scholarly journals Active Play in After-school Programmes: development of an intervention and description of a matched-pair cluster-randomised trial assessing physical activity play in after-school programmes

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e016585 ◽  
Author(s):  
Kirsti Riiser ◽  
Sølvi Helseth ◽  
Hanna Ellingsen ◽  
Bjørg Fallang ◽  
Knut Løndal
Keyword(s):  
Physical Activity ◽  
First Graders ◽  
Randomised Trial ◽  
Matched Pair ◽  
After School ◽  
Cluster Randomised Trial ◽  
Small Scale ◽  
Control Group ◽  
Active Play ◽  
Cluster Randomised

IntroductionInterventions delivered in after-school programmes (ASPs) have the potential to become a means of ensuring adequate physical activity among schoolchildren. This requires a motivational climate, allowing for self-determined play. If trained, ASP staff may represent a valuable resource for supporting such play. Increasing knowledge and supportive skills among ASP staff may also potentially increase their motivation for work. The purpose of this article is to describe the development of the ‘Active Play in ASP’ intervention, which aims to promote physical activity among first graders attending ASP, and to present a protocol for a matched-pair cluster-randomised trial to evaluate the intervention.Methods and analysisInformed by experiences from practice, evidence-based knowledge and theory, the intervention was developed in a stepwise process including focus group meetings and a small-scale pilot test. The intervention contains a course programme for ASP staff to increase their skills in how to support physical activity through play. In a cluster randomised controlled trial, the ASPs will be matched and randomly allocated to receive the 7-month intervention or to a control group. Outcomes will be assessed at baseline, after 7 and 19 months. First graders attending the ASPs included are eligible. The primary outcome will be accelerometer-determined minutes in moderate to vigorous physical activity in the ASP. The study uses a mixed methods approach including observations and interviews to provide rich descriptions of the concept of children's physical activity in ASP. Moreover, the trial will assess whether the ASP staff benefits from participation in the intervention in terms of increased work motivation. Lastly, process evaluations of programme fidelity, satisfaction and suggestions on improvement will be performed.Ethics and disseminationThe study is approved by the Data Protection Official for Research (reference no 46008). Results will be presented in conferences and peer-reviewed journals.Trial registration numberClinical Trials (NCT02954614), pre-results.

scholarly journals Effects of the Informed Health Choices primary school intervention on the ability of children in Uganda to assess the reliability of claims about treatment effects, one-year follow-up: a cluster-randomised trial

2019 ◽  
Author(s):  
Allen Nsangi ◽  
Daniel Semakula ◽  
Andrew David Oxman ◽  
Astrid Austvoll- Dalghren ◽  
Matt Oxman ◽  
...  
Keyword(s):  
Primary School ◽  
Primary Schools ◽  
Randomised Trial ◽  
Multiple Choice ◽  
Cluster Randomised Trial ◽  
Control Group ◽  
Cluster Randomised ◽  
Health Choices ◽  
The Mean ◽  
One Year

Abstract Introduction We evaluated an intervention designed to teach 10 to 12-year-old primary school children to assess claims about the effects of treatments (any action intended to maintain or improve health). We report here on outcomes measured one year after the intervention. Methods In this cluster-randomised trial, we included primary schools in the central region of Uganda that taught year-five children (aged 10 to 12 years). We randomly allocated a representative sample of eligible schools to either an intervention or control group. Intervention schools received the Informed Health Choices primary school resources (textbooks, exercise books, and a teachers’ guide). The primary outcome, measured at the end of the school term and again after one year, was the mean score on a test with two multiple-choice questions for each of the 12 concepts and the proportion of children with passing scores. Results We assessed 2960 schools for eligibility; 2029 were eligible, and a random sample of 170 were invited to recruitment meetings. After recruitment meetings, 120 eligible schools consented and were randomly assigned to either the intervention group (n=60, 76 teachers and 6383 children) or control group (n=60, 67 teachers and 4430 children). After one year, the mean score in the multiple-choice test for the intervention schools was 68.7% compared to 53.0% for the control schools (adjusted mean difference 16.7%, 95% CI 13.9 to 19.5; p<0·00001). In the intervention schools, 3160 (80.1%) of 3943 children that completed the test after one year achieved a predetermined passing score (≥13 of 24 correct answers) compared with 1464 (51.5%) of 2844 children in the control schools (adjusted difference 39.5%, 95% CI 29.9 to 47.5). Conclusion Use of the learning-resources led to a large improvement in the ability of children to assess claims, which was sustained for at least one year.

scholarly journals Feasibility of alcohol screening and brief intervention in primary health care in Kazakhstan: study protocol of a pilot cluster randomised trial

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Bernd Schulte ◽  
Amy O’Donnell ◽  
Harald Lahusen ◽  
Christina Lindemann ◽  
Mariya Prilutskaya ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Brief Intervention ◽  
Randomised Trial ◽  
Alcohol Screening ◽  
Cluster Randomised Trial ◽  
Control Group ◽  
Screening And Brief Intervention ◽  
Primary Health ◽  
Cluster Randomised

