“läuft.” - a school-based multi-component program to establish a physically active lifestyle in adolescence: study protocol for a cluster-randomized controlled trial

Trials

Reiner Hanewinkel²  James D Sargent¹  Burkhard Weisser³  Ingeborg Sauer³  Katrin Müller⁴  Claus Krieger⁴  Maike Johannsen⁵  Julia Hansen⁵  Barbara Isensee⁵  Vivien Suchert⁵ 

[1] Geisel School of Medicine at Dartmouth, Cancer Control Research Program, Norris Cotton Cancer Center, Lebanon, NH, USA;University Medical Center Schleswig-Holstein, Institute for Medical Psychology and Medical Sociology, Kiel, Germany;Christian-Albrechts-University of Kiel, Institute for Sports Science, Kiel, Germany;University of Hamburg School of Education, Psychology and Human Movement, Hamburg, Germany;Institute for Therapy and Health Research, IFT-Nord, Harmsstrasse 2, Kiel 24114, Germany

关键词: Pedometer;    School-based intervention;    Adolescents;    Cluster-randomized trial;    Physical activity;   

Others  :  807846
DOI  :  10.1186/1745-6215-14-416

 received in 2013-09-24, accepted in 2013-11-20,  发布年份 2013

【 摘 要 】

Background

Physical activity during childhood and adolescence is associated with substantial health benefits and tracks into adulthood. Nevertheless, only 22.7% of German adolescents are sufficiently physically active. Thus, the promotion of an active lifestyle in youth is an essential issue of public health.

This study will evaluate the implementation and efficacy of the “läuft.” program to enhance physical activity in adolescence. “läuft.” is a multicomponent school-based program developed on the basis of effective strategies for health interventions and behavioral change.

Methods/design

The “läuft.” physical activity program targets four different levels. (a) Each student receives a pedometer and documents his/her steps over 12 weeks using an interactive user account on the “läuft.” homepage. (b) For classes there will be different competitions, with achieving the most steps in selected weeks, the highest increases of steps and developing the most inventive ideas to promote physical activity in school. Besides, the intervention includes four educational lessons. (c) The headmasters and teaching staff of the participating schools will get information material with suggestions and encouragement to enhance physical activity in school. Participating teachers will be invited to an introductory seminar. (d) Parents will be provided with informational material about the program and will be invited to a parent-teacher conference about the benefits of being physically active and how they can support their children in engaging in a physically active lifestyle.

To evaluate the efficacy of the “läuft.” physical activity program, a two-arm cluster randomized controlled trial will be conducted in three waves: (1) baseline assessment, January/February 2014, (2) post assessment, June/July 2014 and (3) 12-month follow-up assessment, June/July 2015. Data collection will include physical and medical testing, self-administered questionnaires, group discussions and document analyses.

Discussion

“läuft.” aims at fostering a physically active lifestyle in adolescence while a considerable decline of physical activity is present. Physical activity programs based in the school setting and following a multicomponent approach have been proven to be most successful. Furthermore, the use of pedometers is promising to enhance physical activity during the entire day and targets a wide range of adolescents regarding fitness and weight.

Trial registration

Current Controlled Trials ISRCTN49482118.

