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Published in: Trials 1/2011

Open Access 01-12-2011 | Study protocol

The Active for Life Year 5 (AFLY5) school based cluster randomised controlled trial: study protocol for a randomized controlled trial

Authors: Debbie A Lawlor, Russell Jago, Sian M Noble, Catherine R Chittleborough, Rona Campbell, Julie Mytton, Laura D Howe, Tim J Peters, Ruth R Kipping

Published in: Trials | Issue 1/2011

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Abstract

Background

Low levels of physical activity, high levels of sedentary behaviour and low levels of fruit and vegetable consumption are common in children and are associated with adverse health outcomes. The aim of this paper is to describe the protocol for a cluster randomised controlled trial (RCT) designed to evaluate a school-based intervention that aims to increase levels of physical activity, decrease sedentary behaviour and increase consumption of fruit and vegetables in school children.

Methods/design

The Active for Life Year 5 (AFLY5) study is a school-based, cluster RCT that targets school children in Year 5 (age 9-10 years). All state junior/primary schools in the area covered by Bristol City and North Somerset Council are invited to participate; special schools are excluded. Eligible schools are randomised to one of two arms: intervention arm (receive the intervention 2011-2012) and control arm (receive the intervention after the final follow-up assessment, 2013-2014). The primary outcomes of the trial are levels of accelerometer assessed physical activity and sedentary behaviour and questionnaire assessed fruit and vegetable consumption. A number of secondary outcomes will also be measured, including body mass index, waist circumference and overweight/obesity. Outcomes will be assessed at baseline (prior to intervention when the children are in Year 4), at the end of intervention 'immediate follow-up' and '12 months long-term' follow-up. We will use random effects linear and logistic regression models to compare outcomes by randomised arm. The economic evaluation from a societal perspective will take the form of a cost consequence analysis. Data from focus groups and interviews with pupils, parents and teachers will be used to increase understanding of how the intervention has any effect and is integrated into normal school activity.

Discussion

The results of the trial will provide information about the public health effectiveness of a school-based intervention aimed at improving levels of physical activity, sedentary behaviour and diet in children.