Abstract Background Identifying and addressing heavy drinking represents a major public health priority worldwide. Whilst the majority of alcohol screening and brief intervention (ASBI) research has been conducted in western, high-income countries, evidence is growing that ASBI can also impact positively on heavy drinkers in low- and middle-income country populations. This mixed methods study aims to assess the feasibility of conducting a fully randomised controlled trial of the effectiveness of ASBI in primary care in Kazakhstan and explore the feasibility and acceptability of implementing ASBI in this setting from patients’ and physicians’ perspectives. Methods Six primary health care units in the region of Pavlodar will be cluster randomised to either an intervention (WHO manualised 5 min alcohol brief intervention plus alcohol leaflet) or control group (simple feedback plus alcohol leaflet). Primary feasibility measures will be rates of participation at baseline and retention of eligible patients at the 3-month follow-up point. Patient/physician questionnaires and physician focus groups will assess additional dimensions of feasibility, as well as acceptability, according to the RE-AIM framework: Reach (rates of eligible patients screened/received advice); Effectiveness (change in AUDIT-C score); Adoption (rate/representativeness of participating physicians); Implementation (quality of ASBI/barriers and facilitators to delivery); and Maintenance (potential sustainability of intervention). Discussion This is the first trial of the feasibility and acceptability of ASBI in Kazakhstan. As the planning and assessment of implementation determinants is based on the RE-AIM framework, the project outcomes will be relevant for the future development, tailoring and implementation of ASBI in Kazakhstan. Trial registration DRKS, DRKS00015882, Registered 17 December 2018.

scholarly journals Effects of the Informed Health Choices primary school intervention on the ability of children in Uganda to assess the reliability of claims about treatment effects, one-year follow-up: a cluster-randomised trial

2019 ◽  
Author(s):  
Allen Nsangi ◽  
Daniel Semakula ◽  
Andrew David Oxman ◽  
Astrid Austvoll- Dalghren ◽  
Matt Oxman ◽  
...  
Keyword(s):  
Primary School ◽  
Primary Schools ◽  
Randomised Trial ◽  
Multiple Choice ◽  
Cluster Randomised Trial ◽  
Control Group ◽  
Cluster Randomised ◽  
Health Choices ◽  
The Mean ◽  
One Year

Abstract Introduction We evaluated an intervention designed to teach 10 to 12-year-old primary school children to assess claims about the effects of treatments (any action intended to maintain or improve health). We report here on outcomes measured one year after the intervention. Methods In this cluster-randomised trial, we included primary schools in the central region of Uganda that taught year-five children (aged 10 to 12 years). We randomly allocated a representative sample of eligible schools to either an intervention or control group. Intervention schools received the Informed Health Choices primary school resources (textbooks, exercise books, and a teachers’ guide). The primary outcome, measured at the end of the school term and again after one year, was the mean score on a test with two multiple-choice questions for each of the 12 concepts and the proportion of children with passing scores. Results We assessed 2960 schools for eligibility; 2029 were eligible, and a random sample of 170 were invited to recruitment meetings. After recruitment meetings, 120 eligible schools consented and were randomly assigned to either the intervention group (n=60, 76 teachers and 6383 children) or control group (n=60, 67 teachers and 4430 children). After one year, the mean score in the multiple-choice test for the intervention schools was 68.7% compared to 53.0% for the control schools (adjusted mean difference 16.7%, 95% CI 13.9 to 19.5; p<0·00001). In the intervention schools, 3160 (80.1%) of 3943 children that completed the test after one year achieved a predetermined passing score (≥13 of 24 correct answers) compared with 1464 (51.5%) of 2844 children in the control schools (adjusted difference 39.5%, 95% CI 29.9 to 47.5). Conclusion Use of the learning-resources led to a large improvement in the ability of children to assess claims, which was sustained for at least one year.

scholarly journals Active Play in ASP –A matched-pair cluster-randomized trial investigating the effectiveness of an intervention in After-school programs for supporting children’s physical activity

2020 ◽  
Author(s):  
Kirsti Riiser ◽  
Kåre Rønn Richardsen ◽  
Anders Lund Hage Haugen ◽  
Siv Lund ◽  
Knut Løndal
Keyword(s):  
Physical Activity ◽  
Sedentary Behavior ◽  
First Graders ◽  
After School Programs ◽  
Matched Pair ◽  
After School ◽  
School Programs ◽  
Cluster Randomized ◽  
Sedentary Behavior Time

Abstract Background: Interventions directed at after school programs (ASPs) have the potential to support physical activity (PA) in young children. Research has indicated that interventions that emphasize competence building among the ASP staff can lead to increased PA among the children. The present study evaluates the effectiveness of the Active Play in ASP intervention—a program for ASP staff aimed at supporting physical activity among first graders in ASP. Methods: We used a matched-pair cluster randomized design and included 456 first graders from 14 schools in Norway. From these, 7 ASPs received the intervention (N = 229), while 7 acted as controls (N = 227). Measurements were taken at baseline, immediately post intervention (7 month follow-up) and after a year (19 month follow-up). The primary outcome was moderate to vigorous physical activity (MVPA), which was estimated with predefined cut points of counts per minute (CPM) and expressed as minutes/hour. Secondary outcomes were vigorous and light intensity physical activity (VPA and LPA) and sedentary behavior. The analyses of intervention effects were based on between-group differences in outcome changes between the 3 measurement points and were conducted using a mixed-effects model for repeated measures using categorical time. In exploratory analyses, we investigated gender, baseline body mass index, and baseline CPM as potential effect modifiers. Results: No significant intervention effects was observed on MVPA (0.55 min/hour [99% CI -0.55:1.64]) or on the secondary outcomes, min/hour of LPA, VPA or sedentary behavior. Exploratory analyses indicated that among the 50% least physically active children at baseline, children in intervention ASPs reduced sedentary time from baseline to 19 months follow up by 1.67 min/hour (95% CI -3.12:-0.21) compared to the controls. Conclusions: Although the intervention did not significantly increase the mean MVPA among the children in the intervention ASPs compared to controls, it did seem to have a small effect by reducing sedentary behavior time among the least active children. An even stronger emphasis on how to identify less active children and support their activity may be needed in order to increase their PA and further reduce sedentary behavior time.

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