Feasibility of an after-school group-based exercise and lifestyle programme to improve cardiorespiratory fitness and health in less-active Pacific and Maori adolescents

Abstract

INTRODUCTION: Obesity and low levels of physical activity are increasing among Pacific and Māori adolescents in New Zealand.AIM: To assess the feasibility of an after-school exercise and lifestyle programme to improve cardiorespiratory fitness, health and usual activity in less-active Pacific and Māori adolescents over six weeks.METHODS: Eighteen less-active secondary school students participated. The six-week programme included 3 x 1.5 hour exercise and healthy lifestyle sessions per week. Outcomes included estimated cardiorespiratory fitness (VO 2 max), insulin resistance (Homeostasis Model Assessment), physical activity, glycated haemoglobin (HbA1c), fasting plasma glucose, blood pressure, waist circumference and fasting lipids, measured at baseline and six weeks. Programme attendance and qualitative comments were also recorded. Student's t-tests were used. RESULTS:Of the 18 students enrolled, 16 (89%) completed six-week follow-up, 14 (78%) were female, 13 (72%) were Pacific ethnicity and 5 (28%) were Māori. At baseline, mean age was 16.3 (standard deviation [SD] 1.0) years, body mass index (BMI) 35.2 (SD 6.7) kg/m 2 , VO 2 max 31.5 (SD 4.3) mL/kg/min, systolic blood pressure 125.0 (SD 12.9) mm Hg, HbA1c 39.9 (SD 3.8) mmol/mol, fasting serum insulin 28.3 (SD 27.8) µU/mL. At follow-up, improvements had occurred in VO 2 max (3.2 mL/kg/min; p=0.02), systolic blood pressure (-10.6 mm Hg; p=0.003), HbA1c (-1.1 mmol/mol; p=0.03) and weekly vigorous (4 hours, p=0.002) and moderate (2 hours, p=0.006) physical activity, although waist circumference increased (p=0.005). Programme attendance was over 50%. Comments were mostly positive. DISCUSSION:The after-school exercise and lifestyle programme and study methods were feasible. Such programmes have the potential to improve health outcomes for Pacific and Māori adolescents.

Interventions to prevent or treat childhood obesity in Māori & Pacific Islanders: a systematic review

“…A previously used [20] modified version of the checklist was used for simplicity and clarity: instead of calculating a range of potential study powers in Item 27, we determined if each study performed a power calculation (1 = yes, 0 = no), thus making 28 the highest possible score for the checklist. Downs and Black scores were assigned to the following score ranges, according to Hooper et al [21]: excellent (26)(27)(28); good (20)(21)(22)(23)(24)(25); fair (15)(16)(17)(18)(19); and poor (≤14). Any discrepancies in the article screening, data extraction and synthesis, or quality and risk of bias assessment phases were discussed and resolved with a third reviewer (JLW).…”

“…An additional two articles were identified via reference list scoping of identified full-text articles. Of these 11 articles, six met the inclusion criteria and were included for qualitative synthesis in the present systematic review [22][23][24][25][26][27]. The six articles described outcomes from five independent programs or initiatives.…”

“…While two articles describe results from a single program [25,26], Quality assessment and risk of bias Table 1 describes the quality assessment and risk of bias results for each study. According to the modified Downs and Black checklist, four articles were assessed to be of 'fair' quality [23][24][25]27] and two articles of 'good' quality [22,26]. The strongest scoring article [25]…”

“…The total sample size for each study ranged from 18 [23] to 6629 [25] (mean: 1431). Programs targeted: both children and adolescents (5-16 y) (n = 1) [22]; younger (5-7 years [26], and 6-8 years [25]) and older (10-12 y [26], and 9-11 y [25]) children separately, but within the same school program (n = 2); older children only (mean age 9.8 y [24], and aged 9-12 y [27]) (n = 2); and adolescents only (mean age 16.3 y [23]) (n = 1). A higher percentage of female participants was reported in three studies [23,25,26], with one study reporting equal sex distribution [24].…”

Editorial: Catering for vulnerable populations: customised care

“…A feasibility study of an after-school group exercise programme for underactive Māori and Pacific high school students was successful in getting the young people to participate and demonstrated some improvement in cardiorespiratory markers, hence warranting further investigation. 8 In a Viewpoint article, Perez and Kidd discuss the untapped community-based resource of using peer support workers in mental health care, possibly working through non-government organisations. 9 While acknowledging the potential barriers of lack of training and funding, peer support workers can assist patients with long-term moderate to severe mental illness to engage with primary health care services and keep appointments.…”