Peer-reviewed article

Effect of a Scalable School-Based Intervention on Cardiorespiratory Fitness in Children

Chris Lonsdale, Taren Sanders, Philip David Parker, Michael Noetel, Timothy B. Hartwig et al. · 3 May 2021

Summary

Written by AI, not yet AICS's view · claude-haiku-4-5-20251001

This study tested an internet-based physical activity intervention delivered to elementary schools in Australia to improve children's fitness. The intervention included online teacher training and minimal in-person support over 9-10 months. Children in intervention schools showed better improvements in cardiorespiratory fitness at 12 and 24 months compared to control schools, at a very low cost per student. The sustained benefits suggest the intervention could be scaled to many schools.

Key points

At 12 months, intervention schools showed an additional 1.20 laps improvement in the 20-m shuttle run test compared to control schools (95% CI, 0.17-2.24 laps)
At 24 months, the adjusted difference increased to 2.22 laps (95% CI, 0.89-3.55 laps)
Cost per student was AUD33 (USD26)
The intervention consisted of standardized online learning for teachers with 9-10 months of minimal in-person mentor support
Study included 1188 students from 22 schools in New South Wales, Australia

Limitations

The study only measured cardiorespiratory fitness and cannot show whether the intervention improved other aspects of children's health or well-being. The research was conducted in government-funded schools in one Australian state, so results may not transfer to other settings or countries.

Abstract

Importance: Cardiorespiratory fitness is an important marker of childhood health and low fitness levels are a risk factor for disease later in life. Levels of children's fitness have declined in recent decades. Whether school-based physical activity interventions can increase fitness at the population level remains unclear. Objective: To evaluate the effect of an internet-based intervention on children's cardiorespiratory fitness across a large number of schools. Design, Setting, and Participants: In this cluster randomized clinical trial, 22 government-funded elementary schools (from 137 providing consent) including 1188 students stratified from grades 3 and 4 in New South Wales, Australia, were randomized. The other schools received the intervention but were not included in the analysis. Eleven schools received the internet-based intervention and 11 received the control intervention. Recruitment and baseline testing began in 2016 and ended in 2017. Research assistants, blinded to treatment allocation, completed follow-up outcome assessments at 12 and 24 months. Data were analyzed from July to August 2020. Interventions: The internet-based intervention included standardized online learning for teachers and minimal in-person support from a project mentor (9-10 months). Main Outcomes and Measures: Multistage 20-m shuttle run test for cardiorespiratory fitness. Results: Of 1219 participants (49% girls; mean [SD] age, 8.85 [0.71] years) from 22 schools, 1188 students provided baseline primary outcome data. At 12 months, the number of 20-m shuttle runs increased by 3.32 laps (95% CI, 2.44-4.20 laps) in the intervention schools and 2.11 laps (95% CI, 1.38-2.85 laps) in the control schools (adjusted difference = 1.20 laps; 95% CI, 0.17-2.24 laps). By 24 months, the adjusted difference was 2.22 laps (95% CI, 0.89-3.55 laps). The cost per student was AUD33 (USD26). Conclusions and Relevance: In this study, a school-based intervention improved children's cardiorespiratory fitness when delivered in a large number of schools. The low cost and sustained effect over 24 months of the intervention suggests that it may have potential to be scaled at the population level. Trial Registration: http://anzctr.org.au Identifier: ACTRN12616000731493.

Findings the Hub has extracted

Each claim below is labelled by its type of design and links back to this report.

Development

Problem

Low cardiorespiratory fitness in children and declining fitness levels in recent decades

Intervention: Internet-based intervention including standardized online learning for teachers and minimal in-person support from a project mentor over 9-10 months
Population: 1188 students in grades 3 and 4 from 22 government-funded elementary schools in New South Wales, Australia (mean age 8.85 years, 49% girls)

Key finding

At 12 months, intervention schools showed 1.20 additional laps improvement in 20-m shuttle run test compared to control (95% CI, 0.17-2.24)

Experimental