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Allee KA, Garcia JM, Roberts SK, Clark MH. Sitting Less for Success: Reducing Sedentary Behaviors to Increase Kindergarten Achievement. THE JOURNAL OF SCHOOL HEALTH 2024; 94:117-127. [PMID: 37953631 DOI: 10.1111/josh.13409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 10/07/2023] [Accepted: 10/10/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Physical activity (PA) improves outcomes, but disadvantaged children typically experience more sedentary behavior (SB). This study explored movement, executive function (EF) health, and academic achievement (AA) for economically disadvantaged kindergarteners. METHODS Children in 2 classrooms (n = 16; n = 7) wore wrist-based accelerometers to assess PA/SB during the school day. Independent t-tests and analysis of variance analyzed mean group differences in PA/SB and EF/AA, and correlations explored AA and EF associations. RESULTS The movement-based class spent significantly less time in SB compared to the contemporary class (t = 2.552, g = 1.115), made greater reading (t = -2.611) and math (t = .967) gains, and had better EF (t = .012). There were significant negative correlations between SB and math (r = -.534) and reading (r = -.592), but no significant relationships with EF. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY Schools should consider methods to decrease time spent in SB at lower-SES schools, which is financially feasible and less time-consuming than programs to increase PA. CONCLUSION Decreased SB time was associated with better AA. More research is needed to determine whether interventions to decrease time spent in SB at school improve academic outcomes in disadvantaged children.
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Affiliation(s)
- Karyn A Allee
- Atlanta Graduate Teacher Education, Tift College of Education, Mercer University, 3001 Mercer University Drive, Atlanta, GA, 30341
| | - Jeanette M Garcia
- School of Sports Sciences, College of Applied Human Sciences, West Virginia University, 375 Birch Street, Morgantown, WV, 26506
| | - Sherron K Roberts
- School of Teacher Education, College of Community Innovation and Education, University of Central Florida, 12494 University Boulevard, Orlando, FL, 32816
| | - M H Clark
- Department of Learning Sciences and Educational Research, College of Community Innovation and Education, University of Central Florida, 12494 University Boulevard, Orlando, FL, 32816
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Mateus N, Exel J, Santos S, Gonçalves B, Sampaio J. Effectiveness of wearable technology to optimize youth soccer players' off-training behaviour and training responses: a parallel group randomized trial. SCI MED FOOTBALL 2023; 7:384-393. [PMID: 35983660 DOI: 10.1080/24733938.2022.2114604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/13/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND Although youth soccer players meet and exceed the weekly physical activity (PA) guidelines also exhibit high off-training sedentary behaviour (SB) levels. Recent evidence indicated that low PA preceding training leads to decreased PA intensity in soccer practice and that SB impairs sports performance and recovery. Thus, a parallel group randomized trial examined the effect of activity wristbands on young players' off-training PA and SB profiles; assessed the added value of wearable wristbands with PA warnings; and investigated whether manipulating off-training PA can affect the players' training responses. METHODS Thirty-two adolescent soccer players (16.1 ± 0.9 years old) were monitored during weekdays for two weeks (interspersed with one week). Players were randomly assigned to a reminder to move (REM) and a non-reminder to move group (nREM). The REM wore an activity wristband (Fitbit Charge 2) with PA warnings in the last week of research, while the nREM wore identical monitors without PA feedback. Throughout the study, off-training PA was assessed using tri-axial accelerometers, and training responses were analysed using wearable inertial monitoring units. Gardner-Altman estimation plots and a Fisher's Exact Test of Independence estimated each group's off-training PA changes between the monitored weeks. Complementary, an analysis of covariance (ANCOVA) quantified the effect of Fitbit wristband configurations (with a reminder to move or without a reminder to move) on the off-training PA and soccer training external load variables. The independent variable group had two levels (REM and nREM). The off-training PA and training load values collected in the first week were introduced in the model as a covariate, the groups were designated fixed factors and the off-training PA and training load from the third week were the dependent variables. The team was also included as a covariate and the between-group differences post-intervention were adjusted for baseline and team. RESULTS Interestingly, results showed that different wearable wristbands did not influence the players' off-training PA profiles (p > 0.05). Concomitantly, no differences were observed in training responses (p > 0.05). CONCLUSION Findings emphasize the importance of health and youth sports organizations in developing newer approaches for promoting healthier lifestyles, beyond training practices, with potentially favourable implications for sports performance.
