The West Midlands ActiVe lifestyle and healthy Eating in School children (WAVES) study: a cluster randomised controlled trial testing the clinical effectiveness and cost-effectiveness of a multifaceted obesity prevention intervention programme targeted at children aged 6–7 years

Adab, Peymané; Barrett, Timothy; Bhopal, Raj; Cade, Janet; Canaway, Alastair; Cheng, Kar Keung; Clarke, Joanne; Daley, Amanda; Deeks, Jonathan J; Duda, Joan L.; Ekelund, Ulf; Frew, Emma; Gill, Paramjit; Griffin, Tania; Hemming, Karla; Hurley, Kiya; Lancashire, Emma; Martín, James; McGee, Eleanor; Pallan, Miranda; Parry, Jonathan; Passmore, Sandra

doi:10.3310/hta22080

Cited by 24 publications

(66 citation statements)

References 89 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Eight studies were conducted in the USA [34, 36, 41, 44-46, 48, 53], and six were from Australia [30,33,40,42,47,49]. The rest were conducted in Great Britain (n = 5) [24,27,32,37,38], Ireland (n = 2) [29,52], Germany (n = 1) [39], China (n = 1) [35], South Korea (n = 1) [54], Canada (n = 1) [28], Denmark (n = 1) [31], Spain (n = 2) [43,51], Norway (n = 1) [50] and Turkey (n = 2) [25,26].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…The duration of the interventions varied from 4 weeks to 4 years. The level of implementation reach was low in six studies [24,27,28,30,38,48], medium in two studies [32,41], high in eighteen studies [25, 31, 33, 34, 36, 37, 39, 40, 42-47, 49-51, 53] and unknown in five studies [26,29,35,52,54]. A description of qualitative implementation factors (fidelity, dose delivered or received, responsiveness, level of adaptation) is shown in Online resource 3.…”

Section: Study Characteristicsmentioning

confidence: 99%

See 1 more Smart Citation

School-related physical activity interventions and mental health among children: a systematic review and meta-analysis

et al. 2020

View full text Add to dashboard Cite

Background Low levels of physical activity, sedentary behaviour and mental health problems are issues that have received considerable attention in the last decade. The aim of this systematic review and meta-analysis was to investigate effects of interventions targeting school-related physical activity or sedentary behaviour on mental health in children and adolescents and to identify the features of effective interventions. Methods Scientific articles published between January 2009 and October 2019 fulfilling the following criteria were included: general populations of children and adolescents between age 4 and 19, all types of school-related efforts to promote physical activity or reduce sedentary behaviour. Study selection, data extraction and quality assessment were done by at least two authors independently of each other. Data were analysed with a random effects meta-analysis and by narrative moderator analyses. Results The literature search resulted in 10265 unique articles. Thirty-one articles, describing 30 interventions, were finally included. Eleven relevant outcomes were identified: health-related quality of life, well-being, self-esteem and self-worth, resilience, positive effect, positive mental health, anxiety, depression, emotional problems, negative effect and internalising mental health problems. There was a significant beneficial effect of school-related physical activity interventions on resilience (Hedges’ g = 0.748, 95% CI = 0.326; 1.170, p = 0.001), positive mental health (Hedges’ g = 0.405, 95% CI = 0.208; 0.603, p = < 0.001), well-being (Hedges’ g = 0.877, 95% CI = 0.356; 1.398, p = < 0.001) and anxiety (Hedges’ g = 0.347, 95% CI = 0.072; 0.623, p = 0.013). Heterogeneity was moderate to high (I2 = 59–98%) between studies for all outcomes except positive effect, where heterogeneity was low (I2 = 2%). The narrative moderator analyses of outcomes based on 10 or more studies showed that age of the children moderated the effect of the intervention on internalising mental health problems. Interventions in younger children showed a significantly negative or no effect on internalising mental health problems while those in older children showed a significant positive or no effect. Moreover, studies with a high implementation reach showed a significant negative or no effect while those with a low level of implementation showed no or a positive effect. No signs of effect moderation were found for self-esteem, well-being or positive mental health. Risk of publication bias was evident for several outcomes, but adjustment did not change the results. Conclusions School-related physical activity interventions may reduce anxiety, increase resilience, improve well-being and increase positive mental health in children and adolescents. Considering the positive effects of physical activity on health in general, these findings may reinforce school-based initiatives to increase physical activity. However, the studies show considerable heterogeneity. The results should therefore be interpreted with caution. Future studies should report on implementation factors and more clearly describe the activities of the control group and whether the activity is added to or replacing ordinary physical education lessons in order to aid interpretation of results. Trial registration PROSPERO, CRD42018086757.

show abstract

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

School-related physical activity interventions and mental health among children: a systematic review and meta-analysis

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Within the trial, proportionally more children within the intervention arm (10%) compared to the control arm (7%) transitioned from a baseline healthy weight to a state defined as having obesity at follow up two. A multilevel logit model from the main trial analysis [29] demonstrated that the odds ratio associated with children in the intervention arm transitioning to living with obesity at follow up two, was 1.17 (0.66, 2.09), when controlling for pre-specified covariates. Although this was not a statistically significant difference, this estimated effect in favour of the control arm made the planned economic analysis for estimating the cost per ‘case of childhood obesity prevented’ not possible, that is, the control arm dominated the intervention arm.…”

