Effects of statewide health promotion in primary schools on children’s sick days, visits to a physician and parental absence from work: a cluster-randomized trial

Abstract Background: Neck pain is prevalent among office workers. This study evaluated the impact of an ergonomic and exercise training (EET) intervention and an ergonomic and health promotion (EHP) intervention on neck pain intensity among the general office workers and a subgroup of office workers with neck pain at baseline. Methods: A prospective 12-month cluster-randomized trial was conducted in 14 public and private organisations. Participants were office workers, aged ≥18 years working ≥30 hours per week (n=740). All participants received an individualised workstation ergonomic intervention, followed by 1:1 allocation to the EET group (neck-specific exercise training), or the EHP group (health promotion) for 12 weeks. Neck pain intensity (scale: 0-9) was recorded at baseline, 12 weeks, and 12 months. Participants with data at these three time points were included for analysis (n=367). Intervention group differences were analysed using generalized estimating equation models on an intention-to-treat basis and adjusted for potential confounders (demographic, health or work-related). Subgroup analysis was performed on participants symptomatic at baseline (neck cases) (n=96).Results: The EET group demonstrated significantly greater reductions in neck pain intensity at 12 weeks compared to the EHP group for both the general office workers (EET: b=-0.53 points 95%CI: -0.84– -0.22 [36%] and EHP: b=-0.17 points 95%CI: -0.47–0.13 [10.5%], p-value=0.02) and neck cases subgroup (EET: b=-2.32 points 95%CI: -3.09– -1.56 [53%] and EHP: b=-1.75 points 95%CI: -2.35– -1.16 [36%], p=0.04). Reductions in pain intensity were not maintained at 12 months with no between-group differences observed in either the general office workers (EET: b=-0.18, 95%CI: -0.53–0.16 and EHP: b=-0.14 points 95%CI: -0.49–0.21, p=0.53) or neck cases subgroup, although in both groups an overall reduction was found (EET: b= -1.61 points 95%CI: -2.36– -0.89 and EHP: b=-1.9 points 95%CI: -2.59– -1.20, p=0.26). Conclusion: EET was more effective and clinically meaningful than EHP in reducing neck pain intensity in both general office workers and those with neck pain immediately following the intervention period (12 weeks) but not at 12 months follow-up. Findings suggest the need for continuation of exercise to maintain benefits in the longer term.Clinical trial registration: ACTRN12612001154897 Date of Registration: 31/10/2012

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A cluster randomized trial to evaluate the efficacy of a school-based behavioral intervention for health promotion among children aged 3 to 5

BMC Public Health ◽

10.1186/1471-2458-13-656 ◽

2013 ◽

Vol 13 (1) ◽

Cited By ~ 31

Author(s):

José L Peñalvo ◽

Gloria Santos-Beneit ◽

Mercedes Sotos-Prieto ◽

Ramona Martínez ◽

Carla Rodríguez ◽

...

Keyword(s):

Health Promotion ◽

Randomized Trial ◽

Behavioral Intervention ◽

Cluster Randomized Trial ◽

School Based ◽

Cluster Randomized

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A cluster-randomized trial of workplace ergonomics and neck-specific exercise versus ergonomics and health promotion for office workers to manage neck pain—a secondary outcome analysis

10.21203/rs.3.rs-32053/v2 ◽

2020 ◽

Author(s):

Venerina Johnston ◽

Xiaoqi Chen ◽

Alyssa Welch ◽

Gisela Sjøgaard ◽

Tracy A Comans ◽

...

Keyword(s):

Health Promotion ◽

Neck Pain ◽

Randomized Trial ◽

Cluster Randomized Trial ◽

Office Workers ◽

Secondary Outcome ◽

Outcome Analysis ◽

Specific Exercise ◽

Cluster Randomized

Abstract The authors have withdrawn this preprint due to author disagreement.

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Improving service delivery of water, sanitation, and hygiene in primary schools: a cluster-randomized trial in western Kenya

Journal of Water and Health ◽

10.2166/wh.2013.213 ◽

2013 ◽

Vol 11 (3) ◽

pp. 507-519 ◽

Cited By ~ 20

Author(s):

Kelly T. Alexander ◽

Robert Dreibelbis ◽

Matthew C. Freeman ◽

Betty Ojeny ◽

Richard Rheingans

Keyword(s):

Service Delivery ◽

Randomized Trial ◽

Primary Schools ◽

Cluster Randomized Trial ◽

Control Group ◽

Sanitation And Hygiene ◽

Community Monitoring ◽

Additional Funding ◽

Cluster Randomized ◽

Treated Drinking Water

Water, sanitation, and hygiene (WASH) programs in schools have been shown to improve health and reduce absence. In resource-poor settings, barriers such as inadequate budgets, lack of oversight, and competing priorities limit effective and sustained WASH service delivery in schools. We employed a cluster-randomized trial to examine if schools could improve WASH conditions within existing administrative structures. Seventy schools were divided into a control group and three intervention groups. All intervention schools received a budget for purchasing WASH-related items. One group received no further intervention. A second group received additional funding for hiring a WASH attendant and making repairs to WASH infrastructure, and a third group was given guides for student and community monitoring of conditions. Intervention schools made significant improvements in provision of soap and handwashing water, treated drinking water, and clean latrines compared with controls. Teachers reported benefits of monitoring, repairs, and a WASH attendant, but quantitative data of WASH conditions did not determine whether expanded interventions out-performed our budget-only intervention. Providing schools with budgets for WASH operational costs improved access to necessary supplies, but did not ensure consistent service delivery to students. Further work is needed to clarify how schools can provide WASH services daily.

