Long-term effects of the Active for Life Year 5 (AFLY5) school-based cluster-randomised controlled trial

Abstract

ObjectiveTo investigate the long-term effectiveness of a school-based intervention to improve physical activity and diet in children.DesignCluster-randomised controlled trial.Setting60 primary schools in the southwest of England.ParticipantsPrimary school children who were aged 8–9 years at recruitment, 9–10 years during the intervention and 10–11 years at the long-term follow-up assessment.InterventionTeacher training, provision of lesson and child–parent interactive homework plans and teaching materials.Main outcome measuresPrimary outcomes were accelerometer-assessed minutes of moderate to vigorous physical activity (MVPA) per day, accelerometer-assessed minutes of sedentary behaviour per day and reported daily consumption of servings of fruit and vegetables.Results60 schools with 2221 eligible children were recruited. As in the previously published assessment immediately after the end of the intervention, none of the three primary outcomes differed between children in schools allocated to the intervention, compared with those in control schools at the end of the long-term follow-up (1 year after the end of the intervention). Differences in secondary outcomes were consistent with those at the immediate follow-up, with no evidence that these had diminished over time. Comparing intervention with control schools, the difference in mean child-reported screen viewing at the weekend was −16.03 min (95% CI −32.82 to 0.73), for servings of snacks per day, the difference was −0.11 (95% CI −0.39 to 0.06), in servings of high-energy drinks per day −0.20 (95% CI −0.39 to −0.01) and in servings of high-fat foods per day −0.12 (95% CI −0.39 to 0.00). None of these reached our predefined level of statistical significance, especially after accounting for multiple testing.ConclusionsSchool-based curriculum interventions alone are unlikely to have a major public health impact on children's diet and physical activity.Trial registration numberISRCTN50133740, Post-results.

A developmental cascade perspective of paediatric obesity: A systematic review of preventive interventions from infancy through late adolescence

“…We reviewed 38 distinct interventions across 69 published articles for the childhood developmental stage . We classified 37% of these as universal prevention, 26% as selective, and the remaining 37% as indicated.…”

A Systematic Review and Qualitative Synthesis Resulting in a Typology of Elementary Classroom Movement Integration Interventions

“…Seven researcherdriven interventions did not provide training [53,63,64,67,68,75,79] and four did not report if there was any training [52,76,82,84]. The duration of the training varied from 30 min [54] to a full school day [50,60,61,78]. Ongoing support throughout the implementation was reported only by five interventions [51,58,60,61,86] with one providing weekly consultations [51] and two offering 1-2 booster sessions halfway through [60,61].…”

“…The duration of MI activities per day varied substantially from under 10 min [52,65,68,73,76] to over 50 min [60,66], with the most common duration being 10-20 min [51, 53, 56, 58, 59, 61-65, 70-72, 75, 80, 83, 85, 86] and the shortest being 3-4 min [68,73]. Six studies did not specify the recommended duration of the activities [50,55,57,67,69,84] and seven lasted between 20 and 30 min per day [54, 74, 77-79, 81, 82]. Almost all of the researcher-driven interventions were recommended on a daily basis or did not provide information about weekly frequency.…”

“…About one-fourth of the researcher-driven interventions did not measure fidelity [52,53,63,64,67,69,72,76,82,84], and of those that measured it, about half studies reported that the intervention was delivered as intended [50,51,58,61,62,65,68,70,74,80,81,83,85]. The measures used for fidelity varied between teacher logs [54-56, 58, 73, 75, 77], direct observation [51,57,65,68,74], activity monitors [62,70,80], meetings or ending surveys [60,86], or a combination of measures [50,59,61,66,78,79].…”

Promoting Healthy Eating among Young People—A Review of the Evidence of the Impact of School-Based Interventions

“…In our extract of studies, the sample size ranged from 65-2997 subjects/participants, and the intervention duration ranged from 1 and half month to 36 months. The systematic review locations identified by the author were: 26 from Europe [21,36,[38][39][40]44,46,49,52,54,57,58,[63][64][65][66][67][68][69][70][71][72][73][74][75], six from Asia [35,42,48,59,60,62], 10 from America [37,41,43,45,47,50,51,53,55,61] and one from Africa [56]. We categorized all interventions according to their intervention components.…”