Abstract
BackgroundSedentary behaviour (sitting) is a highly prevalent negative health behaviour, with individuals of all ages exposed to environments that promote prolonged sitting. Excessive sedentary behaviour adversely affects health in children and adults. As sedentary behaviour tracks from childhood into adulthood, the reduction of sedentary time in young people is key for the prevention of chronic diseases that result from excessive sitting in later life. The sedentary school classroom represents an ideal setting for environmental change, through the provision of sit-stand desks. Whilst the use of sit-stand desks in classrooms demonstrates positive effects in some key outcomes, evidence is currently limited by small samples and/or short intervention durations, with few studies adopting randomised controlled trial (RCT) designs. This paper describes the protocol of a pilot cluster RCT of a sit-stand desk intervention in primary school classrooms.Methods/DesignA two-arm pilot cluster RCT will be conducted in eight primary schools (four intervention, four control) with at least 120 year 5 children (aged 9–10 years). Sit-stand desks will replace six standard desks in the intervention classrooms. Teachers will be encouraged to ensure all pupils are exposed to the sit-stand desks for at least 1 h/day on average using a rotation system. Schools assigned to the control arm will continue with their usual practice, no environmental changes will be made to their classrooms. Measurements will be taken at baseline, before randomisation, and at the end of the schools’ academic year. In this study, the primary outcomes of interest will be school and participant recruitment and attrition, acceptability of the intervention, and acceptability and compliance to the proposed outcome measures (including activPAL-measured school-time and school-day sitting, accelerometer-measured physical activity, adiposity, blood pressure, cognitive function, academic progress, engagement, and behaviour) for inclusion in a definitive trial. A full process evaluation and an exploratory economic evaluation will also be conducted to further inform a definitive trial.DiscussionThe primary output of this study will be acceptability data to inform the development of a definitive cluster RCT designed to examine the efficacy of this intervention on health- and education-related outcomes in UK primary school children.Trial registrationISRCTN12915848 (retrospectively registered, date registered 9 November 2016).
Highlights
Sedentary behaviour is a highly prevalent negative health behaviour, with individuals of all ages exposed to environments that promote prolonged sitting
Adverse associations between sedentary behaviour and cardio-metabolic health risk markers have been reported in children [7, 8]. Given this and as sedentary behaviours track throughout childhood into adolescence and adulthood [9], the reduction of sitting time in young people is pertinent for the primary and secondary prevention of chronic diseases that result from excessive sitting in adulthood [3, 4]
With the emergence of an increased cardio-metabolic health risk profile being observed in the first decade of life in some ethnic groups in the United Kingdom (UK) [10], may suggest that these individuals could be more vulnerable to the adverse health effects of excessive sitting time
Summary
Sedentary behaviour (sitting) is a highly prevalent negative health behaviour, with individuals of all ages exposed to environments that promote prolonged sitting. Adverse associations between sedentary behaviour and cardio-metabolic health risk markers (obesity, blood pressure, cholesterol, insulin) have been reported in children [7, 8]. Given this and as sedentary behaviours track throughout childhood into adolescence and adulthood [9], the reduction of sitting time in young people is pertinent for the primary and secondary prevention of chronic diseases that result from excessive sitting in adulthood [3, 4]. The early reduction of sedentary behaviour in children in such higher-risk groups could be an important strategy for reducing ethnicity-related health inequalities later in life
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