【 授权许可】

   
2013 Suchert et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]World Cancer Research Fund / American Institute for Cancer Research: Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. Washington, DC: AICR; 2007.
• [2]Warburton DE, Nicol CW, Bredin SS: Health benefits of physical activity: the evidence. CMAJ 2006, 174:801-809.
• [3]US Department of Health and Human Services: Physical Activity and Health: A Report of the Surgeon General. Atlanta, GA: U.S: Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion; 1996.
• [4]Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT: Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet 2012, 380:219-229.
• [5]Janssen I, LeBlanc AG: Systematic review of the health benefits of physical activity and fitness in school-aged children and youth. Int J Behav Nutr Phys Act 2010, 7:40. BioMed Central Full Text
• [6]Ekelund U, Luan J, Sherar LB, Esliger DW, Griew P, Cooper A: Moderate to vigorous physical activity and sedentary time and cardiometabolic risk factors in children and adolescents. JAMA 2012, 307:704-712.
• [7]Malina RM: Physical activity and fitness: pathways from childhood to adulthood. Am J Hum Biol 2001, 13:162-172.
• [8]Telama R: Tracking of physical activity from childhood to adulthood: a review. Obes Facts 2009, 2:187-195.
• [9]Hasselstrom H, Hansen SE, Froberg K, Andersen LB: Physical fitness and physical activity during adolescence as predictors of cardiovascular disease risk in young adulthood: Danish youth and sports study: an eight-year follow-up study. Int J Sports Med 2002, 23:S27-S31.
• [10]Twisk JW, Kemper HC, van Mechelen W: The relationship between physical fitness and physical activity during adolescence and cardiovascular disease risk factors at adult age. The Amsterdam Growth and Health Longitudinal Study. Int J Sports Med 2002, 23(Suppl 1):S8-S14.
• [11]World Health Organization: Global Recommendations on Physical Activity for Health. Geneva: World Health Organization; 2010.
• [12]Lampert T, Mensink GB, Romahn N, Woll A: Physical activity among children and adolescents in Germany. Results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Bundesgesundhbl Gesundheitsforsch Gesundheitsschutz 2007, 50:634-642.
• [13]Dumith SC, Gigante DP, Domingues MR, Kohl HW 3rd: Physical activity change during adolescence: a systematic review and a pooled analysis. Int J Epidemiol 2011, 40:685-698.
• [14]Nader PR, Bradley RH, Houts RM, McRitchie SL, O’Brien M: Moderate-to-vigorous physical activity from ages 9 to 15 years. JAMA 2008, 300:295-305.
• [15]Kriemler S, Meyer U, Martin E, van Sluijs EM, Andersen LB, Martin BW: Effect of school-based interventions on physical activity and fitness in children and adolescents: a review of reviews and systematic update. Br J Sports Med 2011, 45:923-930.
• [16]Dobbins M, De Corby K, Robeson P, Husson H, Tirilis D: School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6–18. Cochrane Database Syst Rev 2009., 1CD007651
• [17]De Meester F, van Lenthe FJ, Spittaels H, Lien N, de Bourdeaudhuij I: Interventions for promoting physical activity among European teenagers: a systematic review. Int J Behav Nutr Phys Act 2009, 6:6. BioMed Central Full Text
• [18]van Sluijs EM, McMinn AM, Griffin SJ: Effectiveness of interventions to promote physical activity in children and adolescents: systematic review of controlled trials. Br J Sports Med 2008, 42:653-657.
• [19]Kang M, Marshall SJ, Barreira TV, Lee JO: Effect of pedometer-based physical activity interventions: a meta-analysis. Res Q Exerc Sport 2009, 80:648-655.
• [20]Lubans DR, Morgan PJ, Tudor-Locke C: A systematic review of studies using pedometers to promote physical activity among youth. Prev Med 2009, 48:307-315.
• [21]Schofield L, Mummery WK, Schofield G: Effects of a controlled pedometer-intervention trial for low-active adolescent girls. Med Sci Sports Exerc 2005, 37:1414-1420.
• [22]Lubans D, Morgan P: Evaluation of an extra-curricular school sport programme promoting lifestyle and lifetime activity for adolescents. J Sports Sci 2008, 26:519-529.
