期刊论文详细信息
International Journal of Behavioral Nutrition and Physical Activity
Intervention effects on physical activity: the HEIA study - a cluster randomized controlled trial
Sigmund Alfred Anderssen1  Knut-Inge Klepp2  Yngvar Ommundsen3  Lene Frost Andersen2  Nanna Lien2  Mona Bjelland2  Ingunn Holden Bergh3  May Grydeland1 
[1] Department of Sports Medicine, Norwegian School of Sports Sciences, PB 4014 Ullevaal Stadion, Oslo NO-0806, Norway;Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway;Department of Coaching and Psychology, Norwegian School of Sport Sciences, Oslo, Norway
关键词: Adolescents;    Children;    Intervention;    Accelerometers;    Overweight;    Obesity prevention;   
Others  :  810869
DOI  :  10.1186/1479-5868-10-17
 received in 2012-05-25, accepted in 2013-01-28,  发布年份 2013
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【 摘 要 】

Background

Although school-based interventions to promote physical activity in adolescents have been suggested in several recent reviews, questions have been raised regarding the effects of the strategies and the methodology applied and for whom the interventions are effective. The aim of the present study was to investigate effects of a school-based intervention program: the HEalth in Adolescents (HEIA) study, on change in physical activity, and furthermore, to explore whether potential effects varied by gender, weight status, initial physical activity level and parental education level.

Methods

This was a cluster randomized controlled 20 month intervention study which included 700 11-year-olds. Main outcome-variable was mean count per minute (cpm) derived from ActiGraph accelerometers (Model 7164/GT1M). Weight and height were measured objectively. Adolescents reported their pubertal status in a questionnaire and parents reported their education level on the consent form. Linear mixed models were used to test intervention effects and to account for the clustering effect of sampling by school.

Results

The present study showed an intervention effect on overall physical activity at the level of p = 0.05 with a net effect of 50 cpm increase from baseline to post intervention in favour of the intervention group (95% CI −0.4, 100). Subgroup analyses showed that the effect appeared to be more profound among girls (Est 65 cpm, CI 5, 124, p = 0.03) and among participants in the low-activity group (Est 92 cpm, CI 41, 142, p < 0.001), as compared to boys and participants in the high-activity group, respectively. Furthermore, the intervention affected physical activity among the normal weight group more positively than among the overweight, and participants with parents having 13–16 years of education more positively than participants with parents having either a lower or higher number of years of education. The intervention seemed to succeed in reducing time spent sedentary among girls but not among boys.

Conclusions

A comprehensive but feasible, multi-component school-based intervention can affect physical activity patterns in adolescents by increasing overall physical activity. This intervention effect seemed to be more profound in girls than boys, low-active adolescents compared to high-active adolescents, participants with normal weight compared to the overweight, and for participants with parents of middle education level as opposed to those with high and low education levels, respectively. An implementation of the HEIA intervention components in the school system may have a beneficial effect on public health by increasing overall physical activity among adolescents and possibly among girls and low-active adolescents in particular.