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Effects of TX Sprouts, A School-Based Cluster Randomized Gardening, Nutrition, and Cooking Intervention, on Dietary Quality

Current Developments in Nutrition ◽

10.1093/cdn/nzaa059_038 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1321-1321 ◽

Cited By ~ 1

Author(s):

Matthew Landry ◽

Fiona Asigbee ◽

Sarvenaz Vandyousefi ◽

Matthew Jeans ◽

Reem Ghaddar ◽

...

Keyword(s):

Health Promotion ◽

Randomized Trial ◽

Cluster Randomized Trial ◽

Dietary Quality ◽

Control Groups ◽

Post Intervention ◽

School Based ◽

Cluster Randomized ◽

And Control ◽

Component Scores

Abstract Objectives School gardens have become a common school-based health promotion strategy to enhance dietary behaviors in the US. The goal of this study was to examine the effects of TX Sprouts, a one-year school-based gardening, nutrition, and cooking cluster randomized trial on dietary quality. Methods Eight schools were randomly assigned to TX Sprouts intervention and eight schools to control (i.e., delayed intervention) over three years (2016–2019). The intervention arm received: formation of Garden Leadership Committees; a 0.25-acre outdoor teaching garden; 18 student lessons including gardening, nutrition, and cooking activities, taught weekly during school hours; and nine parent lessons. The following outcomes were collected on the children at baseline and post-intervention: height, weight, waist circumference, and body composition via bioelectrical impedance. Dietary intake via two, 24-hour dietary recalls (24hDR) were collected on a subsample. Dietary quality was assessed using the Healthy Eating Index 2015 (HEI-2015). Analytic sample included subjects with complete data. Mixed-effects linear regression models, accounting for the cluster effect, were used to assess changes in outcomes between intervention and control groups. Results Of the 4239 eligible students, 3135 students consented and provided baseline clinical measures. Two 24hDR were collected on a subsample of 440 children at baseline and post-intervention. Children were 54% female with the mean age of 9 years, 60% were Hispanic, and 66% received free and reduced lunch. Change in HEI-2015 total score was not significantly different between intervention and control groups [+2.02 (0.96) vs. 0.98 (1.05); P = 0.46]. The intervention group compared to control group resulted in significant increases, mean change (SE), in HEI-2015 vegetable component scores [+0.18 (0.13) vs. −0.06 (0.12); P = 0.003] and HEI-2015 greens and beans component scores [+0.13 (0.18) vs. −0.32 (0.18); P = 0.02]. Conclusions This is the largest, cluster-randomized trial to examine the effects of a school-based gardening, nutrition, and cooking program on diet quality in primarily low-income Hispanic children. School-based garden programs may serve as promising health promotion strategies in improving vegetable consumption. Funding Sources Supported by National Heart, Lung, and Blood Institute grant R01HL123865.

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A cluster-randomized trial of workplace ergonomics and neck-specific exercise versus ergonomics and health promotion for office workers to manage neck pain – a secondary outcome analysis

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-03945-y ◽

2021 ◽

Vol 22 (1) ◽

Cited By ~ 1

Author(s):

Venerina Johnston ◽

Xiaoqi Chen ◽

Alyssa Welch ◽

Gisela Sjøgaard ◽

Tracy A. Comans ◽

...

Keyword(s):

Health Promotion ◽

Exercise Training ◽

Neck Pain ◽

Randomized Trial ◽

Pain Intensity ◽

Cluster Randomized Trial ◽

Office Workers ◽

Group Differences ◽

Specific Exercise ◽

Cluster Randomized

Abstract Background Neck pain is prevalent among office workers. This study evaluated the impact of an ergonomic and exercise training (EET) intervention and an ergonomic and health promotion (EHP) intervention on neck pain intensity among the All Workers and a subgroup of Neck Pain cases at baseline. Methods A 12-month cluster-randomized trial was conducted in 14 public and private organisations. Office workers aged ≥18 years working ≥30 h per week (n = 740) received an individualised workstation ergonomic intervention, followed by 1:1 allocation to the EET group (neck-specific exercise training), or the EHP group (health promotion) for 12 weeks. Neck pain intensity (scale: 0–9) was recorded at baseline, 12 weeks, and 12 months. Participants with data at these three time points were included for analysis (n = 367). Intervention group differences were analysed using generalized estimating equation models on an intention-to-treat basis and adjusted for potential confounders. Subgroup analysis was performed on neck cases reporting pain ≥3 at baseline (n = 96). Results The EET group demonstrated significantly greater reductions in neck pain intensity at 12 weeks compared to the EHP group for All Workers (EET: β = − 0.53 points 95% CI: − 0.84– − 0.22 [36%] and EHP: β = − 0.17 points 95% CI: − 0.47–0.13 [10.5%], p-value = 0.02) and the Neck Cases (EET: β = − 2.32 points 95% CI: − 3.09– − 1.56 [53%] and EHP: β = − 1.75 points 95% CI: − 2.35– − 1.16 [36%], p = 0.04). Reductions in pain intensity were not maintained at 12 months with no between-group differences observed in All Workers (EET: β = − 0.18, 95% CI: − 0.53–0.16 and EHP: β = − 0.14 points 95% CI: − 0.49–0.21, p = 0.53) or Neck Cases, although in both groups an overall reduction was found (EET: β = − 1.61 points 95% CI: − 2.36– − 0.89 and EHP: β = − 1.9 points 95% CI: − 2.59– − 1.20, p = 0.26). Conclusion EET was more effective than EHP in reducing neck pain intensity in All Workers and Neck Cases immediately following the intervention period (12 weeks) but not at 12 months, with changes at 12 weeks reaching clinically meaningful thresholds for the Neck Cases. Findings suggest the need for continuation of exercise to maintain benefits in the longer term. Clinical trial registration hACTRN12612001154897 Date of Registration: 31/10/2012.

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