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Abstract
BackgroundExcessive sedentary behaviour (sitting) is a risk factor for poor health in children and adults. Incorporating sit-stand desks in the classroom environment has been highlighted as a potential strategy to reduce children’s sitting time. The primary aim of this study was to examine the feasibility of conducting a cluster randomised controlled trial (RCT) of a sit-stand desk intervention within primary school classrooms.MethodsWe conducted a two-armed pilot cluster RCT involving 8 primary schools in Bradford, United Kingdom. Schools were randomised on a 1:1 basis to the intervention or usual practice control arm. All children (aged 9–10 years) in participating classes were eligible to take part. Six sit-stand desks replaced three standard desks (sitting 6 children) in the intervention classrooms for 4.5-months. Teachers were encouraged to use a rotation system to ensure all pupils were exposed to the sit-stand desks for > 1 h/day on average. Trial feasibility outcomes (assessed using quantitative and qualitative measures) included school and participant recruitment and attrition, intervention and outcome measure completion rates, acceptability, and preliminary effectiveness of the intervention for reducing sitting time. A weighted linear regression model compared changes in weekday sitting time (assessed using the activPAL accelerometer) between trial arms.ResultsSchool and child recruitment rates were 33% (n = 8) and 75% (n = 176). At follow-up, retention rates were 100% for schools and 97% for children. Outcome measure completion rates ranged from 63 to 97%. A preliminary estimate of intervention effectiveness revealed a mean difference in change in sitting of − 30.6 min/day (95% CI: − 56.42 to − 4.84) in favour of the intervention group, after adjusting for baseline sitting and wear time. Qualitative measures revealed the intervention and evaluation procedures were acceptable to teachers and children, except for some problems with activPAL attachment.ConclusionThis study provides evidence of the acceptability and feasibility of a sit-stand desk intervention and evaluation methods. Preliminary evidence suggests the intervention showed potential in reducing children’s weekday sitting but some adaptations to the desk rotation system are needed to maximize exposure. Lessons learnt from this trial will inform the planning of a definitive trial.Trial registrationISRCTN12915848 (registered: 09/11/16).
Highlights
Excessive sedentary behaviour is a risk factor for poor health in children and adults
We have previously demonstrated the feasibility of incorporating sit-stand desks in the classroom environment over a 9-week period in a small non-randomised controlled study conducted within one United Kingdom (UK) primary school with children aged 9–10 years [33]
Data from the 2016– 2017 school census [56] show that the proportion of children eligible for free school meals was similar across the recruited schools and the declined schools, with these values being higher than the national average of 14.8% in 2016–2017
Summary
Excessive sedentary behaviour (sitting) is a risk factor for poor health in children and adults. Incorporating sit-stand desks in the classroom environment has been highlighted as a potential strategy to reduce children’s sitting time. Sedentary time is associated with an increased risk of a number of chronic conditions in adults, including cardiovascular disease, type 2 diabetes and all-cause mortality [4,5,6,7]. Whilst evidence of the associations of sedentary time with increased risk of adiposity/weight gain and clustered cardiometabolic risk in children is largely restricted to screen time [8], sedentary behaviours have been shown to increase across key transitions in children’s lives (e.g. from primary to secondary school) [9] and track into both adolescence [10] and adulthood [11]. Reducing children’s sitting time may be important for the primary prevention of chronic diseases in adulthood [12]
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