Elementary School-based Intervention Research Articles

Impact of a Georgia elementary school-based intervention on physical activity opportunities: A quasi-experimental study

ObjectivesTo assess the impact of Power Up for 30, a flexible, Comprehensive School Physical Activity Program-based state-wide elementary school initiative, on school physical activity opportunities (physical education, recess, in-class physical activity, before-school physical activity, and after-school physical activity) one year after Power Up for 30 training. DesignQuasi-experimental. MethodsIn 2013, all 1333 public Georgia elementary schools were invited to complete the School Physical Activity Survey which assessed school physical activity opportunities. Upon survey completion, schools were invited to attend training. Of the 719 (54%) schools meeting survey response criteria, 300 schools attended training by 9/2014 and 419 schools did not. Between 3/2015–5/2015, 79 trained and 80 untrained schools were randomly selected to receive a follow-up survey assessing the frequency and duration of physical activity opportunities. Analyses, adjusted for baseline physical activity opportunities and school characteristics, compared weekly minutes of physical activity opportunities at follow-up between trained and untrained schools. ResultsIn adjusted analyses at follow-up, trained schools provided 36 more minutes of weekly physical activity opportunities than untrained schools (99% confidence interval: 16–56), particularly during recess (mean difference: 8min per week; 99% confidence interval: 0–17), during in-class breaks (mean difference: 11min per week, 99% confidence interval: 3–20), and before school (mean difference: 8min per week, 99% confidence interval: 4–12). ConclusionsFlexible, multi-component interventions like Power Up for 30 increase physical activity opportunities. If future studies identify that school physical activity opportunities positively impact student physical activity, this model may be a feasible strategy for broad-scale implementation.

Polygenic Score × Intervention Moderation: an Application of Discrete-Time Survival Analysis to Model the Timing of First Marijuana Use Among Urban Youth.

The present study examines the interaction between a polygenic score and an elementary school-based universal preventive intervention trial and its effects on a discrete-time survival analysis of time to first smoking marijuana. Research has suggested that initiation of substances is both genetically and environmentally driven (Rhee et al., Archives of general psychiatry 60:1256-1264, 2003; Verweij et al., Addiction 105:417-430, 2010). A previous work has found a significant interaction between the polygenic score and the same elementary school-based intervention with tobacco smoking (Musci et al., in press). The polygenic score reflects the contribution of multiple genes and has been shown in prior research to be predictive of smoking cessation, tobacco use, and marijuana use (Uhl et al., Molecular Psychiatry 19:50-54, 2014). Using data from a longitudinal preventive intervention study (N = 678), we examined age of first marijuana use from sixth grade to age 18. Genetic data were collected during emerging adulthood and were genotyped using the Affymetrix 6.0 microarray (N = 545). The polygenic score was computed using these data. Discrete-time survival analysis was employed to test for intervention main and interaction effects with the polygenic score. We found main effect of the polygenic score approaching significance, with the participants with higher polygenic scores reporting their first smoking marijuana at an age significantly later than controls (p = .050). We also found a significant intervention × polygenic score interaction effect at p = .003, with participants at the higher end of the polygenic score benefiting the most from the intervention in terms of delayed age of first use. These results suggest that genetics may play an important role in the age of first use of marijuana and that differences in genetics may account for the differential effectiveness of classroom-based interventions in delaying substance use experimentation.

Bounce back: Effectiveness of an elementary school-based intervention for multicultural children exposed to traumatic events.

To evaluate the feasibility and acceptability of a school-based intervention for diverse children exposed to a range of traumatic events, and to examine its effectiveness in improving symptoms of posttraumatic stress, depression, and anxiety. Participants were 74 schoolchildren (Grades 1-5) and their primary caregivers. All participating students endorsed clinically significant posttraumatic stress symptoms. School clinicians were trained to deliver Bounce Back, a 10-session cognitive-behavioral group intervention. Children were randomized to immediate or delayed (3-month waitlist) intervention. Parent- and child-report of posttraumatic stress and depression, and child report of anxiety symptoms, were assessed at baseline, 3 months, and 6 months. Bounce Back was implemented with excellent clinician fidelity. Compared with children in the delayed condition, children who received Bounce Back immediately demonstrated significantly greater improvements in parent- and child-reported posttraumatic stress and child-reported anxiety symptoms over the 3-month intervention. Upon receipt of the intervention, the delayed intervention group demonstrated significant improvements in parent- and child-reported posttraumatic stress, depression, and anxiety symptoms. The immediate treatment group maintained or showed continued gains in all symptom domains over the 3-month follow-up period (6-month assessment). Findings support the feasibility, acceptability, and effectiveness of the Bounce Back intervention as delivered by school-based clinicians for children with traumatic stress. Implications are discussed.

