CompletedPsychology & BehaviourPregnancy, Children & Inherited Conditions
Active For Life Year 5: A cluster randomised controlled trial of a primary school-based intervention to increase levels of physical activity, decrease sedentary behaviour and improve diet
Nine- and ten-year-olds in Bristol primary schools will wear accelerometers on their hips for five days so researchers can measure whether a classroom-based healthy lifestyle programme actually changes how much they move, sit, and eat. Childhood obesity and poor diet are linked to long-term health problems, but many school-based interventions have never been rigorously tested with objective measurements. This cluster randomised controlled trial will compare children whose teachers receive training and lesson plans—including homework activities for parents and a healthy activity day—against children whose schools continue as normal. The researchers will track physical activity, sedentary time, diet, and body measurements at the start, after one year, and after two years to see whether any effects last. If the intervention works, it could give schools a practical, evidence-based toolkit to improve children’s health without expensive equipment or major timetable changes. The findings could influence how the Department for Education and public health bodies design future childhood obesity strategies. If it does not work, the study will still show policymakers what does not shift behaviour in this age group, saving money on ineffective programmes.
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Design: School-based cluster randomised controlled trial. Setting: State primary and junior schools with Year 5 children (aged 9-10) in the city of Bristol. Special schools will be excluded. Participants will be Year 5 children in these schools whose parents provide opt-out consent. Children will only have measurements if they provide assent. Target population: UK school children aged 9-10 Intervention: Schools randomised to the intervention (N=30; 750 children) will receive the intervention immediately and those randomised to control (N=30;750) after completion of the 2-year follow-up assessment. The intervention comprises: a) training for classroom teachers; b) provision of 16 lesson-plans and teaching materials, including pictures, CDs and journals; c) provision of 10 parental-child interaction homework activities (see detailed project description); d) information in the school newsletters about the importance of increasing physical activity, reducing sedentary behaviour and improving diet; e) written information for parents on how to encourage their children to eat healthily and be active; f) a healthy activity day at school for parents, teachers and children in the middle of the intervention period. Training for classroom teachers will take place over 1 day (as in the feasibility/pilot studies) and will be provided by the two teacher trainers who provided training for our feasibility/pilot studies, together with input from the applicants and the trial coordinator. At the end of the training the teachers will be provided with lesson plans and all necessary materials for the 16-lessons and 10 homework activities, as well as contact details of the trial coordinator. Measurements of Outcome and Duration of follow-up: All outcomes will be assessed at baseline (prior to starting the intervention); 1 year later (at the end of the intervention) and 2 years later (to assess any long term impact). All three assessments will be conducted at the same time of year and will be completed by two trained fieldworkers. At each stage of assessment the following will be measured on the children: 1. Accelerometer assessment of physical activity and sedentary behaviour We will use an ActiGraph accelerometer and will use the same protocol to that used in our feasibility/pilot work. The accelerometers will be shown to the children and verbal instructions provided in the class room with all children together. Data will be collected on three weekdays and both weekend days. The accelerometer data will be downloaded and analysed using standard protocols to define sedentary, light, moderate and vigorous levels of activity. 2. Weight, height and waist circumference All anthropometric measurements will be completed with each child in a private room. Weight (to the nearest 0.1kg) will be measured without shoes in light clothing on a Seca digital scale. Height will be measured, to the nearest 0.1cm, without shoes using a portable Harpenden stadiometer. Waist circumference will be measured the nearest 1mm at the mid-point between the lower ribs and the pelvic bone with a flexible tape. 3. Questionnaire assessment of diet, physical activity and sedentary behaviour All questionnaires will be combined into one document and administered in the classroom with the two fieldworkers present to answer any queries. Fruit and vegetable consumption and other dietary outcomes will be assessed using the “A Day in the Life Questionnaire” (DILQ), which was used in our feasibility/pilot studies and has been previously validated in children of this age. Fruit and vegetable consumption will be assessed using an established scoring scheme. The DILQ data will also be used to create categories of snacks, high fat food and high energy drink. As in the pilot study allocation of foods written in text to categories will be undertaken independently by two individuals with discrepancies checked by the trial coordinator. An abbreviated and updated version of a previousl
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