TY - JOUR
T1 - Transform-Us! cluster RCT
T2 - 18-month and 30-month effects on children's physical activity, sedentary time and cardiometabolic risk markers
AU - Salmon, Jo
AU - Arundell, Lauren
AU - Cerin, Ester
AU - Ridgers, Nicola Dawn
AU - Hesketh, Kylie D.
AU - Daly, Robin M.
AU - Dunstan, David
AU - Brown, Helen
AU - Della Gatta, Jacqui
AU - Della Gatta, Paul
AU - Chinapaw, Mai J. M.
AU - Shepphard, Lauren
AU - Moodie, Marj
AU - Hume, Clare
AU - Brown, Vicki
AU - Ball, Kylie
AU - Crawford, David
N1 - Funding Information: National Health and Medical Research Council (NHMRC) of Australia Project Grant (ID: 533815); Diabetes Australia Research Trust. The funders played no role in the design of the study, the collection, analysis or interpretation of the data, in the writing of the paper or the decision to submit for publication. JS is supported by an NHMRC Leadership Level 2 Fellowship (APP 1176885). DD is supported by an NHMRC Senior Research Fellowship (APP1078360) and in part by the Victorian Government’s OIS Program. VB is supported by an Alfred Deakin Postdoctoral Research Fellowship. EC is supported by an Australian Research Council Future Fellowship (FT140100085). KDH is supported by an Australian Research Council Future Fellowship (FT130100637). NR is supported by a Future Leader Fellowship from the National Heart Foundation of Australia (Award ID 101895). All authors are independent of the funders, have full access to the data in the study and can take responsibility for the integrity of the data and accuracy of the data analysis. Publisher Copyright: © 2022 Author(s). Published by BMJ.
PY - 2022
Y1 - 2022
N2 - Objective: To test the efficacy of the Transform-Us! school- A nd home-based intervention on children's physical activity (PA), sedentary behaviour (SB) and cardiometabolic risk factor profiles. Methods: A 30-month 2×2 factorial design cluster randomised controlled trial delivered in 20 primary schools (148 Year 3 classes) in Melbourne, Australia (2010-2012), that used pedagogical and environmental strategies to reduce and break up SB, promote PA or a combined approach, compared with usual practice. Primary outcomes (accelerometry data; n=348) were assessed at baseline, 18 and 30 months. Secondary outcomes included body mass index (BMI) and waist circumference (WC) (n=564), blood pressure (BP) (n=537) and biomarkers (minimum n=206). Generalised linear mixed models estimated the interactive effects of the PA and SB interventions on the outcomes. If there was no interaction, the main effects were assessed. Results: At 18 months, there were intervention effects on children's weekday SB (-27 min, 95% CI:-47.3 to-5.3) for the PA intervention, and on children's average day PA (5.5 min, 95% CI: 0.1 to 10.8) for the SB intervention. At 30 months, there was an intervention effect for children's average day SB (-33.3 min, 95% CI:-50.6 and-16.0) for the SB intervention. Children's BMI (PA and SB groups) and systolic BP (combined group) were lower, and diastolic BP (PA group) was higher. There were positive effects on WC at both time points (SB intervention) and mixed effects on blood parameters. Conclusions: The Transform-Us! PA and SB interventions show promise as a pragmatic approach for reducing children's SB and adiposity indicators; but achieving substantial increases in PA remains challenging. Trial registration: ISRCTN83725066; ACTRN12609000715279.
AB - Objective: To test the efficacy of the Transform-Us! school- A nd home-based intervention on children's physical activity (PA), sedentary behaviour (SB) and cardiometabolic risk factor profiles. Methods: A 30-month 2×2 factorial design cluster randomised controlled trial delivered in 20 primary schools (148 Year 3 classes) in Melbourne, Australia (2010-2012), that used pedagogical and environmental strategies to reduce and break up SB, promote PA or a combined approach, compared with usual practice. Primary outcomes (accelerometry data; n=348) were assessed at baseline, 18 and 30 months. Secondary outcomes included body mass index (BMI) and waist circumference (WC) (n=564), blood pressure (BP) (n=537) and biomarkers (minimum n=206). Generalised linear mixed models estimated the interactive effects of the PA and SB interventions on the outcomes. If there was no interaction, the main effects were assessed. Results: At 18 months, there were intervention effects on children's weekday SB (-27 min, 95% CI:-47.3 to-5.3) for the PA intervention, and on children's average day PA (5.5 min, 95% CI: 0.1 to 10.8) for the SB intervention. At 30 months, there was an intervention effect for children's average day SB (-33.3 min, 95% CI:-50.6 and-16.0) for the SB intervention. Children's BMI (PA and SB groups) and systolic BP (combined group) were lower, and diastolic BP (PA group) was higher. There were positive effects on WC at both time points (SB intervention) and mixed effects on blood parameters. Conclusions: The Transform-Us! PA and SB interventions show promise as a pragmatic approach for reducing children's SB and adiposity indicators; but achieving substantial increases in PA remains challenging. Trial registration: ISRCTN83725066; ACTRN12609000715279.
KW - Child Health
KW - Physical activity
KW - Schools
KW - Sedentary Behavior
UR - http://www.scopus.com/inward/record.url?scp=85144417256&partnerID=8YFLogxK
U2 - https://doi.org/10.1136/bjsports-2022-105825
DO - https://doi.org/10.1136/bjsports-2022-105825
M3 - Article
C2 - 36428089
SN - 0306-3674
JO - British Journal of Sports Medicine
JF - British Journal of Sports Medicine
M1 - 105825
ER -