ObjectivesChildren spend a significant amount of their time in a school environment, often engaged in sedentary activities. The Daily Mile is a physical activity intervention which aims to increase physical activity and fitness in children through the completion of an outdoor teacher-led walk or run during the school day. This study aimed to explore the barriers, facilitators and perceived benefits of the Daily Mile from the perspectives of teachers through the use of qualitative semi-structured interviews. It also aimed to identify important context-specific factors, which might require consideration for those who intend to adopt the Daily Mile.SettingEight Local Authority primary schools in the City of Edinburgh and East Lothian, UK.ParticipantsThirteen teachers (eleven women) who teach children in primaries one to seven in a school which delivered the Daily Mile.ResultsData were analysed using an interpretative thematic analysis. Teachers were positive and enthusiastic about the Daily Mile and perceived it to be beneficial to children’s health and fitness. A number of barriers to participation were identified including inadequate all-weather running surfaces and time constraints in an already full school curriculum. The perceived impact on learning time was identified as a concern for teachers, while other benefits were also identified including increased teacher–child rapport and perceived enhanced classroom concentration levels.ConclusionThe Daily Mile appears to be a valuable addition to the school day, however important context-specific barriers to delivery of the Daily Mile exist, which should be considered when implementing the Daily Mile in schools.
To identify useful components of interventions aimed at prevention of childhood obesity and related non-communicable diseases (NCDs), which included physical activity and which targeted any or all of four life-course stages: peri-conception; pregnancy; infancy and toddlerhood (0 to 23 months); and early childhood (24 to 59 months). In May 2016, WHO Geneva searched the Cochrane Library and PubMed for systematic reviews of interventions including physical activity to prevent childhood obesity or risk factors for obesity-related NCDs. Using a narrative synthesis, the efficacy of randomized controlled trials (RCTs) to alter energy balance outcomes (measures of weight status or body fatness) was characterized by life-course stage, study characteristics, intervention functions (as defined in the behaviour change wheel), and level of the socio-ecological model (SEM) targeted. The quality of included systematic reviews was assessed. We retrieved 82 reviews from the World Health Organization (WHO) search, of which 23 were eligible for the present synthesis. The number of eligible studies by life-course stage was: 0 (peri-conception); 0 (pregnancy); 8 (infancy and toddlerhood, age 0 to 23 months; seven RCTs; age); and 37 (early childhood, age 24 to 59 months; 30 RCTs;). Thus, there was a lack of evidence for physical activity interventions during peri-conception and pregnancy.Almost all relevant studies in the 0-to 23-and 24-to 59-month life-course stages were multicomponent interventions (ie, targeted physical activity, dietary, and/or sedentary behaviours). Interventions with evidence of efficacy tended to target multiple levels of the SEM, with emphasis on parents, and extend over long periods.Effective intervention elements for early life obesity prevention included classes on parenting skills, alteration of the kindergarten playground, and financial incentives.Evidence from low-and middle-income countries was scarce, and evidence for ---
Background: High levels of childhood obesity have been observed globally over the last three decades. Preschools are promising settings to implement obesity prevention interventions in the early years. The aim of this study was to test the feasibility of a cluster randomised controlled trial of the ToyBox-Scotland preschool obesity prevention intervention. Methods: Six preschools in predominantly deprived areas of Glasgow, UK, were randomised to either the ToyBox intervention (n = 3) or usual curriculum control group (n = 3). The intervention ran for 18 weeks from March-June 2018, and consisted of practitioner-led physical activity and sedentary behaviour sessions in preschools, with an additional interactive home component. Primary outcome measures were intervention fidelity, recruitment rates, attrition rates, and compliance with trial procedures. Secondary outcomes were body mass index (BMI) z-score, bioelectrical impedance analysis (BIA), objectively measured physical activity and sedentary time via activPAL accelerometer, and parent-reported home eating, snacking, and water consumption. Results: The preschool component of the intervention was implemented with high fidelity (64%), while the home component was implemented with low fidelity (41%). A cluster-level recruitment rate of 10% was achieved, and the individual-level recruitment rate was 18% (42/233 children, mean age 4.4 years; 17 girls). The attrition rate was 14%, and compliance rates varied considerably by the outcome. Compliance was highest for BMI (86%), while 19% of the sample returned valid accelerometer data for both baseline and follow-up and the parental questionnaire response rate was 23%. Both intervention and control groups showed small increases in BMI z-scores at follow-up of 0.02 and 0.06, respectively. Both groups had small decreases in physical activity and increases in sedentary time at follow-up. Conclusions: Before progression to an effectiveness trial, additional procedures should be considered to improve recruitment rates, compliance with outcome measures, and implementation of the home-based component of the ToyBox-Scotland intervention.
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