Abstract
BackgroundChildren and adolescents spend a lot of time sitting at school. Implementing standing desks in the classroom is one potential strategy to reduce and break up sitting time. The first aim was to evaluate the effect of implementing standing desks in classrooms in primary and secondary schools on pupils’ sitting-related behaviour and determinants. The second aim was to quantitatively and qualitatively evaluate the process of implementing the desks in the classroom.MethodsWe conducted a cluster-randomised controlled trial with a pre-, mid-, and post-test design including 10 intervention schools (5 primary, 5 secondary schools) and 9 control schools (5 primary, 4 secondary schools) across Flanders, Belgium. Three standing desks were placed in one class in each intervention school for 6 months. At pre-, mid- and post-test, all pupils (n = 311; 54.5% girls) completed a questionnaire whilst a subsample of three pupils per class wore an activPAL inclinometer for one school week. Focus groups with pupils and interviews with teachers were conducted at mid-test. Process evaluation questions were added to the mid- and post-test questionnaire for the intervention group. Qualitative data were analysed using NVivo 11. Multilevel regression analyses were conducted in MLwiN 2.31.ResultsFew significant intervention effects were observed, although activPAL data showed favourable intervention effects on primary school pupils’ sitting and standing time and bouts. Focus groups and interviews showed a generally positive attitude towards using standing desks in both teachers and pupils, although some barriers and suggestions for future implementation were noted, for example regarding the amount of desks per classroom. Quantitative process evaluation data showed a low individual use of standing desks (between 57 and 83 min per week), which significantly decreased across the school year for primary school pupils only.ConclusionsAlthough pupils and teachers were generally positive about the desks, relatively few intervention effects were found. Future studies should consider how to optimise the use of standing desks in classrooms to impact on sitting time, by for example, determining the most feasible intervention design and by encouraging the continued use of standing desks throughout the school year. Moreover, additional intervention strategies (e.g. educational strategies) might be needed.Trial registrationNCT03163004. ClinicalTrials.gov. Registered 22 May 2017 (retrospectively registered).
Highlights
Children and adolescents spend a lot of time sitting at school
Children and adolescents spend more than 60% of their waking hours sedentary [14,15,16] of which a large amount is accumulated during school hours whilst sitting in class [17, 18]
The participating schools were randomly assigned to the intervention or control group, stratified by educational system and education type by a researcher who was not involved in the recruitment of schools
Summary
Children and adolescents spend a lot of time sitting at school. Implementing standing desks in the classroom is one potential strategy to reduce and break up sitting time. Several studies and reviews have found adverse associations between sedentary behaviour(s) and health in this population, such as unfavourable weight status, reduced physical fitness, and lower self-esteem and school performance [5,6,7,8]. Since sedentary behaviour in early life tracks into adulthood [9, 10] where it can have potential health implications such as an increased risk of developing type 2 diabetes and metabolic risk factors [6, 11,12,13], effective strategies are needed to reduce the time that children and adolescents spend in sedentary behaviours. The classroom is an important setting for implementing specific strategies to reduce sedentary behaviour in this target group [19]
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