakin University Institute for Physical Activity and Nutrition, Geelong, Victoria, Australia jo.salmon@deakin.edu.au.
² School of Exercise and Nutrition Sciences, Deakin University Institute for Physical Activity and Nutrition, Geelong, Victoria, Australia.
³ Institute for Health and Ageing, Australian Catholic University Faculty of Health Sciences, Melbourne, Victoria, Australia.
⁴ Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia.
⁵ Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia.
⁶ School of Exercise and Nutrition Sciences, Deakin University Centre for Sport Research, Geelong, Victoria, Australia.
⁷ School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia.
⁸ Department of Public and Occupational Health, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
⁹ Institute for Health Transformation, Deakin University Faculty of Health, Burwood, Victoria, Australia.
¹⁰ Deakin Health Economics, Deakin University, Geelong, Victoria, Australia.
¹¹ School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia.

PMID: 36428089
PMCID: PMC9985722
DOI: 10.1136/bjsports-2022-105825

Randomized Controlled Trial

Transform-Us! cluster RCT: 18-month and 30-month effects on children's physical activity, sedentary time and cardiometabolic risk markers

Jo Salmon et al. Br J Sports Med. 2023 Mar.

. 2023 Mar;57(5):311-319.

doi: 10.1136/bjsports-2022-105825. Epub 2022 Nov 25.

Authors

Affiliations

¹ School of Exercise and Nutrition Sciences, Deakin University Institute for Physical Activity and Nutrition, Geelong, Victoria, Australia jo.salmon@deakin.edu.au.
² School of Exercise and Nutrition Sciences, Deakin University Institute for Physical Activity and Nutrition, Geelong, Victoria, Australia.
³ Institute for Health and Ageing, Australian Catholic University Faculty of Health Sciences, Melbourne, Victoria, Australia.
⁴ Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia.
⁵ Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia.
⁶ School of Exercise and Nutrition Sciences, Deakin University Centre for Sport Research, Geelong, Victoria, Australia.
⁷ School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia.
⁸ Department of Public and Occupational Health, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
⁹ Institute for Health Transformation, Deakin University Faculty of Health, Burwood, Victoria, Australia.
¹⁰ Deakin Health Economics, Deakin University, Geelong, Victoria, Australia.
¹¹ School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia.

PMID: 36428089
PMCID: PMC9985722
DOI: 10.1136/bjsports-2022-105825

Abstract

Objective: To test the efficacy of the Transform-Us! school- and home-based intervention on children's physical activity (PA), sedentary behaviour (SB) and cardiometabolic risk factor profiles.

Methods: A 30-month 2×2 factorial design cluster randomised controlled trial delivered in 20 primary schools (148 Year 3 classes) in Melbourne, Australia (2010-2012), that used pedagogical and environmental strategies to reduce and break up SB, promote PA or a combined approach, compared with usual practice. Primary outcomes (accelerometry data; n=348) were assessed at baseline, 18 and 30 months. Secondary outcomes included body mass index (BMI) and waist circumference (WC) (n=564), blood pressure (BP) (n=537) and biomarkers (minimum n=206). Generalised linear mixed models estimated the interactive effects of the PA and SB interventions on the outcomes. If there was no interaction, the main effects were assessed.

Results: At 18 months, there were intervention effects on children's weekday SB (-27 min, 95% CI: -47.3 to -5.3) for the PA intervention, and on children's average day PA (5.5 min, 95% CI: 0.1 to 10.8) for the SB intervention. At 30 months, there was an intervention effect for children's average day SB (-33.3 min, 95% CI: -50.6 and -16.0) for the SB intervention. Children's BMI (PA and SB groups) and systolic BP (combined group) were lower, and diastolic BP (PA group) was higher. There were positive effects on WC at both time points (SB intervention) and mixed effects on blood parameters.

Conclusions: The Transform-Us! PA and SB interventions show promise as a pragmatic approach for reducing children's SB and adiposity indicators; but achieving substantial increases in PA remains challenging.

Trial registration: ISRCTN83725066; ACTRN12609000715279.

Keywords: Child Health; Physical activity; Schools; Sedentary Behavior.

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Conflict of interest statement

Competing interests: None declared.