【 授权许可】

   
2013 Grydeland et al; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Riddoch CJ, Bo AL, Wedderkopp N, Harro M, Klasson-Heggebo L, Sardinha LB, et al.: Physical activity levels and patterns of 9- and 15-yr-old European children. Med Sci Sports Exerc 2004, 36:86-92.
  • [2]Troiano RP, Berrigan D, Dodd KW, Masse LC, Tilert T, McDowell M: Physical activity in the United States measured by accelerometer. Med Sci Sports Exerc 2008, 40:181-188.
  • [3]Fox K, Riddoch CA, McKenna J: The School and Promotion of Children’s Health-Enhancing Physical Activity: Perspectives from the United Kingdom. J Teach in Phys Educ 2004, 23:338-358.
  • [4]Dobbins M, De CK, 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, 21:CD007651. Review
  • [5]Salmon J, Booth ML, Phongsavan P, Murphy N, Timperio A: Promoting physical activity participation among children and adolescents. Epidemiol Rev 2007, 29:144-159.
  • [6]Van Sluijs EM, McMinn AM, Griffin SJ: Effectiveness of interventions to promote physical activity in children and adolescents: systematic review of controlled trials. BMJ 2007, 335:703.
  • [7]Ekelund U, Tomkinson G, Armstrong N: What proportion of youth are physically active? Measurement issues, levels and recent time trends. Br J Sports Med 2011, 45(11):859-865. Review
  • [8]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.
  • [9]Cox M, Schofield G, Greasley N, Kolt GS: Pedometer steps in primary school-aged children: a comparison of school-based and out-of-school activity. J Sci Med Sport 2006, 9:91-97.
  • [10]Yildirim M, Van Stralen MM, Chinapaw MJ, Brug J, Van MW, Twisk JW, et al.: For whom and under what circumstances do school-based energy balance behavior interventions work? Systematic review on moderators. Int J Pediatr Obes 2011, 6:e46-e57.
  • [11]Brown T, Summerbell C: Systematic review of school-based interventions that focus on changing dietary intake and physical activity levels to prevent childhood obesity: an update to the obesity guidance produced by the National Institute for Health and Clinical Excellence. Obes Rev 2009, 10:110-141.
  • [12]Muller MJ, Danielzik S, Landsberg B, Pust S: Interventions to prevent overweight in children. Int J Vitam Nutr Res 2006, 76:225-229.
  • [13]Kremers SP, De Bruijn GJ, Droomers M, van LF, Brug J: Droomers M, van LF, Brug J: Moderators of environmental intervention effects on diet and activity in youth. Am J Prev Med 2007, 32:163-172.
  • [14]Bergh IH, Bjelland M, Grydeland M, Lien N, Andersen LF, Klepp KI, et al.: Mid-way and post-intervention effects on potential determinants of physical activity and sedentary behavior, results of the HEIA study - a multicomponent school-based randomized trial. Int J Behav Nutr Phys Act 2012, 9:63. BioMed Central Full Text
  • [15]Bjelland M, Bergh IH, Grydeland M, Klepp KI, Andersen LF, Anderssen SA, et al.: Changes in adolescents’ intake of sugar-sweetened beverages and sedentary behaviour: results at 8 month mid-way assessment of the HEIA study–a comprehensive, multi-component school-based randomized trial. Int J Behav Nutr Phys Act 2011, 8:63. BioMed Central Full Text
  • [16]Lien N, Bjelland M, Bergh IH, Grydeland M, Anderssen SA, Ommundsen Y, et al.: Design of a 20-month comprehensive, multicomponent school-based randomised trial to promote healthy weight development among 11–13 year olds: The HEalth In Adolescents study. Scand J Public Health 2010, 38:38-51.
  • [17]Kremers SP, De Bruijn GJ, Visscher TL, van MW, De Vries NK, Brug J: Environmental influences on energy balance-related behaviors: a dual-process view. Int J Behav Nutr Phys Act 2006, 3:9. BioMed Central Full Text
  • [18]Ezendam NP, Brug J, Oenema A: Evaluation of the Web-Based Computer-Tailored FATaintPHAT intervention to promote energy balance among adolescents: results from a school cluster randomized trial. Arch Pediatr Adolesc Med 2012, 166:248-255.
  • [19]Sallis JF, McKenzie TL, Alcaraz JE, Kolody B, Hovell MF, Nader PR: Project SPARK. Effects of physical education on adiposity in children. Ann N Y Acad Sci 1993, 699:127-136.
  • [20]Pate RR, O’Neill JR, Lobelo F: The evolving definition of”sedentary”. Exerc Sport Sci Rev 2008, 36:173-178.