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Affiliation(s)
- Nuno Mateus
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, CreativeLab Research Community, Vila Real, Portugal
- University of Tras-os-Montes and Alto Douro School of Life Sciences and Environment, Department of Sports Science, Exercise and Health, University of Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Juliana Exel
- Department of Sport Science Biomechanics, Kinesiology and Computer Science, University of Vienna, Vienna, Austria
| | - Sara Santos
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, CreativeLab Research Community, Vila Real, Portugal
- University of Tras-os-Montes and Alto Douro School of Life Sciences and Environment, Department of Sports Science, Exercise and Health, University of Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Bruno Gonçalves
- Departamento de Desporto e Saude, Escola de Saude e Desenvolvimento Humano,Universidade de Évora, Évora, Portugal
- Comprehensive Health Research Centre (CHRC), Évora, Portugal
- Portugal Football School, Portuguese Football Federation, Oeiras, Portugal
| | - Jaime Sampaio
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, CreativeLab Research Community, Vila Real, Portugal
- University of Tras-os-Montes and Alto Douro School of Life Sciences and Environment, Department of Sports Science, Exercise and Health, University of Trás-os-Montes e Alto Douro, Vila Real, Portugal
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Caroline Maité Marie B, Léna L, Nicolas F, François T, Julien B. Objectively assessed school-based intervention to reduce children's sedentary time: a systematic review. Health Promot Int 2023; 38:daad140. [PMID: 37877785 DOI: 10.1093/heapro/daad140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023] Open
Abstract
Childhood is a period characterized by a constant increase in sedentary time (ST) but also provides a great window of opportunity for children to learn how to limit ST. As a result, school-based interventions aimed at reducing and preventing children's ST are increasingly becoming more widespread. A previous review found that school-based multi-component interventions appeared to be more effective in comparison to those based on a single component. However, this conclusion was based on just 11 studies published before 2016 and needs to be verified due to the currently growing number of studies on this topic. The objective of this systematic review is to update the evaluation of the effectiveness of school-based interventions published since the previous review according to the PRISMA guidelines. Studies published between August 2015 and August 2023 containing objective measures of ST were analyzed. Of the 18 studies identified, 11 (61.1%) reported significant positive results. Multi-component studies were slightly more effective than their single-component equivalent (63.7% vs. 57.1%). The components that proved the most effective of the multi-component studies were the implementation of sit-to-stand desks (100%), and teachers' training (77.8%). The combination of these two components is the most promising method to limit ST in the school context. Future research should determine how sit-to-stand desks can be introduced into the class environment and how courses can be adapted to this material.
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Affiliation(s)
- Bernal Caroline Maité Marie
- Laboratoire Mouvement Equilibre, Performance & Santé (MEPS, EA 4445), Université de Pau & Pays Adour, Tarbes, France
| | - Lhuisset Léna
- Laboratoire Mouvement Equilibre, Performance & Santé (MEPS, EA 4445), Université de Pau & Pays Adour, Tarbes, France
| | - Fabre Nicolas
- Laboratoire Mouvement Equilibre, Performance & Santé (MEPS, EA 4445), Université de Pau & Pays Adour, Tarbes, France
| | - Trudeau François
- Département des sciences de l'activité physique, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Bois Julien
- Laboratoire Mouvement Equilibre, Performance & Santé (MEPS, EA 4445), Université de Pau & Pays Adour, Tarbes, France
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Li MH, Sit CHP, Wong SHS, Wing YK, Ng CK, Rudd J, Chow JY, Sum RKW. Effects of a blended classroom-based intervention on aerobic fitness, motor skills, inhibition, and daytime sleepiness among Hong Kong children. Front Public Health 2022; 10:944423. [PMID: 36203680 PMCID: PMC9530981 DOI: 10.3389/fpubh.2022.944423] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 09/01/2022] [Indexed: 01/21/2023] Open
Abstract