Trial registration

Appendix
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Literature
2.
go back to reference Boreham C, Riddoch C: The physical activity, fitness and health of children. J Sports Sci. 2001, 19: 915-929. 10.1080/026404101317108426.CrossRefPubMed Boreham C, Riddoch C: The physical activity, fitness and health of children. J Sports Sci. 2001, 19: 915-929. 10.1080/026404101317108426.CrossRefPubMed
3.
go back to reference Kriemler S, Zahner L, Schindler C, Meyer U, Harmann 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: c785-10.1136/bmj.c785.CrossRefPubMedPubMedCentral Kriemler S, Zahner L, Schindler C, Meyer U, Harmann 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: c785-10.1136/bmj.c785.CrossRefPubMedPubMedCentral
4.
go back to reference Ekelund U, Brage S, Froberg K, Harro M, Anderssen SA, Sardinha LB, Riddoch C, Andersen LB: TV viewing and physical activity are independently associated with metabolic risk in children. PLoS Med. 2006, 3 (12): e488-10.1371/journal.pmed.0030488.CrossRefPubMedPubMedCentral Ekelund U, Brage S, Froberg K, Harro M, Anderssen SA, Sardinha LB, Riddoch C, Andersen LB: TV viewing and physical activity are independently associated with metabolic risk in children. PLoS Med. 2006, 3 (12): e488-10.1371/journal.pmed.0030488.CrossRefPubMedPubMedCentral
5.
go back to reference World Health Organization: Diet, Nutrition and the prevention of Chronic Diseases: report of a joint WHO/FAO expert consultation. 2003, Geneva, Switzerland World Health Organization: Diet, Nutrition and the prevention of Chronic Diseases: report of a joint WHO/FAO expert consultation. 2003, Geneva, Switzerland
6.
go back to reference Nicklas TA: Dietary studies of children and young adults (1973-1988): The Bogalusa Heart Study. The American Journal of Medical Sciences. 1995, 310 (Suppl 1): S101-S108.CrossRef Nicklas TA: Dietary studies of children and young adults (1973-1988): The Bogalusa Heart Study. The American Journal of Medical Sciences. 1995, 310 (Suppl 1): S101-S108.CrossRef
7.
go back to reference Forastiere F, Pistelli R, Sestini P, Fortes C, Renzoni E, Rusconi F, Dell'Orca V, Ciccone G, Bisanti L: Consumption of fresh fruit rich in vitamin C and wheezing symptoms in children. Thorax. 2000, 55: 283-288. 10.1136/thorax.55.4.283.CrossRefPubMedPubMedCentral Forastiere F, Pistelli R, Sestini P, Fortes C, Renzoni E, Rusconi F, Dell'Orca V, Ciccone G, Bisanti L: Consumption of fresh fruit rich in vitamin C and wheezing symptoms in children. Thorax. 2000, 55: 283-288. 10.1136/thorax.55.4.283.CrossRefPubMedPubMedCentral
8.
go back to reference 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, CD007651- 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, CD007651-
9.
go back to reference DeMattia L, Lemont L, Meurer L: Do interventions to limit sedentary behaviours change behaviour and reduce childhood obesity? A critical review of the literature. Obes Rev. 2007, 8: 69-81. 10.1111/j.1467-789X.2006.00259.x.CrossRefPubMed DeMattia L, Lemont L, Meurer L: Do interventions to limit sedentary behaviours change behaviour and reduce childhood obesity? A critical review of the literature. Obes Rev. 2007, 8: 69-81. 10.1111/j.1467-789X.2006.00259.x.CrossRefPubMed
11.
go back to reference Gonzalez-Suarez C, Worley A, Grimmer-Somers K, Dones V: School-Based Interventions on Childhood Obesity: A Meta-Analysis. American Journal of Preventive Medicine. 2009, 37: 418-427. 10.1016/j.amepre.2009.07.012.CrossRefPubMed Gonzalez-Suarez C, Worley A, Grimmer-Somers K, Dones V: School-Based Interventions on Childhood Obesity: A Meta-Analysis. American Journal of Preventive Medicine. 2009, 37: 418-427. 10.1016/j.amepre.2009.07.012.CrossRefPubMed
12.
go back to reference Katz DL, O'Connell M, Njike VY, Yeh M-C, Nawaz H: Strategies for the prevention and control of obesity in the school setting: systematic review and meta-analysis. Int J Obes. 2005, 32: 1780-1789.CrossRef Katz DL, O'Connell M, Njike VY, Yeh M-C, Nawaz H: Strategies for the prevention and control of obesity in the school setting: systematic review and meta-analysis. Int J Obes. 2005, 32: 1780-1789.CrossRef
13.
go back to reference Kipping RR, Payne C, Lawlor DA: Randomised controlled trial adapting US school obesity prevention to England. Arch Dis Child. 2008, 93: 469-473. 10.1136/adc.2007.116970.CrossRefPubMed Kipping RR, Payne C, Lawlor DA: Randomised controlled trial adapting US school obesity prevention to England. Arch Dis Child. 2008, 93: 469-473. 10.1136/adc.2007.116970.CrossRefPubMed
