Changes in Physical Activity, Physical Fitness and Well-Being Following a School-Based Health Promotion Program in a Norwegian Region with a Poor Public Health Profile: A Non-Randomized Controlled Study in Early Adolescents.
ABSTRACT: The purpose of this study was to examine the changes in physical activity (PA), physical fitness and psychosocial well-being in early adolescents following implementation of a school-based health promotion program in secondary schools. METHODS:Six municipalities in Telemark County, Norway, were recruited into intervention (6 schools) or control groups (9 schools). A total of 644 pupils participated in the study (response rate: 79%). The schools in the intervention group implemented the Active and Healthy Kids program, where the PA component consisted of (1) 120 min/week of physically active learning (PAL) and (2) 25 min/week of physical active breaks. Furthermore, both the intervention and control schools carried out 135 min/week of physical education. The primary outcome was PA. Secondary outcomes were sedentary time, physical fitness, subjective vitality and health-related quality of life (HRQoL) in five domains: physical health, psychological well-being, parent, peers and school. RESULTS:There was a group x time effect on school-based PA (p < 0.05), but not total PA, as well as on physical fitness (p < 0.05) and vitality (p < 0.01). In girls, there also was a group x time effect on three out of the five domains on HRQoL (p < 0.05). CONCLUSIONS:A multi-component, school-based health-promotion program with emphasis on the use of PAL led to positive changes in school-based PA levels. Furthermore, positive changes were seen in physical fitness, vitality and HRQoL among early adolescents in a county with a poor public health profile. This might have implications for the development and promotion in schools of general health and well-being throughout adolescence.
Project description:Introduction: Regular physical activity is associated with multiple health benefits for children. Evidence from cross-sectional studies suggests that physical activity is positively associated with health-related quality of life (HRQoL). The promotion of physical activity, and hence HRQoL, through a school-based intervention is therefore an important endeavor, particularly in disadvantaged areas of low- and middle-income countries, including South Africa. Methods: We designed a multicomponent physical activity intervention that was implemented over a 20-week period in 2015 in eight disadvantaged primary schools of Port Elizabeth, South Africa. Overall, 758 children aged 8-13 years participated. HRQoL was measured with the 27-item KIDSCREEN questionnaire. Self-reported physical activity was assessed with a single item of the Health-Behavior of School-Aged Children test, and cardiorespiratory fitness with the 20-m shuttle run test. Post-intervention scores were predicted with mixed linear regression models, taking into consideration the clustered nature of the data. Results: Higher baseline levels as well as increasing levels of self-reported physical activity predicted all dimensions of children's HRQoL. Baseline levels and increases in cardiorespiratory fitness predicted children's self-perceived physical well-being (one of the HRQoL subscales). Participation in the multicomponent physical activity intervention did not affect children's HRQoL. Conclusion: Higher and increasing self-reported physical activity predict all assessed HRQoL dimensions, which underlines that the promotion of regular physical activity among children living in disadvantaged settings is an important public health measure. Policy makers should encourage schools to create physical activity friendly environments, while schools should implement regular physical education as proposed by the school curriculum.
Project description:OBJECTIVES:Health-related quality of life (HRQoL) is an important outcome for health interventions, such as physical activity (PA) promotion among high-risk populations. The aim of this study was to investigate levels of PA and HRQoL, and associations between PA and HRQoL, in participants attending a behavior change service within primary care in Norway. METHODS:Adult participants (? 18 years) from 32 Healthy Life Centers (HLCs) in four regions of Norway, who provided valid data on HRQoL (SF-36) and PA (ActiGraph accelerometer) were included (N = 835). HRQoL scores were compared to normative data by independent sample t-tests. Associations between eight dimensions of HRQoL and time spent sedentary (SED), in light PA (LPA) or in moderate to vigorous PA (MVPA) were determined using general linear models adjusted for relevant confounders. RESULTS:Nineteen percent of the participants (mean age 50; body mass index 32) met PA recommendations of > 150 min MVPA per week. SF-36 scores were 10 to 28 points lower than the norm (all p < 0.001). Positive associations were found between MVPA and the SF-36 dimensions physical functioning, role physical, general health and vitality, (all p < 0.045). LPA was positively associated with physical functioning, role physical, general health, vitality and role emotional (all p < 0.046). Time spent SED was negatively associated with physical functioning, general health, vitality, social functioning and mental health (all p < 0.030). CONCLUSIONS:Individuals attending a Norwegian behavior change service within primary care had low PA level and low HRQoL compared to the general population. Our study suggest there is a positive dose-response relationship between PA and HRQoL, and a negative relationship between SED and HRQoL. Furthermore, that specific PA intensities and SED are related to different dimensions of HRQoL.