In response to the all-round development of primary school children, this study aimed to evaluate the effectiveness of a blended intervention program on children's health-related outcomes of aerobic fitness, motor skills, inhibition and daytime sleepiness in classroom settings. Three experimental conditions include: (1) the "Stand + Move" group combining sit-stand desks and physical activity (PA) recess, (2) "Move" group with PA recess only, and (3) Control group (CG; normal class schedule). A total of 64 primary school children (37.5% girls and 62.5% boys, M [SD] = 9.6 [0.61], BMI mean = 17.0 ± 3.0) participated in all assessments, including aerobic fitness, motor skills, inhibitory control, and daytime sleepiness. The baseline data collection starts from January 2019, with the intervention lasting for 13 weeks and followed by post-intervention and follow up tests conducted in July and October 2019. There was a significant interaction effect on aerobic fitness [F (2,76) = 10.62, p < 0.001, η2 = 0.22] after the intervention period, whereas no significant interaction was observed for other variables. Significant main effects were observed in aerobic fitness (pre - post: -11.75 and -7.22) for both experimental groups, with the blended group showing greater improvements immediately post the test, while motor skills only showed a significant increase at the three-month follow-up, with the greatest increase in the blended group (pre-follow-up: -2.50). For inhibition control and daytime sleepiness, better improvements were shown for the experimental groups than for the control group. The blended designed intervention, by incorporating multiple components as an innovative strategy to reconstruct children's traditional classroom environment in Hong Kong, has demonstrated improved physical and psychological development of school children. Clinical trial registration ChiCTR, ChiCTR2000035038. Registered 29 July 2020 - Retrospectively registered. http://www.chictr.org.cn/hvshowproject.aspx?id=46038.
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Affiliation(s)
- Ming Hui Li
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Cindy Hui Ping Sit
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Stephen Heung Sang Wong
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Yun Kwok Wing
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Ching Kong Ng
- Stewards Pooi Kei Primary School, Hong Kong, Hong Kong SAR, China
| | - James Rudd
- Department of Teacher Education and Outdoor Studies, Norwegian School of Sport Sciences, Oslo, Norway
| | - Jia Yi Chow
- Physical Education and Sports Science, National Institute of Education, Nanyang Technological University, Singapore, Singapore
| | - Raymond Kim Wai Sum
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China,*Correspondence: Raymond Kim Wai Sum
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Effect of a 16-week multi-level classroom standing desk intervention on cognitive performance and academic achievement in adolescents. Sci Rep 2022; 12:14504. [PMID: 36050353 PMCID: PMC9437021 DOI: 10.1038/s41598-022-18248-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 08/08/2022] [Indexed: 11/29/2022] Open
Abstract
The replacement of traditional classroom desks for active-permissive desks has been tested to reduce sitting time during classes. However, their impact on other domains is still unclear. We aimed to verify the potential effects of a classroom standing desk intervention on cognitive function and academic achievement in 6th-grade students. This was a controlled trial conducted with two classes [intervention (n = 22) and control (n = 27)] from a public school in Lisbon, Portugal. The intervention was carried out for 16 weeks and consisted of multi-level actions (students, parents, and teachers) centered on the implementation of standing desks in the intervention classroom. The control group had traditional classes with no use of standing desks or any other interference/action from the research team. Pre- and post-assessments of executive functions (attention, inhibitory function, memory, and fluid intelligence) and academic achievement were obtained. No differences between groups were found at baseline. Both groups improved (time effect) academic achievement (p < 0.001), memory span (p < 0.001), and inhibitory function (p = 0.008). Group versus time interactions were observed regarding operational memory (intervention: + 18.0% and control: + 41.6%; p = 0.039) and non-verbal fluid intelligence (intervention: − 14.0% and control: + 3.9%; p = 0.017). We concluded that a 16-week classroom standing desk intervention did not improve cognitive performance or academic achievement more than the traditional sitting classes. Trial registration: ClinicalTrials.gov Identifier (NCT03137836) (date of first registration: 03/05/2017).