14.
go back to reference Kipping RR, Jago R, Lawlor DA: Diet outcomes of a pilot school-based randomised controlled prevention study with 9-10 year olds in England. Prev Med. 2010 Kipping RR, Jago R, Lawlor DA: Diet outcomes of a pilot school-based randomised controlled prevention study with 9-10 year olds in England. Prev Med. 2010
15.
go back to reference Gortmaker SL, Cheung LW, Peterson KE, Chomitz G, Cradle JH, Dart H, Fox MK, Bullock RB, Sobol AM, Colditz G, Field AE, Laird N: Impact of a school-based interdisciplinary intervention: eat well and keep moving. Arch Pediatr Adolesc Med. 1999, 153: 975-983.CrossRefPubMed Gortmaker SL, Cheung LW, Peterson KE, Chomitz G, Cradle JH, Dart H, Fox MK, Bullock RB, Sobol AM, Colditz G, Field AE, Laird N: Impact of a school-based interdisciplinary intervention: eat well and keep moving. Arch Pediatr Adolesc Med. 1999, 153: 975-983.CrossRefPubMed
16.
go back to reference Hughes AR, Sherriff A, Lawlor DA, Ness AR, Reilly JJ: Timing of excess weight gain in a large cohort of English children growing up in the 1990s (ALSPAC). Pediatrics. 2011, 127: e730-e736. 10.1542/peds.2010-0959.CrossRefPubMed Hughes AR, Sherriff A, Lawlor DA, Ness AR, Reilly JJ: Timing of excess weight gain in a large cohort of English children growing up in the 1990s (ALSPAC). Pediatrics. 2011, 127: e730-e736. 10.1542/peds.2010-0959.CrossRefPubMed
17.
go back to reference Hughes AR, Sherriff A, Lawlor DA, Ness AR, Reilly JJ: Incidence of obesity during childhood and adolescence in large contemporary cohort. Preventive Medicine. 2011, 52: 300-304. 10.1016/j.ypmed.2011.02.014.CrossRefPubMedPubMedCentral Hughes AR, Sherriff A, Lawlor DA, Ness AR, Reilly JJ: Incidence of obesity during childhood and adolescence in large contemporary cohort. Preventive Medicine. 2011, 52: 300-304. 10.1016/j.ypmed.2011.02.014.CrossRefPubMedPubMedCentral
19.
go back to reference Bandura A: Social foundations of thought and action: A social cognitive theory. 1986, Englewood Cliffs, NJ: Prentice Hall Bandura A: Social foundations of thought and action: A social cognitive theory. 1986, Englewood Cliffs, NJ: Prentice Hall
20.
go back to reference Bandura A: Self-efficacy: The exercise of control. 1997, New York: Freeman Bandura A: Self-efficacy: The exercise of control. 1997, New York: Freeman
21.
go back to reference McClain JJ, Tudor-Locke C: Objective monitoring of physical activity in children: considerations for instrument selection. J Sci Med Sport. 2009, 12: 526-533. 10.1016/j.jsams.2008.09.012.CrossRefPubMed McClain JJ, Tudor-Locke C: Objective monitoring of physical activity in children: considerations for instrument selection. J Sci Med Sport. 2009, 12: 526-533. 10.1016/j.jsams.2008.09.012.CrossRefPubMed
22.
go back to reference Johnson ST, Kuk JL, Mackenzie KA, Huang TT, Rosychuk RJ, Ball GD: Metabolic risk varies according to waist circumference measurement site in overweight boys and girls. J Pediatr. 2010, 156: 247-252. 10.1016/j.jpeds.2009.08.010.CrossRefPubMed Johnson ST, Kuk JL, Mackenzie KA, Huang TT, Rosychuk RJ, Ball GD: Metabolic risk varies according to waist circumference measurement site in overweight boys and girls. J Pediatr. 2010, 156: 247-252. 10.1016/j.jpeds.2009.08.010.CrossRefPubMed
23.
go back to reference Lange I, Kipping RR, Jago J, Lawlor DA: Variation in childhood and adolescent obesity prevalence defined by international and country-specific criteria in England and the US. European Journal of Clinical Nutrition. 2010 Lange I, Kipping RR, Jago J, Lawlor DA: Variation in childhood and adolescent obesity prevalence defined by international and country-specific criteria in England and the US. European Journal of Clinical Nutrition. 2010
24.
go back to reference McCarthy HD, Jarrett KV, Crawley HF: The development of waist circumference percentiles in British children aged 5.0-16.9 y. Eur J Clin Nutr. 2001, 55: 902-907. 10.1038/sj.ejcn.1601240.CrossRefPubMed McCarthy HD, Jarrett KV, Crawley HF: The development of waist circumference percentiles in British children aged 5.0-16.9 y. Eur J Clin Nutr. 2001, 55: 902-907. 10.1038/sj.ejcn.1601240.CrossRefPubMed
25.