Project description:The aim of the current study was to examine the association between Australian primary school children's objectively measured in-school-hours weekly physical activity (PA) and their health-related quality of life (HRQoL). A cross-sectional study of 1128 Grade 2 and 3 children, aged 7-9 years, from 62 primary schools was conducted in New South Wales, Australia between October 2017 and April 2018. Children's PA was assessed via an accelerometer worn for five days during school hours. Their parents completed a telephone interview, answering demographic, child HRQoL and out-of-school-hours PA questions. Children's in-school-hours PA was classified as total PA and moderate-to-vigorous PA (MVPA). HRQoL scores were aggregated and reported at the high construct level domains (Total Quality of Life (Total HRQoL), Physical and Psychosocial Health Summary Scores). Multiple linear mixed regression analyses accounting for clustering were conducted to evaluate the association between children's in-school-hours weekly PA and their HRQoL. After adjusting for potential confounders, significant positive associations were found between children's in-school-hours weekly total PA and Total HRQoL (0.62 units, 95% CI: 0.29; 0.94, p < 0.001), Physical (0.71 units, 95% CI: 0.38; 1.04, p ? 0.001) and Psychosocial (0.58 units, 95% CI: 0.19; 0.97, p = 0.004) scores, with a stronger association observed between average weekly MVPA than average weekly total PA. There were also positive associations between PA and HRQoL for each sex when analysed separately. Our findings demonstrate a positive association between children's objectively-measured in-school-hours PA and parent-reported child HRQoL, strengthening evidence supporting the continued implementation of school-based PA programs for broader health outcomes.
Project description:This paper outlines the implementation of a programme of work that started with the development of a population-level children's health, fitness and lifestyle study in 1996 (SportsLinx) leading to selected interventions one of which is described in detail: the Active City of Liverpool, Active Schools and SportsLinx (A-CLASS) Project. The A-CLASS Project aimed to quantify the effectiveness of structured and unstructured physical activity (PA) programmes on children's PA, fitness, body composition, bone health, cardiac and vascular structures, fundamental movement skills, physical self-perception and self-esteem. The study was a four-arm parallel-group school-based cluster randomised controlled trial (clinical trials no. NCT02963805), and compared different exposure groups: a high intensity PA (HIPA) group, a fundamental movement skill (FMS) group, a PA signposting (PASS) group and a control group, in a two-schools-per-condition design. Baseline findings indicate that children's fundamental movement skill competence levels are low-to-moderate, yet these skills are inversely associated with percentage body fat. Outcomes of this project will make an important contribution to the design and implementation of children's PA promotion initiatives.
Project description:The main purpose of this study was to examine the relationships between school-based sedentary behavior, physical activity, and health-related outcomes, including cardiorespiratory fitness, weight status, and health-related quality of life (HRQOL) among Hispanic children. The participants were 374 children (192 boys, 182 girls; Mage = 9.64) recruited from four elementary schools from 3rd grade through to 5th grade. Sedentary behavior and physical activity behaviors (light physical activity [LPA] and moderate-to-vigorous physical activity (MVPA)) during school were measured by accelerometers. Cardiorespiratory fitness and weight status were measured using the FITNESSGRAM®, while HRQOL was measured using the PedsQL 4.0TM Spanish version, a validated questionnaire. Sedentary behavior was negatively correlated with cardiorespiratory fitness and HRQOL but positively associated with weight status. MVPA was positively correlated with cardiorespiratory fitness and HRQOL, but negatively associated with weight status and sedentary behavior. Multiple regressions demonstrated that sedentary behavior significantly predicted cardiorespiratory fitness and weight status, whereas MVPA significantly predicted HRQOL. With the current public health priority aiming to reduce health disparities in minority populations, the findings of this study provide important insights. Educators, health care providers, or other professionals working with Hispanic children are encouraged to focus on reducing sedentary behavior and promoting physical activity to improve their health-related outcomes.
Project description:The prevalence of non-communicable diseases (NCDs) is increasing worldwide, also among children. Information about primary prevention of NCD's is increasing; however, convincing strategies among children is needed. The present paper describes the design and methods in the Health Oriented Pedagogical Project (HOPP) study. The main objective is to evaluate the effects of a school-based physical activity intervention program on cardio-metabolic risk factors. Secondary objectives include assessment of physical, psychological and academic performance variables.The HOPP study is a 7 years longitudinal large-scale controlled intervention in seven elementary schools (n = 1545) with two control schools (n = 752); all aged 6-11 years at baseline. The school-based physical activity intervention program includes an increase in physical activity (PA) of 225 min/week as an integrated part of theoretical learning, in addition to the curriculum based 90 min/week of ordinary PA. Primary outcomes include cardio-metabolic risk factors measured as PA level, BMI status, waist circumference, muscle mass, percent fat, endurance test performance, total serum cholesterol, high-density lipoprotein (HDL), non-HDL, micro C-reactive protein (mCRP) and long-term blood sugar (HbA1c). In addition, secondary outcomes include anthropometric growth measures, physical fitness, quality of life (QoL), mental health, executive functions, diet and academic performance.HOPP will provide evidence of effects on cardio-metabolic risk factors after a long-term PA intervention program in elementary schoolchildren. School-based PA intervention programs may be an effective arena for health promotion and disease prevention.The study is registered in Clinical trials (ClinicalTrials.gov Identifier: NCT02495714 ) as of June 20th - 2015, retrospectively registered. The collection of baseline values was initiated in mid-January 2015.
