ingredients in the recipe for success of school-based physical activity interventions
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Ingredients in the Recipe for Success of School-Based Physical Activity Interventions. Karin Allor Pfeiffer, Ph.D. Department of Kinesiology Center for Physical Activity and Health Michigan State University [email protected]. Outline. - PowerPoint PPT PresentationTRANSCRIPT
Ingredients in the Recipe for Success of School-Based Physical Activity InterventionsKarin Allor Pfeiffer, Ph.D.
Department of Kinesiology
Center for Physical Activity and Health
Michigan State University
Outline
Why are school-based physical activity interventions important?
What do the data show? Which ingredients belong in the recipe
for success? What are other considerations? What are practical ingredients in the
recipe for success? Example (Project FIT)
Why are school-based physical activity interventions important?
Approximately 40% of U.S. children and adolescents (6-11 years old) do not achieve recommended levels of physical activity (Troiano et al., MSSE, 2008)
Physical activity sharply declines during adolescence (Pate et al., J Adolesc Health, 2009; Kimm et al., Lancet, 2005)
Intervention prior to, during, and after the decline can all be useful
Children in school are a captive audience
What do the data show?
Recent literature reviews indicateMostly positive results for
increasing physical activity during school time
Successful trials usually last longer and use multi-component approaches
Questionable whether results apply to children only (adolescents?)
Results may differ by type of physical activity assessment
Dobbins et al., 2009; De Meester et al., 2009; Salmon et al., 2007; van Sluijs et al., 2007
What do the data show? (2)
Latest review: Effect of school-based interventions on
physical activity and fitness in children and adolescents: a review of reviews and systematic update. Kriemler et al., Br J Sports Med, 2011; 45:923-930
Included studies from January 2007-December 2010
20 trials were relevant 16 of these reported effects with a physical
activity outcome 14 included children up to 12 years old (4
adolescent, 2 included both) Half were multi-component 60% included a family or community component
What do the data show? (3)
Results of Kriemler et al. Every study with a physical activity
outcome reported a significant effect Nine of these addressed total physical activity
(included time outside of school) and were effective Five used objective measures, four subjective
measures of physical activity
Two randomized controlled trials with intervention duration of one year provided the highest level of rigor and showed significant increase in physical activity (assessed by accelerometer)
What do the data show? (4)
Noteworthy points regarding Kriemler et al. 20 trials were eligible to include in the
review over a four-year time period In contrast, Dobbins review included 26 trials
over 50 years 75% of those examining a physical activity
outcome reported increase in overall physical activity
Results extended to overall physical activity instead of in-school only (found in previous reviews)
Similar results found for objective and subjective physical activity assessments
What do the data show? (5)
Kriemler et al., cont’d. Studies including highest level of rigor and
public health significance included Children Multi-component approach over one school year Integration into school curriculum with PE expert Family involvement
Which ingredients belong in the recipe for success?
Multi-component approach over adequate time frame
Include the family (may not be as relevant for adolescents) and environment (community)
Establish sustainability Examine components of implementation
and other aspects of intervention (and conduct formative evaluation)
Which ingredients belong in the recipe for success? (2)
Examine mediation of the intervention effect
Consider cost-effectiveness Consider reducing sedentary
behaviors, particularly in combination with academic activities
What are other considerations? Little information is available regarding
certain types of populations Cultural tailoring to racial/ethnic minority
groups Novelty
Media Technology
Measurement tools Intervention tools
Activity permissive environments Age group (elementary, middle, high
school) Inter-generational efforts
What are practical ingredients in the recipe for success?
Know your environment Understand that you are asking people
to change behavior Find a champion for your cause Determine who in the setting is a
stakeholder in your cause Communicate as much as possible Be collaborative rather than
prescriptive
Example – Project FIT: A School- and Community-Based Intervention to Address Physical Activity and Healthy Eating in Low-Income Elementary School Children
Elementary schools in Grand Rapids, MI (>95% of students in schools eligible for free/reduced-price lunch)
Measures in children grades 3-5 Intervention lasted two years
Guided by social ecological framework Multi-component
School, community, social marketing Eisenmann et al., BMC Public Health, 2011, 11:607
Project FIT (2)
School-based intervention components Staff training 30 min structured physical activity during
the school day 20 hours of nutrition education for the
school year Healthy eating coaches in the school
cafeteria Physical activity and nutrition policy
improvements via coordinated school health team
Staff wellness
Project FIT (3)
Baseline results Mean age = 9.7 years 48% overweight/obese (6% severely obese) 30% met physical activity
recommendations(7 days, 60 min/day) – pedometer data not yet available
24% met screen time recommendations (<2 hrs/day)
Project FIT (4)
Preliminary examination of follow-up data Positive results for
ST Fruits/vegetables
Process evaluation from first year, grades 3-5 Average of ~9 min/day of PA Average of 4.5 hours/classroom of nutrition
education Process evaluation from first year, grades
K-2 Average of ~10 min/day of PA Average of 7 hours/classroom of nutrition
education
Summary
School-based intervention research has progressed in recent years
More work to be performed Use provided ingredients in recipe for
success in school-based interventions; the chef has to appropriately combine and prepare
Thank You