go back to reference Zimmet P, Alberti G, Kaufman F, Tajima N, Silink M, Arslanian S, Wong G, Bennett P, Shaw J, Caprio S: The metabolic syndrome in children and adolescents. Lancet. 2007, 369 (9579): 2059-2061. 10.1016/S0140-6736(07)60958-1.CrossRefPubMed Zimmet P, Alberti G, Kaufman F, Tajima N, Silink M, Arslanian S, Wong G, Bennett P, Shaw J, Caprio S: The metabolic syndrome in children and adolescents. Lancet. 2007, 369 (9579): 2059-2061. 10.1016/S0140-6736(07)60958-1.CrossRefPubMed
26.
go back to reference Edmunds LD, Ziebland S: Development and validation of the Day in the Life Questionnaire (DILQ) as a measure of fruit and vegetable questionnaire for 7-9 year olds. HER. 2002, 17: 211-220. Edmunds LD, Ziebland S: Development and validation of the Day in the Life Questionnaire (DILQ) as a measure of fruit and vegetable questionnaire for 7-9 year olds. HER. 2002, 17: 211-220.
27.
go back to reference Moore GF, Tapper K, Murphy S, Clark R, Lynch R, Moore L: Validation of a self-completion measure of breakfast foods, snacks and fruits and vegetables consumed by 9- to 11-year-old schoolchildren. E J Clin Nutr. 2007, 61: 420-30. 10.1038/sj.ejcn.1602531.CrossRef Moore GF, Tapper K, Murphy S, Clark R, Lynch R, Moore L: Validation of a self-completion measure of breakfast foods, snacks and fruits and vegetables consumed by 9- to 11-year-old schoolchildren. E J Clin Nutr. 2007, 61: 420-30. 10.1038/sj.ejcn.1602531.CrossRef
28.
go back to reference Campbell KJ, Crawford DA, Salmon J, Carver A, Garnett SP, Baur LA: Associations between the home food environment and obesity-promoting eating behaviors in adolescence. Obesity. 2007, 15: 719-730. 10.1038/oby.2007.553.CrossRefPubMed Campbell KJ, Crawford DA, Salmon J, Carver A, Garnett SP, Baur LA: Associations between the home food environment and obesity-promoting eating behaviors in adolescence. Obesity. 2007, 15: 719-730. 10.1038/oby.2007.553.CrossRefPubMed
29.
go back to reference Robinson TN: Reducing children's television viewing to prevent obesity: a randomized controlled trial. JAMA. 1999, 282: 1561-1567. 10.1001/jama.282.16.1561.CrossRefPubMed Robinson TN: Reducing children's television viewing to prevent obesity: a randomized controlled trial. JAMA. 1999, 282: 1561-1567. 10.1001/jama.282.16.1561.CrossRefPubMed
30.
go back to reference Baranowski T, Jago R: Understanding the mechanisms of change in children's physical activity programs. Exerc Sport Sci Rev. 2005, 33: 163-168. 10.1097/00003677-200510000-00003.CrossRefPubMed Baranowski T, Jago R: Understanding the mechanisms of change in children's physical activity programs. Exerc Sport Sci Rev. 2005, 33: 163-168. 10.1097/00003677-200510000-00003.CrossRefPubMed
31.
go back to reference Sherwood NE, Taylor WC, Treuth M, Klesges LM, Baranowski T, Zhou A, Pratt C, McClanahan B, Robinsn TN, Pruitt L, Miller W: Measurement characteristics of activity-related psychosocial measures in 8- to 10-year-old African-American girls (GEMS). Prev Med. 2004, 38 (Suppl): S60-S68.CrossRefPubMed Sherwood NE, Taylor WC, Treuth M, Klesges LM, Baranowski T, Zhou A, Pratt C, McClanahan B, Robinsn TN, Pruitt L, Miller W: Measurement characteristics of activity-related psychosocial measures in 8- to 10-year-old African-American girls (GEMS). Prev Med. 2004, 38 (Suppl): S60-S68.CrossRefPubMed
32.
go back to reference Dyson LK: American cuisine in the 20th century. FoodReview. 2000, 23: 2-7. Dyson LK: American cuisine in the 20th century. FoodReview. 2000, 23: 2-7.
33.
go back to reference Davison KK, Cutting TM, Birch LL: Parents' activity-related parenting practices predict girls' physical activity. Med Sci Sports Exerc. 2003, 35: 1589-1595. 10.1249/01.MSS.0000084524.19408.0C.CrossRefPubMedPubMedCentral Davison KK, Cutting TM, Birch LL: Parents' activity-related parenting practices predict girls' physical activity. Med Sci Sports Exerc. 2003, 35: 1589-1595. 10.1249/01.MSS.0000084524.19408.0C.CrossRefPubMedPubMedCentral
34.
go back to reference Davison KK, Li K, Baskin ML, Cox T, Affuso O: The Activity Support Scale for Multiple Groups (ACTS-MG). Prev Med. 2011, 52: 39-43. 10.1016/j.ypmed.2010.11.008.CrossRefPubMed Davison KK, Li K, Baskin ML, Cox T, Affuso O: The Activity Support Scale for Multiple Groups (ACTS-MG). Prev Med. 2011, 52: 39-43. 10.1016/j.ypmed.2010.11.008.CrossRefPubMed
35.
go back to reference Cullen KW, Baranowski T, Rittenberry L, Cosart C, Hebert D, de Moor C: Child-reported family and peer influences on fruit, juice and vegetable consumption: reliability and validity of measures. Health Educ Res. 2001, 16: 187-00 Cullen KW, Baranowski T, Rittenberry L, Cosart C, Hebert D, de Moor C: Child-reported family and peer influences on fruit, juice and vegetable consumption: reliability and validity of measures. Health Educ Res. 2001, 16: 187-00
