Abstract
BackgroundDespite growing evidence of deleterious health outcomes associated with sedentary behavior, prolonged static sitting in classrooms remains ubiquitous in primary schools. Sedentary behavior is associated with the development of cardio-metabolic conditions and poor back health. Preventative strategies to reduce sedentary behavior and its negative health effects may be required in a resource-constrained environment such as South Africa.ObjectiveThe primary objective of this study is to assess the feasibility of conducting a full trial to evaluate the effects of a multifaceted intervention comprising novel multifunctional classroom furniture and a video-based curriculum versus usual care on sedentary behavior among students aged 10-11 years in primary schools. The secondary objective is to assess the preliminary effects of the intervention on sedentary behavior and postural dynamism.MethodsEighty grade 5 or 6 students, aged 10 and 11 years, in mixed-gender schools within the Western Cape metropolitan urban area in Cape Town, South Africa are eligible to participate in this pilot cluster stepped-wedge trial design with classroom as the unit of randomization. Data will be collected at the schools. The intervention will comprise multifunctional classroom furniture that allows for sitting and standing as well as a video-based curriculum on sedentary behavior. Usual practice is the absence of the intervention. The primary outcomes assessed will be (1) adherence to the intervention and (2) project pragmatics. The secondary outcomes will be (1) sedentariness measured using activPAL3 microsensors and (2) postural dynamism measured using Noraxon Myomotion inertial measurement units. We randomized the school to the first or second start of the intervention. This is an open-label trial and therefore blinding will not be possible for any group. Descriptive analysis of the feasibility and physiological outcomes will be presented. We will report the preliminary estimates of the effects of the intervention on sedentariness and postural dynamism using the mean difference and 95% CI.ResultsAt the time of submission, two classrooms have been recruited into the study. Baseline physical activity and postural dynamism data have been collected from 10 participants from each class.ConclusionsThe results of this feasibility stepped-wedge cluster randomized controlled trial will be useful in informing the design of the main trial to assess whether this multifaceted intervention of multifunctional classroom furniture that allows for sitting and standing as well as a video-based curriculum versus usual care has any effect on sedentary behavior in low-resource-setting primary schools.Trial RegistrationPan African Trials Registry PACTR201811799476016; https://tinyurl.com/y4upoys8International Registered Report Identifier (IRRID)RR1-10.2196/18522
Highlights
BackgroundA lifestyle of sedentary behavior may result in the development of noncommunicable conditions such as metabolic syndrome [1] and poor back health [2]
At the time of submission, two classrooms have been recruited into the study
Baseline physical activity and postural dynamism data have been collected from 10 participants from each class
Summary
A lifestyle of sedentary behavior may result in the development of noncommunicable conditions such as metabolic syndrome [1] and poor back health [2]. Modifying the design of school furniture to optimize postural alignment and dynamism during sitting and increasing sit-stand transitions may address the potential health risks caused by prolonged sitting in the school environment. There is a paucity of studies regarding the effectiveness of classroom furniture in reducing classroom sedentariness and promoting back health, especially for low-to-middle income countries (LMICs). No back health intervention studies have examined an association with sedentary behavior, despite its recognition as an important risk factor. Despite growing evidence of deleterious health outcomes associated with sedentary behavior, prolonged static sitting in classrooms remains ubiquitous in primary schools.
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