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da Costa BGG, Bruner B, Scharoun Benson S, Raymer G, Law B. Canadian Children’s Physical Activity and Sedentary Behaviors During Time-Segments of the School Day. AMERICAN JOURNAL OF HEALTH EDUCATION 2022. [DOI: 10.1080/19325037.2022.2071781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Fisher D, Louw Q. The effect of classroom-based interventions on sedentary behavior and spinal health in school children – a systematic review (Preprint). Interact J Med Res 2022; 11:e39006. [DOI: 10.2196/39006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 08/05/2022] [Accepted: 08/29/2022] [Indexed: 11/13/2022] Open
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Wallace AL, Swartz AM, Cho CC, Kaiver CM, Sullivan RM, Lisdahl KM. Stand-Biased Desks Impact on Cognition in Elementary Students Using a Within-Classroom Crossover Design. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5684. [PMID: 35565079 PMCID: PMC9104799 DOI: 10.3390/ijerph19095684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/28/2022] [Accepted: 05/04/2022] [Indexed: 02/04/2023]
Abstract
Background: There is emerging literature that standing desk interventions may help to improve cognitive performance in school-aged children. The current study examines how desks that promote standing affect cognition over the course of a school year in third, fourth, and sixth graders. Methods: Nighty-nine students between the ages of 8 and 12 (M = 10.23; 58% Male) were assigned to either stand-biased desks or traditional sitting desks. A within-classroom design was used with students switching desks after 9 weeks. Cognitive assessments and teacher behavioral ratings were administered at baseline and readministered before students switched desks and at the conclusion of the study. Results: There were no significant effects on cognition or behavioral ratings from standing-biased desk intervention. Grade significantly moderated the relationship between stand-biased desks and cognition in that third graders showed increased cognitive control (p = 0.02, f2 = 0.06). Further, sex moderated the relationship in that females at stand-biased desks showed increased cognitive control (p = 0.03, f2 = 0.04). Conclusions: These results suggest that stand-biased desks impact cognition depending on grade and sex, indicating a complex relationship that should be teased out further in future research. Stand-biased desks showed moderate improvements in cognition and no deleterious effects, suggesting that they may be a helpful classroom intervention for children in elementary school.
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Affiliation(s)
- Alexander L. Wallace
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA; (C.M.K.); (R.M.S.)
| | - Ann M. Swartz
- Department of Kinesiology, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA;
| | - Chi C. Cho
- Center for Aging and Translational Research, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA;
| | - Christine M. Kaiver
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA; (C.M.K.); (R.M.S.)
| | - Ryan M. Sullivan
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA; (C.M.K.); (R.M.S.)
| | - Krista M. Lisdahl
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA; (C.M.K.); (R.M.S.)
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Silva ECM, Barboza LLS, Gandarela L, Tejada J, Schmitz H, Gomes TN, Silva RJS, Sardinha LB, Silva DR. Two-Year Effectiveness of a Controlled Trial With Physically Active Lessons on Behavioral Indicators of School Children. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2022:1-9. [PMID: 35438617 DOI: 10.1080/02701367.2021.2020707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 12/12/2021] [Indexed: 06/14/2023]
Abstract
Purpose: In this study, we evaluated the effectiveness of two years of an intervention with physically active lessons on indicators of sedentary behavior and physical activity measured objectively in elementary school children. Methods: A controlled clinical trial with cluster sampling was carried out in 2018 and 2019, with four classes of children in the 2nd year of elementary school. The intervention group classes received dynamic activities linked to the pedagogical content (n = 34) for 2 years. The indicators of sedentary behavior and physical activities were evaluated using ActivPal and ActiGraph GT3X accelerometers during the school shift. Crude and adjusted models of Generalized Estimation Equations with Bonferroni's post hoc were used to identify the differences between the groups (three evaluations in 2018 and two evaluations in 2019). Results: There was a reduction in stationary behavior (p = .01) and an increase in light physical activity (p = .044) during the two years. In the first year there were reductions in standing time (p = .044) and number of transitions (p ≤ .001), and an increase in walking time (p = .017). However, in the second year, the mean differences in percentage points were smaller than in the first year. No differences were found for sitting time as well as for moderate and vigorous physical activity. We observed a large effect size for all variables. Conclusions: The introduction of physically active lessons in the classroom reduced time in stationary behavior and increased time in light physical activity. However, the effects on behavior observed in the first year were not maintained in the second year of intervention.
