Intervention Effects of the Health Promotion Programme “Join the Healthy Boat” on Objectively Assessed Sedentary Time in Primary School Children in Germany

Abstract

Sedentary behaviour (SB) in children is related to negative health consequences that can track into adulthood. The programme “Join the Healthy Boat” promotes reduced screen time and a less sedentary lifestyle in schoolchildren. This study investigated the effects of the programme on children’s SB. For one year, teachers delivered the programme. A total of 231 children (7.0 ± 0.6 years) participated in the cluster-randomised study; there were 154 one year later at follow-up. Children’s SB was assessed using multi-sensor accelerometery, screen time via parental questionnaire. Effects were analysed using (linear) mixed effects regression models. At baseline, children spent 211 (±89) min daily in SB, at follow-up 259 (±109) min/day with no significant difference between the intervention (IG) and control group (CG). SB was higher during weekends (p < 0.01, for CG and IG). However, at follow-up, daily screen time decreased in IG (screen time of >1 h/day: baseline: 33.3% vs. 27.4%; follow-up: 41.2% vs. 27.5%, for CG and IG, respectively). This multi-dimensional, low-threshold intervention for one year does not seem to achieve a significant reduction in children’s SB, although screen time decreased in IG. Therefore, it should be considered that screen time cannot be the key contributor to SB and should not solely be used for changing children’s SB. However, if screen time is targeted, interventions should promote the replacement of screen time with active alternatives.

Educational Programs for the Promotion of Health at School: A Systematic Review

“…As seen in the study [23], motivation of the teaching staff is not enough to achieve beneficial changes with the programs. Similarly, it was observed in the study [26], whose program did not work due to the low participation of families from home. Low family participation conditions the results [29].…”

“…The third and last study carried out in primary education [26], showed improvements in development and motivation towards physical activity or sports practice, however, this did not reduce the time dedicated to ICT consumption. In general terms, the program showed some changes, but it was not effective due to the scant participation and collaboration of families in controlling inappropriate habits.…”

“…The fifth program called "Join the Healthy Boat", evaluated by [26], focused on the promotion of non-sedentary habits and the responsible use and consumption of ICT. It focused on the importance of training teaching staff in physical activity, healthy diet, and active free time, as well as motivating families to take part in the project.…”

The Effectiveness of Interventions to Reduce Sedentary Time in Different Target Groups and Settings in Germany: Systematic Review, Meta-Analysis and Recommendations on Interventions

“…Ten studies [ 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 ] referred to published protocols [ 79 , 80 , 81 , 82 , 83 , 84 ] or trial registry records (trial IDs reported in Table 1 ) which were consulted in these cases. Nine studies [ 69 , 70 , 73 , 76 , 77 , 78 , 85 , 86 , 87 ] were judged to be of high risk of bias and four studies [ 71 , 72 , 74 , 75 ] to have some concerns. No studies were judged to be of low risk of bias.…”

“…In two instances [ 88 , 89 ], the authors referred to an additional paper containing more detailed information on the respective study [ 90 , 91 ]. Of the 15 included studies, 14 studies [ 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 85 , 87 , 88 , 89 ] were published in peer-reviewed journals, 14 were written in English [ 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 85 , 87 , 88 , 89 ] and one [ 86 ] in German. The country of origin was Germany for 13 studies [ 69 , 70 , 71 , 73 , 74 , 75 , 76 , 77 , 78 , 85 , 86 , 87 , 88 ] and Belgium [ 89 ] and the UK [ 72 ] for one study each.…”