School-based gardening, cooking and nutrition intervention increased vegetable intake but did not reduce BMI: Texas sprouts - a cluster randomized controlled trial

Abstract Background Although school garden programs have been shown to improve dietary behaviors, there has not been a cluster-randomized controlled trial (RCT) conducted to examine the effects of school garden programs on obesity or other health outcomes. The goal of this study was to evaluate the effects of a one-year school-based gardening, nutrition, and cooking intervention (called Texas Sprouts) on dietary intake, obesity outcomes, and blood pressure in elementary school children. Methods This study was a school-based cluster RCT with 16 elementary schools that were randomly assigned to either the Texas Sprouts intervention (n = 8 schools) or to control (delayed intervention, n = 8 schools). The intervention was one school year long (9 months) and consisted of: a) Garden Leadership Committee formation; b) a 0.25-acre outdoor teaching garden; c) 18 student gardening, nutrition, and cooking lessons taught by trained educators throughout the school-year; and d) nine monthly parent lessons. The delayed intervention was implemented the following academic year and received the same protocol as the intervention arm. Child outcomes measured were anthropometrics (i.e., BMI parameters, waist circumference, and body fat percentage via bioelectrical impedance), blood pressure, and dietary intake (i.e., vegetable, fruit, and sugar sweetened beverages) via survey. Data were analyzed with complete cases and with imputations at random. Generalized weighted linear mixed models were used to test the intervention effects and to account for clustering effect of sampling by school. Results A total of 3135 children were enrolled in the study (intervention n = 1412, 45%). Average age was 9.2 years, 64% Hispanic, 47% male, and 69% eligible for free and reduced lunch. The intervention compared to control resulted in increased vegetable intake (+ 0.48 vs. + 0.04 frequency/day, p = 0.02). There were no effects of the intervention compared to control on fruit intake, sugar sweetened beverages, any of the obesity measures or blood pressure. Conclusion While this school-based gardening, nutrition, and cooking program did not reduce obesity markers or blood pressure, it did result in increased vegetable intake. It is possible that a longer and more sustained effect of increased vegetable intake is needed to lead to reductions in obesity markers and blood pressure. Clinical trials number NCT02668744.

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Effectiveness of a gamification strategy to prevent childhood obesity in schools: a cluster-randomized controlled trial

Proceedings of The Nutrition Society ◽

10.1017/s0029665120000932 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Sebastián Peña ◽

Macarena Carranza ◽

Cristóbal Cuadrado ◽

Paula Espinoza ◽

Valeska Müller ◽

...

Keyword(s):

Blood Pressure ◽

Randomized Controlled Trial ◽

Childhood Obesity ◽

Controlled Trial ◽

Mean Difference ◽

Cluster Randomized Controlled Trial ◽

Z Score ◽

Randomized Controlled ◽

School Based ◽

Cluster Randomized

AbstractIntroductionSchool-based interventions to prevent obesity have shown heterogeneous results. Recent school-based trials with “negative” have cast doubt on their effectiveness. In the Juntos Santiago trial, we used an innovative, theory-based gamification strategy to increase motivation and participation in healthy behavioural changes. This is the first trial, to our knowledge, to use gamification to prevent childhood obesity.ObjectiveTo examine the effectiveness of a multicomponent gamification strategy to prevent obesity in 5th and 6th-grade schoolchildren in Santiago de Chile.Materials and methodsSchool-based, parallel cluster-randomized controlled trial. 81 schools in two municipalities in Santiago, Chile, with more than 40 students in 5th and 6th grade altogether were eligible. Schools were randomized and sequentially invited to participate. The multicomponent intervention was a gamification strategy with four components: (i) healthy challenges (snacks, steps and healthy activities); (ii) gamification incentives, such as points, levels, leaderboards and badges; (iii) rewards (infrastructure and fun activity) and (iv) an online platform for parents and students to monitor the progress. Participants were followed up at 5 and 8 months. Pre-registered primary outcomes were body mass index (BMI) z-score and waist circumference (WC) at 8 months. Secondary outcomes were BMI and systolic (SBP) and diastolic blood pressure (DBP) at 8 months. Multilevel analysis adjusted for individual and school-level covariates were used.Results24 schools (9 controls) and 2333 students (709 controls) were assessed at baseline and 2264 students (689 controls) were assessed at 8 months. The mean BMI z-score was lower in the intervention group compared to the control group at 8 months (mean difference -0.132, 95% CI -0.249; -0.014), while no difference was observed for WC. Mean BMI and SBP were lower in the intervention arm compared to the control arm (mean difference for SBP -0.139; 95% CI -2.39; -0.40). No difference was observed for DBP.DiscussionThe gamification strategy appears to prevent childhood obesity and reduce systolic blood pressure in school children in Santiago. These effects are larger than the pooled effects from existing meta-analyses. Further research should identify which components of the gamification strategy were more effective.Trial registrationClinicalTrials.gov NCT03459742Funded byMayors Challenge 2016, Bloomberg Philanthropies

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TX Sprouts: A School-Based Cluster Randomized Gardening, Nutrition, and Cooking Intervention: Effects on Obesity, Blood Pressure and Diet

Current Developments in Nutrition ◽

10.1093/cdn/nzaa059_013 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1296-1296

Author(s):

Jaimie Davis ◽

Katie Nikah ◽

Fiona Asigbee ◽

Matthew Landry ◽

Sarvenaz Vandyousefi ◽

...