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Kuzik N, da Costa BGG, Hwang Y, Verswijveren SJJM, Rollo S, Tremblay MS, Bélanger S, Carson V, Davis M, Hornby S, Huang WY, Law B, Salmon J, Tomasone JR, Wachira LJ, Wijndaele K, Saunders TJ. School-related sedentary behaviours and indicators of health and well-being among children and youth: a systematic review. Int J Behav Nutr Phys Act 2022; 19:40. [PMID: 35382825 PMCID: PMC8979786 DOI: 10.1186/s12966-022-01258-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 02/08/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The purpose of this systematic review was to examine the associations between school-related sedentary behaviours and indicators of health and well-being in children and youth (~ 5-18 years) attending school. METHODS This review was conducted to inform the development of School-Related Sedentary Behaviour Recommendations. Peer-reviewed, published, or in-press articles in English were included. Reviews, meta-analyses, and case studies were excluded; all other study designs were eligible. Further, articles had to meet the a priori study criteria for population, intervention, comparator (PROSPERO ID: CRD42021227600). Embase, MEDLINE® ALL, and PsycINFO were searched. Risk of bias was assessed for individual experimental studies using the Cochrane risk of bias assessment tool, and in observational studies based on the GRADE framework and in line with previous systematic reviews examining sedentary behaviours in children. Overall quality of evidence was assessed using the GRADE framework for each outcome category and study design. Results were synthesized narratively, grouped by study design and outcome category. Further, several high-level summaries were conducted to help interpret results. RESULTS Evidence was synthesized from 116 reports, including 1,385,038 participants and 1173 extracted associations. More school-related sedentary behaviour was favourably associated with nearly one-third of extracted associations for cognitive (33%) and social-emotional (32%) indicators (e.g., less anxiety), but unfavourably associated with other movement behaviours (e.g., less physical activity) (35%). Active lessons were favourable (72%), compared to more school-related sedentary behaviours, when examining associations for all health and well-being indicators. More homework was favourable across all health and well-being indicators in 4% of extracted associations for primary school children, and 25% of extracted associations for secondary school children. However, ≥2 h/day of homework appeared to be unfavourable for health and well-being. Limitations for synthesized studies included generally low quality of evidence and a lack of studies in South American, African, or low-middle income countries. CONCLUSIONS Findings can help inform policy makers, schools, and teachers, regarding the amount of homework assigned and the introduction of active lessons into the classroom to enhance health and well-being of children. More research is needed examining school-related sedentary behaviours and indicators of health and well-being in low- and middle-income countries.
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Affiliation(s)
- Nicholas Kuzik
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada. .,Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
| | - Bruno G. G. da Costa
- grid.260989.c0000 0000 8588 8547School of Physical & Health Education, Nipissing University, North Bay, Canada
| | - Yeongho Hwang
- grid.17089.370000 0001 2190 316XFaculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Simone J. J. M. Verswijveren
- grid.1021.20000 0001 0526 7079Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Scott Rollo
- grid.414148.c0000 0000 9402 6172Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Canada ,grid.28046.380000 0001 2182 2255Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Mark S. Tremblay
- grid.414148.c0000 0000 9402 6172Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Canada ,grid.28046.380000 0001 2182 2255Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Canada ,grid.34428.390000 0004 1936 893XDepartment of Health Sciences, Carleton University, Ottawa, Canada
| | - Stacey Bélanger
- grid.14848.310000 0001 2292 3357Département de Pédiatrie, Faculté de Médicine, Université de Montréal and CHU Sainte Justine, CIRENE (Centre Intégré du Réseau en Neurodéveloppement de L’Enfant), Montréal, Quebec Canada
| | - Valerie Carson
- grid.17089.370000 0001 2190 316XFaculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Melanie Davis
- Physical and Health Education (PHE) Canada, Ottawa, Canada
| | - Susan Hornby
- Pan-Canadian Joint Consortium for School Health (JCSH), Summerside, Canada
| | - Wendy Yajun Huang
- grid.221309.b0000 0004 1764 5980Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Barbi Law
- grid.260989.c0000 0000 8588 8547School of Physical & Health Education, Nipissing University, North Bay, Canada
| | - Jo Salmon
- grid.1021.20000 0001 0526 7079Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Jennifer R. Tomasone
- grid.410356.50000 0004 1936 8331School of Kinesiology and Health Studies, Queen’s University, Kingston, Canada
| | - Lucy-Joy Wachira
- grid.9762.a0000 0000 8732 4964Physical Education, Exercise and Sports Science, Kenyatta University, Nairobi, Kenya
| | - Katrien Wijndaele
- grid.5335.00000000121885934MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Travis J. Saunders
- grid.139596.10000 0001 2167 8433Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, Canada
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Fenesi B, Graham JD, Crichton M, Ogrodnik M, Skinner J. Physical Activity in High School Classrooms: A Promising Avenue for Future Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:688. [PMID: 35055510 PMCID: PMC8776126 DOI: 10.3390/ijerph19020688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 01/04/2022] [Accepted: 01/06/2022] [Indexed: 11/17/2022]
Abstract
Adolescence represents a sensitive period whereby lifestyle factors such as physical activity can have profound, long-lasting effects on development and later life habits. However, adolescence constitutes a period of frequent sedentary behaviour. Among children, integrating physical activity into elementary school classrooms has been shown to reduce sedentary behaviour and improve academic achievement and overall physical and mental health. However, this promising area of research has not extended to adolescents and high school classrooms. In this paper, we describe the benefits of conducting research on the impact of physically active high school classrooms, and highlight the challenges and potential misconceptions associated with research in this field. Specifically, we review research on the role of physical activity in adolescent development, the benefits of classroom-based physical activity for children, and discuss the factors that may have led researchers to focus on classroom-based physical activity primarily for children, despite the potentially similar benefits for adolescents.
