Abstract
BackgroundPhysical inactivity is recognised as a public health concern within children and interventions to increase physical activity are needed. GreatFun2Run was a school-based healthy lifestyles intervention that showed positive changes in physical activity levels and body composition immediately post-intervention. The purpose of this paper was to examine whether these changes in physical activity and body composition were maintained 18-20 months after the intervention ended.MethodParticipants (n = 589, aged 7-11 yrs) from 4 intervention and 4 control schools took part in the 10-month intervention, of which 421 (71%) were present for follow-up. The intervention comprised a CD-rom learning and teaching resource for teachers; an interactive website for pupils, teachers and parents; two highlight physical activity events (1 mile school runs/walks); a local media campaign; and a summer activity wall planner and record. Randomisation was not possible because of local media content. Outcome measures were objectively measured physical activity (pedometers and accelerometers) and body composition variables (body mass index, waist circumference, estimated percent body fat, and sum of skinfolds). Teacher interviews and participant focus groups were conducted. Multi-level modelling was employed for the data analysis.ResultsBoth control and intervention participants had increased their physical activity at follow-up but there was no group by time interaction (control: 2726 steps per day increase; intervention 3404 steps per day increase, p > .05). There were significant increases in estimated percent body fat, sum of skinfolds, waist circumference and body mass index (BMI) with increasing age. In the control group, there was evidence for a plateauing in the rate of change in all body composition variables with increasing age, except BMI. In contrast, significant interaction terms suggest that the rate of change in waist circumference, BMI and BMISDS continued to increase with age in the intervention group. Teacher interviews suggested that because of time pressures, competing resources, curriculum demands and staff changes the majority of teachers had not continued to use the resources.ConclusionsWhile the intervention initially produced positive changes in physical activity levels and body composition, these changes were not sustained once the intervention ended. Facilitating long-term health behaviour change in children remains a challenge.
Highlights
Physical inactivity is recognised as a public health concern within children and interventions to increase physical activity are needed
Both control and intervention participants had increased their physical activity at follow-up but there was no group by time interaction
Significant interaction terms suggest that the rate of change in waist circumference, body mass index (BMI) and BMISDS continued to increase with age in the intervention group
Summary
Physical inactivity is recognised as a public health concern within children and interventions to increase physical activity are needed. At three year follow-up, when participants were in grade 8 (age ~13 years), significant differences favouring the intervention participants remained for both diet and physical activity variables, the size of the differences had attenuated [5] Both these studies took a similar intervention approach, delivering non-competitive forms of exercise during physical education classes, delivering classroom based health lessons, and encouraging parental involvement. Both these studies had positive short- and long-term intervention effects because of cultural and educational differences between countries questions have been raised about the appropriateness of taking interventions from one country and implementing them in another [7,8]
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