36.
go back to reference Moher D, Schulz KF, Altman D: The CONSORT statement: revised recommendations. JAMA. 2001, 285: 1987-91. 10.1001/jama.285.15.1987.CrossRefPubMed Moher D, Schulz KF, Altman D: The CONSORT statement: revised recommendations. JAMA. 2001, 285: 1987-91. 10.1001/jama.285.15.1987.CrossRefPubMed
37.
go back to reference Greenland S: An introduction to instrumental variables for epidemiologists. IJE. 2000, 29: 722-9. Greenland S: An introduction to instrumental variables for epidemiologists. IJE. 2000, 29: 722-9.
38.
go back to reference Peterson A, Mann S, Kealey K, Marek P: Experimental design and methods for school-based randomized trials: experience from the Hutchinson Smoking Prevention Project (HSPP). Controlled Clinical Trials. 2000, 21: 144-165. 10.1016/S0197-2456(99)00050-1.CrossRefPubMed Peterson A, Mann S, Kealey K, Marek P: Experimental design and methods for school-based randomized trials: experience from the Hutchinson Smoking Prevention Project (HSPP). Controlled Clinical Trials. 2000, 21: 144-165. 10.1016/S0197-2456(99)00050-1.CrossRefPubMed
39.
go back to reference Ellickson PL, Hawes JA: An assessment of active versus passive methods for obtaining parental consent. Evaluation Review. 1989, 13: 45-55. 10.1177/0193841X8901300104.CrossRefPubMed Ellickson PL, Hawes JA: An assessment of active versus passive methods for obtaining parental consent. Evaluation Review. 1989, 13: 45-55. 10.1177/0193841X8901300104.CrossRefPubMed
40.
go back to reference Cross-Government Obesity Unit: The National Child Measurement Programme Guidance For Primary Care Trusts 2010/11. Department of Health London. 2010 Cross-Government Obesity Unit: The National Child Measurement Programme Guidance For Primary Care Trusts 2010/11. Department of Health London. 2010
41.
go back to reference Warren JM, Henry CJ, Lightowler HJ, Bradshaw SM, Perwaiz S: Evaluation of a pilot school programme aimed at the prevention of obesity in children. Health Promot Int. 2003, 18: 287-296. 10.1093/heapro/dag402.CrossRefPubMed Warren JM, Henry CJ, Lightowler HJ, Bradshaw SM, Perwaiz S: Evaluation of a pilot school programme aimed at the prevention of obesity in children. Health Promot Int. 2003, 18: 287-296. 10.1093/heapro/dag402.CrossRefPubMed
42.
go back to reference Sahota P, Rudolf MC, Dixey R, Hill AJ, Barth JH, Cade J: Randomised controlled trial of primary school-based intervention to reduce risk factors for obesity. BMJ. 2001, 323: 1029-1032. 10.1136/bmj.323.7320.1029.CrossRefPubMedPubMedCentral Sahota P, Rudolf MC, Dixey R, Hill AJ, Barth JH, Cade J: Randomised controlled trial of primary school-based intervention to reduce risk factors for obesity. BMJ. 2001, 323: 1029-1032. 10.1136/bmj.323.7320.1029.CrossRefPubMedPubMedCentral
43.
go back to reference James J, Thomas P, Cavan D, Kerr D: Preventing childhood obesity by reducing consumption of carbonated drinks: cluster randomised controlled trial. BMJ. 2004, 328: 1237-10.1136/bmj.38077.458438.EE.CrossRefPubMedPubMedCentral James J, Thomas P, Cavan D, Kerr D: Preventing childhood obesity by reducing consumption of carbonated drinks: cluster randomised controlled trial. BMJ. 2004, 328: 1237-10.1136/bmj.38077.458438.EE.CrossRefPubMedPubMedCentral
44.
go back to reference James J, Thomas P, Kerr D: Preventing childhood obesity: two year follow-up results from the Christchurch obesity prevention programme in schools (CHOPPS). BMJ. 2007, 335: 762-10.1136/bmj.39342.571806.55.CrossRefPubMedPubMedCentral James J, Thomas P, Kerr D: Preventing childhood obesity: two year follow-up results from the Christchurch obesity prevention programme in schools (CHOPPS). BMJ. 2007, 335: 762-10.1136/bmj.39342.571806.55.CrossRefPubMedPubMedCentral
Metadata
Title
The Active for Life Year 5 (AFLY5) school based cluster randomised controlled trial: study protocol for a randomized controlled trial
Authors
Debbie A Lawlor
Russell Jago
Sian M Noble
Catherine R Chittleborough
Rona Campbell
Julie Mytton
Laura D Howe
Tim J Peters
Ruth R Kipping
Publication date
01-12-2011
Publisher
BioMed Central
Published in
Trials / Issue 1/2011
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/1745-6215-12-181

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