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Affiliation(s)
- Barbara Fenesi
- Faculty of Education, Western University, London, ON N6G 1G7, Canada; (M.C.); (J.S.)
| | - Jeffrey D. Graham
- Faculty of Health Sciences, Ontario Tech University, Oshawa, ON L1G 0C5, Canada;
| | - Madeline Crichton
- Faculty of Education, Western University, London, ON N6G 1G7, Canada; (M.C.); (J.S.)
| | - Michelle Ogrodnik
- Department of Kinesiology, McMaster University, Hamilton, ON L8S 4L8, Canada;
| | - Jasmyn Skinner
- Faculty of Education, Western University, London, ON N6G 1G7, Canada; (M.C.); (J.S.)
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Nelson-Wong E, Corrigan J, Mertz P, Kutcher S, Carlson I, DiRocco T, Hall-Nelson B. Office-workers maintain decreased workplace sitting time long-term following participation in a sit-stand desk intervention study. ERGONOMICS 2021; 65:1-9. [PMID: 34694213 DOI: 10.1080/00140139.2021.1998647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 10/14/2021] [Indexed: 06/13/2023]
Abstract
Previous studies report decreased workplace sitting time when standing desk interventions are provided to office workers. It is unclear whether decreased sedentary behaviours are maintained long-term. This was a follow-up to a previous intervention study to investigate whether observed sitting time decreases of 30-50% were sustained 12-24 months later. A secondary aim was to compare overall physical activity between office workers with and without standing desks. Although sitting time increased over the follow-up period, this did not reach significance and reductions in workplace sitting remained significantly lower (23.5% decrease) from baseline values. There were no differences in the physical activity measures between workers with and without access to standing desks, although this was a small sample size and further research is needed. Individuals who are motivated to try standing desks at work can benefit through decreased sitting time long-term, however this may not extend to increased overall physical activity levels. Practitioner summary: Providing standing desk options to office-based employees can have long-lasting impacts with reducing sitting time at work. Office workers who choose to stand at work do not appear to compensate with overall activity level reduction outside of work.Abbreviations: LBP: low back pain; OSPAQ: occupational sitting and physical activity questionnaire; VAS: visual analog scale; ANOVA: analysis of variance; BMI: body mass index; ICC: intraclass correlation coefficient.
