Abstract
Classroom-based physical activity (PA) interventions offer the opportunity to increase PA without disrupting the curriculum. We aimed to explore the feasibility and potential effectiveness of a classroom-based intervention on moderate to vigorous PA (MVPA) and total PA. The secondary aim was to assess the acceptability and sustainability of the intervention. In a mixed-methods, non-randomised, exploratory controlled before-and-after study, 152 children (10 ± 0.7 years) were recruited from five schools; two intervention (n = 72) and three control (n = 80) schools. School teachers delivered an 8-week classroom-based intervention, comprising of 10 minutes daily MVPA integrated into the curriculum. The control schools maintained their usual school routine. Mean daily MVPA (min), total PA (mean cpm), physical fitness, and health-related quality of life measurements were taken at baseline, end of intervention, and 4-weeks post-intervention (follow-up). Data were analysed using a constrained baseline longitudinal analysis model accounting for the hierarchical data structure. For the primary outcomes (MVPA and total PA) the posterior mean difference and 95% compatibility interval were derived using a semi-Bayesian approach with an explicit prior. The acceptability and sustainability of the intervention was explored via thematic content analysis of focus group discussions with teachers (n = 5) and children (n = 50). The difference in mean daily MVPA (intervention-control) was 2.8 (-12.5 to 18.0) min/day at 8 weeks and 7.0 (-8.8 to 22.8) min/day at follow-up. For total PA, the differences were -2 (-127 to 124) cpm at 8-weeks and 11 (-121 to 143) cpm at follow-up. The interval estimates indicate that meaningful mean effects (both positive and negative) as well as trivial effects are reasonably compatible with the data and design. The intervention was received positively with continuation reported by the teachers and children. Classroom-based PA could hold promise for increasing average daily MVPA, but a large cluster randomised controlled trial is required.
Highlights
The benefits of physical activity (PA) to children’s health are well established
The school setting is an obvious choice for implementation of health promotion initiatives, including PA, due to children spending most of their waking weekday hours at school [2]
Schools are under academic performance pressure, which often results in a reduction of Physical Education time and PA opportunities to allow time to meet the academic objectives [11]
Summary
The benefits of physical activity (PA) to children’s health are well established. in England only 23% of boys and 20% of girls meets the UK Chief Medical Officers’ recommendation of at least 60 min of at least moderate intensity physical activity per day [1], showing the need to explore different strategies to increase daily PA in children. Designing school-based PA interventions can be challenging, as the intervention should be incorporated into the school environment effectively and be easy to deliver and maintain by the school Factors such as time (competing requirements, teacher overload), resource availability, and supportive school climate might affect implementation [2]. These studies found that curriculum-based activities may promote PA [13, 14, 15, 16], increase time on task [13, 14], and might improve academic performance [18] in schoolchildren These studies were implemented in the US and Ireland and none to our knowledge were delivered in the UK. There are no studies reporting children’s views on classroom-based interventions
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