The effect of a curriculum-based physical activity intervention on accelerometer-assessed physical activity in schoolchildren: A non-randomised mixed methods controlled before-and-after study

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.

The Preliminary Effects of a Multi-Recess School Intervention: Using Accelerometers to Measure Physical Activity Patterns in Elementary Children

“…Students in the intervention schools are achieving significantly more MVPA during the school day (~145 min) compared to other studies that implement PA interventions during school (~30 min) [21,40]. This finding suggests that outdoor, unstructured free play is more effective to increase steps and MVPA in children than structured classroom-based PA (e.g., Go Noodle) or physical education interventions [21,40]. In addition, the intervention school students had an 18% increase in MVPA and a 10% decrease in sedentary and light PA over the control schools students.…”

“…Studies that implement PA interventions in schools report anywhere from a 2%-12% increase in MVPA [23,24]. Students in the intervention schools are achieving significantly more MVPA during the school day (~145 min) compared to other studies that implement PA interventions during school (~30 min) [21,40]. This finding suggests that outdoor, unstructured free play is more effective to increase steps and MVPA in children than structured classroom-based PA (e.g., Go Noodle) or physical education interventions [21,40].…”

“…School-based PA interventions have been implemented to promote PA, including recess and classroom interventions [21]. Many of the PA or recess interventions can be implemented on a larger scale, but sadly, most focus on 6 weeks or less to gather data or outcomes and are less frequent during school hours and more frequent in after school programs [22].…”

“…Many of the PA or recess interventions can be implemented on a larger scale, but sadly, most focus on 6 weeks or less to gather data or outcomes and are less frequent during school hours and more frequent in after school programs [22]. When a researcher studies a classroom-based PA intervention, it typically means that an instructional break is introduced in the classroom for 3-5 min to engage students in a short movement activity like "go noodle" [21,23]. Interventions outside of the classroom usually involve adding recess during the school day to the lunch period or before school.…”

The school playground environment as a driver of primary school children’s physical activity behaviour: A direct observation case study

“…Therefore, there is a need for children to be provided with other opportunities for physical activity during school hours, (Daly-Smith et al, 2020) including classroom (Innerd et al, 2019) and break-times (also commonly referred to as recess, internationally) (Escalante et al, 2014). Understanding the nature and complexity of physical activity during break and lunchtime could be important in the development of school-based interventions and playground design.…”