Keyword(s):

Blood Pressure ◽

Dietary Intake ◽

Vegetable Intake ◽

Intervention Group ◽

Control Group ◽

Hispanic Males ◽

School Based ◽

Cluster Randomized ◽

One Year ◽

Delayed Intervention

Abstract Objectives To assess the effects of a one-year school-based gardening, nutrition, and cooking cluster randomized controlled trial, called TX Sprouts, on dietary intake, obesity markers, and blood pressure. Methods Sixteen schools were randomly assigned to either the TX Sprouts intervention (n = 8 school) or to delayed intervention (n = 8 schools). The intervention arm received: formation/training 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 delayed intervention received the same protocol one year later. Primary child outcomes were measured at baseline and after one school year included: changes in dietary intake (fruit and vegetables servings via screener), height, weight, waist circumference, body composition, and blood pressure. Ten multiple imputations and generalized linear mixed models with schools as the random cluster were used to assess differences in changes in primary outcomes between intervention and control groups. Results Of the 4239 eligible students, 3135 (74%) of students consented and completed baseline clinical measures and child surveys. Participants were 47.4% male and average age was 9.2 years. Approximately 64% were Hispanic, and 69% were economically disadvantaged with attendance to TX Sprouts lessons was 95% of the intervention children. Ninety-one % of children completed both pre and post measures. Intervention group compared to control group resulted in increases, mean change (SE), in vegetable intake [+0.33(0.13) vs. 0.03(0.11) serv/d; P = 0.003]. There was a significant race/ethnicity by sex interaction (P = 0.01) for diastolic blood pressure, with Hispanic males in the intervention group compared to Hispanic males in the control group having reductions in diastolic blood pressure [−2.5(1.0) vs. +0.8(1.10) Hg/mm; P = 0.021). There was no effect of the intervention on any of the obesity parameters. Conclusions The TX Sprouts intervention targets the school nutrition environment, and may provide a sustainable approach to increase vegetable intake and reduce blood pressure in low-income, primarily Hispanic children. Funding Sources NIH/NHLBI (1R01HL123865, 2015-2020), Whole Kids Foundation, Home Depot, Sprouts Healthy Communities Foundation.

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Efficacy of a Web-Enabled, School-Based, Preventative Intervention to Reduce Bullying and Improve Mental Health in Children and Adolescents: Study Protocol for a Cluster Randomized Controlled Trial

Frontiers in Pediatrics ◽

10.3389/fped.2021.628984 ◽

2021 ◽

Vol 9 ◽

Author(s):

Covadonga M. Díaz-Caneja ◽

Javier Martín-Babarro ◽

Renzo Abregú-Crespo ◽

Miguel Á. Huete-Diego ◽

Marta Giménez-Dasí ◽

...

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Randomized Controlled Trial ◽

Study Protocol ◽

Controlled Trial ◽

Bullying Victimization ◽

Randomized Controlled ◽

School Based ◽

Cluster Randomized

Introduction: Bullying is a major preventable risk factor for mental disorders. Available evidence suggests school-based interventions reduce bullying prevalence rates. This study aims to test the efficacy of a web-enabled, school-based, multicomponent anti-bullying intervention to prevent school bullying and to assess its effects on mental health and quality of life.Methods and analysis: Cluster randomized controlled trial conducted in 20 publicly funded primary and secondary schools in Madrid, Spain. Schools are randomly allocated to either the intervention arm (n = 10) or conventional practices arm (n = 10). The web-enabled intervention (LINKlusive) lasts ~12 weeks and consists of three main components: (i) an online training program for teachers and parents, (ii) a web-guided educational program for students, focusing on promoting respect for diversity, empathy, and social skill development, and (iii) a web-guided, teacher-delivered, targeted intervention program for bullying situations identified based on peer-support strategies and individual intervention for those involved (i.e., bullying victims and perpetrators). The primary objective is to compare differences between peer-reported bullying victimization in the intervention and control arms at the end of the intervention. Secondary outcome measures are additional measures of bullying victimization and perpetration, mental health symptoms, self-esteem, and quality of life. A follow-up assessment is conducted 1 year after the end of the intervention. Treatment effects will be tested using multilevel mixed models, adjusting for school-, classroom-, and student-related covariates. Considering the increased bullying rates in children with special educational needs, a specific subgroup analysis will test the efficacy of the intervention on bullying prevalence, mental health, and quality of life in this particularly vulnerable population.Ethics and Dissemination: The Deontology Commission of the School of Psychology, Universidad Complutense in Madrid, Spain reviewed the study protocol and granted ethical approval on 21st January 2019. The results of the trial will be disseminated in relevant peer-reviewed journals and at conferences in the field.Trial Registration Number: ISRCTN15719015.

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