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Affiliation(s)
- Erika Nelson-Wong
- Augustana University Department of Physical Therapy, Sioux Falls, SD, USA
- Regis University School of Physical Therapy, Denver, CO, USA
| | - John Corrigan
- Regis University School of Physical Therapy, Denver, CO, USA
| | - Patrick Mertz
- Regis University School of Physical Therapy, Denver, CO, USA
| | | | - Ingrid Carlson
- Regis University School of Physical Therapy, Denver, CO, USA
| | - Tara DiRocco
- Regis University School of Physical Therapy, Denver, CO, USA
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Weaver RG, Tassitano RM, Tenório MCM, Brazendale K, Beets MW. Temporal Trends in Children's School Day Moderate to Vigorous Physical Activity: A Systematic Review and Meta-Regression Analysis. J Phys Act Health 2021; 18:1446-1467. [PMID: 34627126 PMCID: PMC8669348 DOI: 10.1123/jpah.2021-0254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 07/25/2021] [Accepted: 07/26/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Evidence from a limited sample of countries indicates that time for physical education and recess during school have declined. Schools are called to provide children with 30 minutes of moderate to vigorous physical activity (MVPA). This systematic review and meta-analysis estimated temporal trends in children's school day MVPA. METHODS Three online databases were searched to identify studies with objectively measured MVPA, during school hours, in school aged children (5-18 y). Multilevel random-effects meta-analyses estimated MVPA by year, and meta-regression analyses estimated temporal trends in school day MVPA. RESULTS Studies (N = 65) providing 171 MVPA estimates, representing 60,779 unique children, from 32 countries, and spanning 2003-2019 were identified. Most studies were conducted in North America (n = 33) or Europe (n = 21). School day MVPA ranged from 18.1 (95% confidence interval, 15.1-21.1) to 47.1 (95% confidence interval, 39.4-54.8) minutes per day in any given year. Meta-regression analyses indicated that MVPA declined from 2003 to 2010 (approximately 15 min decline), plateaued from 2010 to 2015 (approximately 1 min decrease), and increased from 2015 to 2019 (approximately 5 min increase). CONCLUSIONS School day MVPA decreased from 2003 to 2010 and has recently begun to increase. However, the majority of the evidence is from North America and Europe with some evidence from Oceania and very little evidence from Asia to South America.
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Neil-Sztramko SE, Caldwell H, Dobbins M. School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18. Cochrane Database Syst Rev 2021; 9:CD007651. [PMID: 34555181 PMCID: PMC8459921 DOI: 10.1002/14651858.cd007651.pub3] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Physical activity among children and adolescents is associated with lower adiposity, improved cardio-metabolic health, and improved fitness. Worldwide, fewer than 30% of children and adolescents meet global physical activity recommendations of at least 60 minutes of moderate to vigorous physical activity per day. Schools may be ideal sites for interventions given that children and adolescents in most parts of the world spend a substantial amount of time in transit to and from school or attending school. OBJECTIVES The purpose of this review update is to summarise the evidence on effectiveness of school-based interventions in increasing moderate to vigorous physical activity and improving fitness among children and adolescents 6 to 18 years of age. Specific objectives are: • to evaluate the effects of school-based interventions on increasing physical activity and improving fitness among children and adolescents; • to evaluate the effects of school-based interventions on improving body composition; and • to determine whether certain combinations or components (or both) of school-based interventions are more effective than others in promoting physical activity and fitness in this target population. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, BIOSIS, SPORTDiscus, and Sociological Abstracts to 1 June 2020, without language restrictions. We screened reference lists of included articles and relevant systematic reviews. We contacted primary authors of studies to ask for additional information. SELECTION CRITERIA Eligible interventions were relevant to public health practice (i.e. were not delivered by a clinician), were implemented in the school setting, and aimed to increase physical activity among all school-attending children and adolescents (aged 6 to 18) for at least 12 weeks. The review was limited to randomised controlled trials. For this update, we have added two new criteria: the primary aim of the study was to increase physical activity or fitness, and the study used an objective measure of physical activity or fitness. Primary outcomes included proportion of participants meeting physical activity guidelines and duration of moderate to vigorous physical activity and sedentary time (new to this update). Secondary outcomes included measured body mass index (BMI), physical fitness, health-related quality of life (new to this update), and adverse events (new to this update). Television viewing time, blood cholesterol, and blood pressure have been removed from this update. DATA COLLECTION AND ANALYSIS: Two independent review authors used standardised forms to assess each study for relevance, to extract data, and to assess risk of bias. When discrepancies existed, discussion occurred until consensus was reached. Certainty of evidence was assessed according to GRADE. A random-effects meta-analysis based on the inverse variance method was conducted with participants stratified by age (children versus adolescents) when sufficient data were reported. Subgroup analyses