Project description:BACKGROUND:The purpose of this study was to examine the association of physical education (PE) class characteristics, such as lesson context, teacher's physical activity (PA) promotion behavior, and lesson location, with student engagement in moderate- and vigorous-intensity physical activity (MVPA) during PE lessons in elementary school (ES), middle school (MS), and high school (HS). METHODS:The study sample included 2106 PE classes from 40 schools located in low-income communities. The System for Observing Fitness Instruction Time (SOFIT) was used to assess lesson context, teacher's behavior, and student PA during PE lessons. Mixed models were used to examine the association between PE class characteristics and the probability of meeting the recommended level of MVPA during PE lessons (MVPA ?50%), accounting for within-school random effects and school characteristics. RESULTS:Almost all PE classes (90%) with ?60-70% of lesson time spent in motor content and???10-20% in teacher's in-class PA promotion met the recommended level of MVPA across the school levels. More specifically, among the sub-categories of motor content, more lesson time spent in fitness was significantly associated with MVPA ?50% in all school levels. However, more lesson time spent in game play was a significant factor only in ES (OR?=?2.1; 95% CI?=?1.4-3.0). Outdoor lessons were a significant factor in ES (OR?=?5.3; 95% CI?=?3.1-9.0) and MS (OR?=?21.0; 95% CI?=?6.3-69.4), but not HS (OR?=?1.4; 95% CI?=?0.6, 3.2). CONCLUSIONS:PE lessons with higher motor content and higher teacher's in-class PA promotion are more likely to meet the recommended level of MVPA in all school levels. However, the sub-categories of motor content and lesson location could impact student MVPA differently by school levels.
Project description:Taking part in regular physical activity (PA) is important for young adolescents to maintain physical, social and mental health. Schools are vibrant settings for health promotion and the complexity of driving a whole-school approach to PA has not been tested in the Irish school context. The feasibility of the pilot programme of the Department of Education and Skills second level Active School Flag (SLASF) is needed. SLASF is a two year process that consists of the Active School Flag (ASF) certificate programme (year 1) and the ASF flag programme (year 2). This protocol paper is specific to the first year certificate process. Three schools around Ireland were recruited as pilot schools to carry out the year-long SLASF programme with 17 planned actions involving the entire school. Students in the transition year programme have a particular role in the promotion of PA in SLASF. Data collection consists of physical measures, accelerometers, survey data and interviews at the beginning and the end of the academic year. The primary focus on the feasibility of the programme is through process evaluation tools and fidelity checks consisting of implementation of the SLASF programme through whole-school surveys, focus group discussions of key stakeholder groups, as well as one-to-one interviews with a member of management at each school and the SLASF coordinator of the school. Secondary outcomes include PA levels and its social cognitive theories based correlates through physical health measures, surveys carried out pre- and post-intervention, as well as focus group discussions of the students. The results of this study are needed to improve the development of the SLASF through a predetermined stopping criteria and inclusion into systems thinking approaches such as the Healthy Ireland Demonstration Project.
Project description:Higher sedentary time and lower physical activity (PA) are associated with a poor health-related quality of life (HRQoL) in children. The aims of this study were: (1) to analyze the sedentary time, objectively measured PA levels (light, moderate, vigorous, and moderate-to-vigorous physical activity (MVPA)), and HRQoL dimensions (physical well-being, emotional well-being, self-esteem, family, friends, school, and total score) in children; and (2) to examine the association between sedentary time, PA levels, and HRQoL in children separately by sex. A total of 459 children (8.4 ± 0.4 years old, 50.54% males) from 15 schools in Granada (Spain) participated in the study. A tri-axial accelerometer was used to measure PA levels in the children for 7 consecutive days. The Revidierter KINDer Lebensqualitätsfragebogen (KINDL-R) questionnaire was used to determine the children's HRQoL dimensions. The results showed that males presented more minutes engaged in MVPA than females. Both sedentary time and PA levels were associated with self-esteem and total score (all <i>p</i> < 0.05). In males, moderate and vigorous PA levels were associated with higher HRQoL, whereas light PA was associated with higher HRQoL in females. Future studies should take into account the use of activities with difference intensities in order to increase HRQoL in males and females.
Project description:Effective lifestyle interventions are needed to prevent noncommunicable diseases in low- and middle-income countries. We analyzed the effects of a school-based health promotion intervention on physical fitness after 28 months and explored if the effect varied with important school characteristics. We also assessed effects on screen time, physical activity and BMI.We performed a cluster-randomized pair matched trial in schools in urban Ecuador. The intervention included an individual and environmental component tailored to the local context and resources. Primary outcomes were physical fitness (EUROFIT battery), screen time (questionnaires) and physical activity (accelerometers). Change in BMI was a secondary outcome. A total of 1440 grade 8 and 9 adolescents (intervention: n = 700, 48.6%) and 20 schools (intervention: n = 10, 50%) participated. Data of 1083 adolescents (intervention: n = 550, 50.8%) from 20 schools were analyzed.A school-based intervention with an individual and environment component can improve physical fitness and can minimize the decline in physical activity levels from childhood into adolescence in urban Ecuador.Clinicaltrials.gov identifier NCT01004367.