Section: Resultsmentioning

confidence: 99%

Economic evaluation of a childhood obesity prevention programme for children: Results from the WAVES cluster randomised controlled trial conducted in schools

et al. 2019

Self Cite

View full text Add to dashboard Cite

Background Childhood obesity is a serious public health challenge and schools have been identified as an ideal place to implement prevention interventions. The aim of this study was to measure the cost-effectiveness of a multi-faceted school-based obesity prevention intervention targeting children aged 6–7 years when compared to ‘usual activities’. Methods A cluster randomised controlled trial in 54 schools across the West Midlands (UK) was conducted. The 12-month intervention aimed to increase physical activity by 30 minutes per day and encourage healthy eating. Costs were captured from a public sector perspective and utility-based health related outcomes measured using the CHU-9D. Multiple imputation using chained equations was used to address missing data. The cost effectiveness was measured at 30 months from baseline using a hierarchical net-benefit regression framework, that controlled for clustering and prespecified covariates. Any uncertainty in the results was characterised using cost-effectiveness acceptability curves. Results At 30 months, the total adjusted incremental mean cost of the intervention was £155 (95% confidence interval [CI]: £139, £171), and the incremental mean QALYs gained was 0.006 (95% CI: -0.024, 0.036), per child. The incremental cost-effectiveness at 30 months was £26,815 per QALY and using a standard willingness to pay threshold of £30,000 per QALY, there was a 52% chance that the intervention was cost-effective. Conclusions The cost-effectiveness of the school-based WAVES intervention was subject to substantial uncertainty. We therefore recommend more research to explore obesity prevention within schools as part of a wider systems approach to obesity prevention. Trial registration This paper uses data collected by the WAVES trial: Controlled trials ISRCTN97000586 (registered May 2010).

show abstract

“…However, obesity prevalence in the participating schools was compared with the prevalence estimated from the National Child Measurement Programme at the time and was found to be similar. 31 Comparisons of demographic characteristics of children with and without parental consent to participate in the WAVES trial (undertaken as part of the WAVES trial) also did not show major differences, 32 suggesting that the study sample is broadly representative.…”

Section: Discussionmentioning

confidence: 97%

Relationship between primary school healthy eating and physical activity promoting environments and children’s dietary intake, physical activity and weight status: a longitudinal study in the West Midlands, UK

et al. 2020

Self Cite

View full text Add to dashboard Cite

ObjectiveWe aimed to examine the association between food and physical activity environments in primary schools and child anthropometric, healthy eating and physical activity measures.DesignObservational longitudinal study using data from a childhood obesity prevention trial.SettingState primary schools in the West Midlands region, UK.Participants1392 pupils who participated in the WAVES (West Midlands ActiVe lifestyle and healthy Eating in School children) childhood obesity prevention trial (2011–2015).Primary and secondary outcome measuresSchool environment (exposure) was categorised according to questionnaire responses indicating their support for healthy eating and/or physical activity. Child outcome measures, undertaken at three time points (ages 5–6, 7–8 and 8–9 years), included body mass index z-scores, dietary intake (using a 24-hour food ticklist) and physical activity (using an Actiheart monitor over 5 days). Associations between school food and physical activity environment categories and outcomes were explored through multilevel models.ResultsData were available for 1304 children (94% of the study sample). At age 8–9 years, children in 10 schools with healthy eating and physical activity-supportive environments had a higher physical activity energy expenditure than those in 22 schools with less supportive healthy eating/physical activity environments (mean difference=5.3 kJ/kg body weight/24 hours; p=0.05). Children in schools with supportive physical activity environments (n=8) had a lower body mass index z-score than those in schools with less supportive healthy eating/physical activity environments (n=22; mean difference=−0.17, p=0.02). School food and physical activity promoting environments were not significantly associated with dietary outcomes.ConclusionsSchool environments that support healthy food and physical activity behaviours may positively influence physical activity and childhood obesity.Trial registration numberISRCTN97000586.

show abstract

The West Midlands ActiVe lifestyle and healthy Eating in School children (WAVES) study: a cluster randomised controlled trial testing the clinical effectiveness and cost-effectiveness of a multifaceted obesity prevention intervention programme targeted at children aged 6–7 years

Abstract: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in ; Vol. 22, No. 8. See the NIHR Journals Library website for further project information.

Cited by 24 publications

References 89 publications

School-related physical activity interventions and mental health among children: a systematic review and meta-analysis

School-related physical activity interventions and mental health among children: a systematic review and meta-analysis

Economic evaluation of a childhood obesity prevention programme for children: Results from the WAVES cluster randomised controlled trial conducted in schools

Relationship between primary school healthy eating and physical activity promoting environments and children’s dietary intake, physical activity and weight status: a longitudinal study in the West Midlands, UK

Contact Info

Product

Resources

About