  • [21]Trost SG, Ward DS, Moorehead SM, Watson PD, Riner W, Burke JR: Validity of the computer science and applications (CSA) activity monitor in children. Med Sci Sports Exerc 1998, 30:629-633.
  • [22]Ekelund U, Sardinha LB, Anderssen SA, Harro M, Franks PW, Brage S, et al.: Associations between objectively assessed physical activity and indicators of body fatness in 9- to 10-y-old European children: a population-based study from 4 distinct regions in Europe (the European Youth Heart Study). Am J Clin Nutr 2004, 80:584-590.
  • [23]Kolle E, Steene-Johannessen J, Andersen LB, Anderssen SA: Objectively assessed physical activity and aerobic fitness in a population-based sample of Norwegian 9- and 15-year-olds. Scand J Med Sci Sports 2010, 20(1):41-47. Epub 2009 Apr 14.
  • [24]Ekelund U, Sjostrom M, Yngve A, Poortvliet E, Nilsson A, Froberg K, et al.: Physical activity assessed by activity monitor and doubly labeled water in children. Med Sci Sports Exerc 2001, 33:275-281.
  • [25]Corder K, Brage S, Ramachandran A, Snehalatha C, Wareham N, Ekelund U: Comparison of two Actigraph models for assessing free-living physical activity in Indian adolescents. J Sports Sci 2007, 25:1607-1611.
  • [26]Cole TJ, Bellizzi MC, Flegal KM, Dietz WH: Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000, 320:1240-1243.
  • [27]Carskadon MA, Acebo C: A self-administered rating scale for pubertal development. J Adolesc Health 1993, 14:190-195.
  • [28]Field A: Discovering Statistics Using SPSS, Third Edition edn. London: SAGE Publications Ltd; 2009.
  • [29]Kriemler S, Zahner L, Schindler C, Meyer U, Hartmann T, Hebestreit H, et al.: Effect of school based physical activity programme (KISS) on fitness and adiposity in primary schoolchildren: cluster randomised controlled trial. BMJ 2010, 340:c785.
  • [30]Bugge A, El-Naaman B, Dencker M, Froberg K, Holme IM, McMurray RG, et al.: Effects of a 3-year intervention: The Copenhagen School Child Intervention Study. Med Sci Sports Exerc 2012, 44(7):1310-1317.
  • [31]Kolle E, Steene-Johannessen J, Andersen LB, Anderssen SA: Seasonal variation in objectively assessed physical activity among children and adolescents in Norway: a cross-sectional study. Int J Behav Nutr Phys Act 2009, 6:36. BioMed Central Full Text
  • [32]Nettlefold L, McKay HA, Warburton DE, McGuire KA, Bredin SS, Naylor PJ: The challenge of low physical activity during the school day: at recess, lunch and in physical education. Br J Sports Med 2011, 45:813-819.
  • [33]Haug E, Torsheim T, Samdal O: Physical environmental characteristics and individual interests as correlates of physical activity in Norwegian secondary schools: the health behaviour in school-aged children study. Int J Behav Nutr Phys Act 2008, 5:47. BioMed Central Full Text
  • [34]Tremblay MS, LeBlanc AG, Kho ME, Saunders TJ, Larouche R, Colley RC, et al.: Systematic review of sedentary behaviour and health indicators in school-aged children and youth. Int J Behav Nutr Phys Act 2011, 8:98. BioMed Central Full Text
  • [35]Sun X, Briel M, Walter SD, Guyatt GH: Is a subgroup effect believable? Updating criteria to evaluate the credibility of subgroup analyses. BMJ 2010, 340:c117.
  • [36]Strong WB, Malina RM, Blimkie CJ, Daniels SR, Dishman RK, Gutin B, et al.: Evidence based physical activity for school-age youth. J Pediatr 2005, 146:732-737.
  • [37]Naylor PJ, Macdonald HM, Warburton DE, Reed KE, McKay HA: An active school model to promote physical activity in elementary schools: action schools! BC. Br J Sports Med 2008, 42:338-343.
  • [38]Petticrew M, Tugwell P, Kristjansson E, Oliver S, Ueffing E, Welch V: Damned if you do, damned if you don’t: subgroup analysis and equity. J Epidemiol Community Health 2012, 66:95-98.
  • [39]Bjelland M: Obesity prevention targeting Norwegian adolescents: Prevalence rates, determinants and intervention effects by gender, parental education and parent–child associations. University of Oslo: Oslo; 2011.
  • [40]The Norwegian Directorate of Health: Fysisk aktivitet blant 6-, 9- og 15-åringer i Norge. Oslo Norway: The Norwegian Directorate of Health; 2012. Ref Type: Report
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