Effectiveness of a school-based programme to prevent obesity

Abstract Introduction Intervention for childhood obesity is a public health priority. The purpose of this study was to evaluate the effectiveness of an elementary school-based intervention against obesity in children. Materials and methods Non-randomised controlled trial was conducted on children from first to fifth grade from two public schools of Aviles (Spain). The intervention lasted for 2 school years comprising healthy diet workshops, educational chats, educational meetings, informative written material, and promotion of physical activities. Primary outcome measure was body mass index z-score. Secondary outcomes included obesity and overweight prevalence, waist circumference, dietary habits, and physical activity. Results A total of 382 (177 girls, 205 boys) out of 526 pupils of both schools were included in the study. Complete anthropometric data were obtained in 340 of the 382 individuals. Compared to children in the control group, those in the intervention group decreased body mass index z-score from 1.14 to 1.02 (P = 0.017), and improved KIDMED score from 7.33 to 7.71 points (P = 0.045). The percentage of students who carried on an optimal diet increased from 42.6% to 52.3% (P = 0.021). There were no statistical differences in the prevalence of obesity and overweight, or in waist circumference between the intervention and control groups. Conclusions This school-based programme resulted in modest beneficial changes in body mass index and diet quality.

Efectividad de una intervención escolar contra la obesidad

IntroductionIntervention for childhood obesity is a public health priority. The purpose of this study was to evaluatethe effectiveness of an elementary school-based intervention against obesity in children. Material and methodsNon-randomised controlled trial was conducted on children from first to fifth grade from two public schools of Avilés (Spain). The intervention lasted for 2 school years comprising healthy diet workshops, educational chats, educational meetings, informative written material, and promotion of physical activities. Primary outcome measure was body mass index z-score. Secondary outcomes included: obesity and overweight prevalence, waist circumference, dietary habits, and physical activity. ResultsA total of 382 (177 girls, 205 boys) out of 526 pupils of both schools were included in the study. Complete anthropometric data were obtained in 340 of the 382 individuals. Compared to children in control group, those in intervention group decreased body mass index z-score from 1.14 to 1.02 (P=.017), and improved KIDMED score from 7.33 to 7.71 points (P=.045). The percentage of students who carried on an optimal diet increased from 42.6% to 52.3% (P=.021). There were no statistical differences in the prevalence of obesity and overweight, or in waist circumference between the intervention and control groups. ConclusionsThis school-based program resulted in modest beneficial changes in body mass index and diet quality.

The Pyramid Club Elementary School-Based Intervention: Testing the Circle Time Technique to Elicit Children’s Service Satisfaction

Children’s views of the social-emotional health services they use are important to service evaluation and development. However, often it is parental or clinician feedback that is gathered. In the current study Circle Time groups were run to identify children’s satisfaction with the Pyramid Club School-based intervention and to test the salience of this technique in eliciting children’s views. Children evaluated Clubs positively, reported no adverse effects and suggested ways to develop the intervention. The efficacy of Pyramid Clubs in building social-emotional competencies is supported by the children’s qualitative reports and Circle Time proved a salient technique for eliciting the views of young children.

Does Childhood Motor Skill Proficiency Predict Adolescent Fitness?

To determine whether childhood fundamental motor skill proficiency predicts subsequent adolescent cardiorespiratory fitness. In 2000, children's proficiency in a battery of skills was assessed as part of an elementary school-based intervention. Participants were followed up during 2006/2007 as part of the Physical Activity and Skills Study, and cardiorespiratory fitness was measured using the Multistage Fitness Test. Linear regression was used to examine the relationship between childhood fundamental motor skill proficiency and adolescent cardiorespiratory fitness controlling for gender. Composite object control (kick, catch, throw) and locomotor skill (hop, side gallop, vertical jump) were constructed for analysis. A separate linear regression examined the ability of the sprint run to predict cardiorespiratory fitness. Of the 928 original intervention participants, 481 were in 28 schools, 276 (57%) of whom were assessed. Two hundred and forty-four students (88.4%) completed the fitness test. One hundred and twenty-seven were females (52.1%), 60.1% of whom were in grade 10 and 39.0% were in grade 11. As children, almost all 244 completed each motor assessments, except for the sprint run (n = 154, 55.8%). The mean composite skill score in 2000 was 17.7 (SD 5.1). In 2006/2007, the mean number of laps on the Multistage Fitness Test was 50.5 (SD 24.4). Object control proficiency in childhood, adjusting for gender (P = 0.000), was associated with adolescent cardiorespiratory fitness (P = 0.012), accounting for 26% of fitness variation. Children with good object control skills are more likely to become fit adolescents. Fundamental motor skill development in childhood may be an important component of interventions aiming to promote long-term fitness.