• [23]Michie S, Abraham C, Whittington C, McAteer J, Gupta S: Effective techniques in healthy eating and physical activity interventions: a meta-regression. Health Psychol 2009, 28:690-701.
• [24]Ory MG, Jordan PJ, Bazzarre T: The behavior change consortium: setting the stage for a new century of health behavior-change research. Health Educ Res 2002, 17:500-511.
• [25]Trost SG, Sallis JF, Pate RR, Freedson PS, Taylor WC, Dowda M: Evaluating a model of parental influence on youth physical activity. Am J Prev Med 2003, 25:277-282.
• [26]Campbell MJ, Donner A, Klar N: Developments in cluster randomized trials and statistics in medicine. Stat Med 2007, 26:2-19.
• [27]Murray DM, Varnell SP, Blitstein JL: Design and analysis of group-randomized trials: a review of recent methodological developments. Am J Public Health 2004, 94:423-432.
• [28]Zahner L, Puder JJ, Roth R, Schmid M, Guldimann R, Pühse U, Knöpfli M, Braun-Fahrländer C, Marti B, Kriemler S: A school-based physical activity program to improve health and fitness in children aged 6–13 years (“Kinder-Sportstudie KISS”): study design of a randomized controlled trial [ISRCTN15360785]. BMC Public Health 2006, 6:147. BioMed Central Full Text
• [29]Kriemler S, Zahner L, Schindler C, Meyer U, Hartmann T, Hebestreit H, Brunner-La Rocca HP, van Mechelen W, Puder JJ: Effect of school based physical activity programme (KISS) on fitness and adiposity in primary schoolchildren: cluster randomised controlled trial. BMJ 2010, 340:c785.
• [30]Cohen J: Statistical Power Analyses for Behavioral Science. Hilldale, New York: Erlbaum; 1988.
• [31]Cohen J: A power primer. Psychol Bull 1992, 112:155-159.
• [32]Campbell MK, Thomson S, Ramsay CR, MacLennan GS, Grimshaw JM: Sample size calculator for cluster randomized trials. Comput Biol Med 2004, 34:113-125.
• [33]Hanewinkel R, Sargent JD: Longitudinal study of exposure to entertainment media and alcohol use among German adolescents. Pediatrics 2009, 123:989-995.
• [34]Hanewinkel R, Isensee B, Sargent JD, Morgenstern M: Cigarette advertising and adolescent smoking. Am J Prev Med 2010, 38:359-366.
• [35]World Health Organisation: Obesity: Preventing and Managing the Global Epidemic. Geneva: World Health Organization; 2004.
• [36]Leger LA, Mercier D, Gadoury C, Lambert J: The multistage 20 metre shuttle run test for aerobic fitness. J Sports Sci 1988, 6:93-101.
• [37]Kunter M, Schümer G, Artelt C, Baumert J, Klieme E, Neubrand M, Prenzel M, Schiefele U, Schneider W, Stanat P, Tillmann K-J, Weiß M: Pisa 2000: Documentation of measures. Berlin: Max-Planck-Institut für Bildungsforschung; 2002.
• [38]Bös K, Worth A, Heel J, Opper E, Romahn N, Tittelbach S, Wank V, Woll A: Testmanual des Motorik Moduls im Rahmen des Kinder- und Jugendgesundheitssurveys des Robert-Koch-Instituts. Haltung Bewegung 2004, 24:3-41.
• [39]Prochaska JJ, Sallis JF, Long B: A physical activity screening measure for use with adolescents in primary care. Arch Pediatr Adolesc Med 2001, 155:554-559.
• [40]Zabinski MF, Norman GJ, Sallis JF, Calfas KJ, Patrick K: Patterns of sedentary behavior among adolescents. Health Psychol 2007, 26:113-120.
• [41]World Health Organization: Guidelines for Controlling and Monitoring the Tobacco Epidemic. Geneva: World Health Organization; 1998.
• [42]Lintonen T, Ahlström S, Metso L: The reliability of self-reported drinking in adolescence. Alcohol Alcohol 2004, 39:362-368.
• [43]Wechsler H, Nelson TF: Binge drinking and the American college student: what’s five drinks? Psychol Addict Behav 2001, 15:287-291.
• [44]Ravens-Sieberer U, Thomas C: Gesundheitsverhalten von Schülern in Berlin: Ergebnisse der HBSC-Jugendgesundheitsstudie 2002 im Auftrag der WHO. Berlin: Robert Koch Institut; 2003.
• [45]Schwarzer R, Jerusalem M: Skalen zur Erfassung von Lehrer- und Schülermerkmalen. Dokumentation der psychometrischen Verfahren im Rahmen der Wissenschaftlichen Begleitung des Modellversuchs Selbstwirksame Schulen. Berlin: Freie Universität Berlin; 1999.