Figures

**Figure 1**
Flowchart showing participant recruitment and drop-out for primary outcomes. SES, socioeconomic status.

See this image and copyright information in PMC

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Koorts H, Timperio A, Abbott G, Arundell L, Ridgers ND, Cerin E, Brown H, Daly RM, Dunstan DW, Hume C, Chinapaw MJM, Moodie M, Hesketh KD, Salmon J. Koorts H, et al. Int J Behav Nutr Phys Act. 2022 Sep 17;19(1):122. doi: 10.1186/s12966-022-01354-5. Int J Behav Nutr Phys Act. 2022. PMID: 36115963 Free PMC article.
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References

1. Janssen I, Leblanc AG. Systematic review of the health benefits of physical activity and fitness in school-aged children and youth. Int J Behav Nutr Phys Act 2010;7:40. 10.1186/1479-5868-7-40 - DOI - PMC - PubMed
1. Aubert S, Barnes JD, Abdeta C, et al. . Global matrix 3.0 physical activity report card grades for children and youth: results and analysis from 49 countries. J Phys Act Health 2018;15:S251–73. 10.1123/jpah.2018-0472 - DOI - PubMed
1. Tremblay MS, Carson V, Chaput J-P, et al. . Canadian 24-hour movement guidelines for children and youth: an integration of physical activity, sedentary behaviour, and sleep. Appl Physiol Nutr Metab 2016;41:S311–27. 10.1139/apnm-2016-0151 - DOI - PubMed
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1. Biddle SJH, Pearson N, Salmon J. Sedentary behaviors and adiposity in young people: causality and conceptual model. Exerc Sport Sci Rev 2018;46:18–25. 10.1249/JES.0000000000000135 - DOI - PubMed

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[1] Janssen I, Leblanc AG. Systematic review of the health benefits of physical activity and fitness in school-aged children and youth. Int J Behav Nutr Phys Act 2010;7:40. 10.1186/1479-5868-7-40 - DOI - PMC - PubMed

[2] Janssen I, Leblanc AG. Systematic review of the health benefits of physical activity and fitness in school-aged children and youth. Int J Behav Nutr Phys Act 2010;7:40. 10.1186/1479-5868-7-40 - DOI - PMC - PubMed

[3] Aubert S, Barnes JD, Abdeta C, et al. . Global matrix 3.0 physical activity report card grades for children and youth: results and analysis from 49 countries. J Phys Act Health 2018;15:S251–73. 10.1123/jpah.2018-0472 - DOI - PubMed

[4] Aubert S, Barnes JD, Abdeta C, et al. . Global matrix 3.0 physical activity report card grades for children and youth: results and analysis from 49 countries. J Phys Act Health 2018;15:S251–73. 10.1123/jpah.2018-0472 - DOI - PubMed

[5] Tremblay MS, Carson V, Chaput J-P, et al. . Canadian 24-hour movement guidelines for children and youth: an integration of physical activity, sedentary behaviour, and sleep. Appl Physiol Nutr Metab 2016;41:S311–27. 10.1139/apnm-2016-0151 - DOI - PubMed

[6] Tremblay MS, Carson V, Chaput J-P, et al. . Canadian 24-hour movement guidelines for children and youth: an integration of physical activity, sedentary behaviour, and sleep. Appl Physiol Nutr Metab 2016;41:S311–27. 10.1139/apnm-2016-0151 - DOI - PubMed

[7] Australian Department of Health . Australian 24-hour movement guidelines for children and young people (5 to 17 years): an integration of physical activity, sedentary behaviour, and sleep Canberra: AGPS; 2019. [Accessed 12 July 2020].

[8] Australian Department of Health . Australian 24-hour movement guidelines for children and young people (5 to 17 years): an integration of physical activity, sedentary behaviour, and sleep Canberra: AGPS; 2019. [Accessed 12 July 2020].

[9] Biddle SJH, Pearson N, Salmon J. Sedentary behaviors and adiposity in young people: causality and conceptual model. Exerc Sport Sci Rev 2018;46:18–25. 10.1249/JES.0000000000000135 - DOI - PubMed

[10] Biddle SJH, Pearson N, Salmon J. Sedentary behaviors and adiposity in young people: causality and conceptual model. Exerc Sport Sci Rev 2018;46:18–25. 10.1249/JES.0000000000000135 - DOI - PubMed

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Transform-Us! cluster RCT: 18-month and 30-month effects on children's physical activity, sedentary time and cardiometabolic risk markers

Affiliations

Transform-Us! cluster RCT: 18-month and 30-month effects on children's physical activity, sedentary time and cardiometabolic risk markers

Authors

Affiliations

Abstract

Conflict of interest statement

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