Physical activity across the curriculum: year one process evaluation results

BackgroundPhysical Activity Across the Curriculum (PAAC) is a 3-year elementary school-based intervention to determine if increased amounts of moderate intensity physical activity performed in the classroom will diminish gains in body mass index (BMI). It is a cluster-randomized, controlled trial, involving 4905 children (2505 intervention, 2400 control).MethodsWe collected both qualitative and quantitative process evaluation data from 24 schools (14 intervention and 10 control), which included tracking teacher training issues, challenges and barriers to effective implementation of PAAC lessons, initial and continual use of program specified activities, and potential competing factors, which might contaminate or lessen program effects.ResultsOverall teacher attendance at training sessions showed exceptional reach. Teachers incorporated active lessons on most days, resulting in significantly greater student physical activity levels compared to controls (p < 0.0001). Enjoyment ratings for classroom-based lessons were also higher for intervention students. Competing factors, which might influence program results, were not carried out at intervention or control schools or were judged to be minimal.ConclusionIn the first year of the PAAC intervention, process evaluation results were instrumental in identifying successes and challenges faced by teachers when trying to modify existing academic lessons to incorporate physical activity.

P56: Fit for Learning

Increasing numbers of youth in Santa Clara County are overweight, with medical co-morbidities. The purpose of Fit For Learning (FFL), an elementary school-based intervention based on social learning theory, is to increase nutrition knowledge and change eating and physical activity behaviors, with the ultimate goal of decreasing rates of overweight. The cornerstone of FFL is a resource guide (“binder”) containing nine monthly lessons including “5-a-day”, “Let’s Move”, “Celebrate”, “Heart Healthy Body” and “Consumer Beware”. Each monthly section contains a calendar of suggested activities, school and take home activities (including copy ready handouts), classroom reward ideas, a classroom poster, and a list of additional resources. All materials meet California State Grade Content Standards. FFL was piloted in 5th grade classrooms in 33 elementary school districts in the county during the 2005-06 school year. Teachers, parents, and counselors were recruited as “Champions” at 99 schools. At the end of the school year, all Champions were surveyed to assess use of materials, ease of implementation, perceived changes in student health and changes in the school environment. Of 74 respondents, 91% reported using some FFL materials. Although 73% reported lack of teaching time an issue, most indicated students spoke more about nutrition and health, brought healthier foods from home, and engaged in more physical activity at school as a result of FFL. Overall, Champions had a positive experience with FFL, but suggested additional trainings to improve teaching skills. In conclusion, FFL can make a positive contribution to the overall school health environment.

Reducing Overweight through a Multidisciplinary School‐based Intervention

This study sought to evaluate the effectiveness of a multidisciplinary elementary school-based intervention entitled Wellness, Academics & You. The primary areas of impact examined were BMI, consumption of fruits and vegetables, and physical activity. The sample consisted of 1013 students in fourth and fifth grades from 69 classes in four states. Intervention and comparison classes were randomly selected at each school. Intervention teachers participated in workshops on the intervention and received program materials. BMI was calculated for baseline and post-data points based on measured height and weight collected by trained research teams. Baseline surveys were administered by the students' teacher in the presence of one of the research team members and collected. SPSS (SPSS, Inc., Chicago, IL) analysis of post-data shows significant positive shifts (p = 0.01) in BMI in the intervention group compared with the comparison group. Notable increases in the consumption of fruits and vegetables and increased physical activity levels were reported in the intervention group. Data from this study indicate that this school-based program may contribute to the reduction of overweight and obesity. The intervention was well received by the classroom teachers and shows promise for a school-based obesity prevention initiative. This program has shown the capacity to effect positive changes in BMI through consumption of fruits and vegetables and physical activity. The evaluation covered a limited time period and, therefore, warrants additional studies to determine whether long-term program fidelity will result in continued improvement.