• [46]Fuchs R, Schwarzer R: Self-efficacy towards physical exercise: reliability and validity of a new instrument. Z Different Diagnost Psychol 1994, 15:141-154.
• [47]Stiller J, Würth S, Alfermann D: The measurement of physical self-concept (PSK) - the development of the PSK-scales for children, adolescents, and young adults. Z Different Diagnost Psychol 2004, 25:239-257.
• [48]Brettschneider AK, Rosario AS, Ellert U: Validity and predictors of BMI derived from self-reported height and weight among 11- to 17-year-old German adolescents from the KiGGS study. BMC Res Notes 2011, 4:414. BioMed Central Full Text
• [49]Jekauc D, Voelkle M, Wagner MO, Mewes N, Woll A: Reliability, validity, and measurement invariance of the German version of the physical activity enjoyment scale. J Pediatr Psychol 2013, 38:104-115.
• [50]Stephenson MT, Hoyle RH, Palmgreen P, Slater MD: Brief measures of sensation seeking for screening and large-scale surveys. Drug Alcohol Depend 2003, 72:279-286.
• [51]Erhart M, Ellert U, Kurth BM, Ravens-Sieberer U: Measuring adolescents’ HRQoL via self reports and parent proxy reports: an evaluation of the psychometric properties of both versions of the KINDL-R instrument. Health Qual Life Outcomes 2009, 7:77. BioMed Central Full Text
• [52]Faulstich ME, Carey MP, Ruggiero L, Enyart P, Gresham F: Assessment of depression in childhood and adolescence: an evaluation of the center for epidemiological studies depression scale for children (CES-DC). Am J Psychiatry 1986, 143:1024-1027.
• [53]Hagger MS, Chatzisarantis N, Biddle SJ, Orbell S: Antecedents of children’s physical activity intentions and behaviour: predictive validity and longitudinal effects. Psychol Health 2001, 16:391-407.
• [54]Galanti MR, Siliquini R, Cuomo L, Melero JC, Panella M, Faggiano F: Testing anonymous link procedures for follow-up of adolescents in a school-based trial: The EU-DAP pilot study. Prev Med 2007, 44:174-177.
• [55]Cole TJ: The LMS method for constructing normalized growth standards. Eur J Clin Nutr 1990, 44:45-60.
• [56]Kromeyer-Hauschild K, Wabitsch M, Kunze P, Geller F, Geiß HC, von Hippel A, Johnsen D, Korte W, Müller G, Müller JM, Niemann-Pilatus A, Remer T, Schaefer F, Wittchen H-U, Zabransky S, Zellner K, Ziegler A, Hebebrand J: Percentiles of body mass index in children and adolescents evaluated from different regional German studies. Monatsschr nderheilkd 2001, 149:807-818.
• [57]Mahar MT, Guerieri AM, Hanna MS, Kemble CD: Estimation of aerobic fitness from 20-m multistage shuttle run test performance. Am J Prev Med 2011, 41:S117-S123.
• [58]van Mechelen W, Hlobil H, Kemper HC: Validation of two running tests as estimates of maximal aerobic power in children. Eur J Appl Physiol Occup Physiol 1986, 55:503-506.
• [59]Barkmann C, Erhart M, Schulte-Markwort M: The German version of the Centre for epidemiological studies depression scale for children: psychometric evaluation in a population-based survey of 7 to 17 years old children and adolescents–results of the BELLA study. Eur Child Adolesc Psychiatry 2008, 17(Suppl 1):116-124.
• [60]Hammersley M: Theoretical sampling. In The Sage Dictionary of Social Research Methods. Edited by Jupp V. London: SAGE Publications; 2006:298-299.
• [61]Bohnsack R: Group discussion. In Qualitative Research - A Handbook. Edited by Flick U, von Kardorff E, Steinke I. Reinbek: Rowohlt Taschenbuch Verlag; 2003:369-384.
• [62]Mayring P: Qualitative Content Analysis. Basics and Methods. Beltz: Weinheim, Basel; 2000.
• [63]Glaser B, Strauss A: The Discovery of Grounded Theory: Strategies for Qualitative Research. New York: Aldine de Gruyter; 1967.
• [64]Strong WB, Malina RM, Blimkie CJ, Daniels SR, Dishman RK, Gutin B, Hergenroeder AC, Must A, Nixon PA, Pivarnik JM, Rowland T, Trost S, Trudeau F: Evidence based physical activity for school-age youth. J Pediatr 2005, 146:732-737.
• [65]Trost SG: State of the art reviews: measurement of physical activity in children and adolescents. Am J Lifestyle Med 2007, 1:299-314.