explored effects by intervention type. MAIN RESULTS Based on the three new inclusion criteria, we excluded 16 of the 44 studies included in the previous version of this review. We screened an additional 9968 titles (search October 2011 to June 2020), of which 978 unique studies were potentially relevant and 61 met all criteria for this update. We included a total of 89 studies representing complete data for 66,752 study participants. Most studies included children only (n = 56), followed by adolescents only (n = 22), and both (n = 10); one study did not report student age. Multi-component interventions were most common (n = 40), followed by schooltime physical activity (n = 19), enhanced physical education (n = 15), and before and after school programmes (n = 14); one study explored both enhanced physical education and an after school programme. Lack of blinding of participants, personnel, and outcome assessors and loss to follow-up were the most common sources of bias. Results show that school-based physical activity interventions probably result in little to no increase in time engaged in moderate to vigorous physical activity (mean difference (MD) 0.73 minutes/d, 95% confidence interval (CI) 0.16 to 1.30; 33 studies; moderate-certainty evidence) and may lead to little to no decrease in sedentary time (MD -3.78 minutes/d, 95% CI -7.80 to 0.24; 16 studies; low-certainty evidence). School-based physical activity interventions may improve physical fitness reported as maximal oxygen uptake (VO₂max) (MD 1.19 mL/kg/min, 95% CI 0.57 to 1.82; 13 studies; low-certainty evidence). School-based physical activity interventions may result in a very small decrease in BMI z-scores (MD -0.06, 95% CI -0.09 to -0.02; 21 studies; low-certainty evidence) and may not impact BMI expressed as kg/m² (MD -0.07, 95% CI -0.15 to 0.01; 50 studies; low-certainty evidence). We are very uncertain whether school-based physical activity interventions impact health-related quality of life or adverse events. AUTHORS' CONCLUSIONS Given the variability of results and the overall small effects, school staff and public health professionals must give the matter considerable thought before implementing school-based physical activity interventions. Given the heterogeneity of effects, the risk of bias, and findings that the magnitude of effect is generally small, results should be interpreted cautiously.
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Affiliation(s)
| | - Hilary Caldwell
- Department of Kinesiology, Child Health & Exercise Medicine Program, McMaster University, Hamilton, Canada
| | - Maureen Dobbins
- School of Nursing, McMaster University, Hamilton, Canada
- National Collaborating Centre for Methods and Tools, Hamilton, Canada
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Effects of Physically Active Lessons on Movement Behaviors, Cognitive, and Academic Performance in Elementary Schoolchildren: ERGUER/Aracaju Project. J Phys Act Health 2021; 18:757-766. [PMID: 34030123 DOI: 10.1123/jpah.2020-0604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 03/05/2021] [Accepted: 03/06/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND To evaluate the effects of the introduction of physically active lessons on movement behaviors, cognitive, and academic performance in schoolchildren. METHODS This was a cluster-controlled trial. A total of 61 students from the second year of elementary school in a public school in Brazil made up 2 intervention classes (n = 34) with the introduction of physically active lessons and 2 control classes (n = 27). Sedentary behavior, physical activity, cognitive, and academic performance were evaluated in 3 moments, which were compared using models of generalized estimating equations. RESULTS The intervention was effective for reducing the standing time between the baseline and 3 months while increasing the walking time between baseline and 3 months and baseline and 9 months. There was a reduction in time in stationary activities and increased time in light physical activities between all moments. The intervention group increased their performance in the go/no go test, showing a smaller number of errors between the baseline and 3 months and baseline and 9 months, and a reduction in the test time between baseline and 3 months. No impact on students' academic performance was observed. CONCLUSION Physically active lessons improve movement behaviors and cognitive functions among elementary schoolchildren.
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Stand Out in Class: Investigating the Potential Impact of a Sit-Stand Desk Intervention on Children's Sitting and Physical Activity during Class Time and after School. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094759. [PMID: 33946984 PMCID: PMC8125156 DOI: 10.3390/ijerph18094759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 04/27/2021] [Accepted: 04/27/2021] [Indexed: 12/18/2022]
Abstract
Sedentary behaviour (sitting) is a risk factor for adverse health outcomes. The classroom environment has traditionally been associated with prolonged periods of sitting in children. The aim of this study was to examine the potential impact of an environmental intervention, the addition of sit–stand desks in the classroom, on school children’s sitting and physical activity during class time and after school. The ‘Stand Out in Class’ pilot trial was a two-arm cluster randomised controlled trial conducted in eight primary schools with children from a mixed socioeconomic background. The 4.5 month environmental intervention modified the physical (six sit–stand desks replaced standard desks) and social (e.g., teachers’ support) environment. All children wore activPAL and ActiGraph accelerometers for 7 days at baseline and follow-up. In total 176 children (mean age = 9.3 years) took part in the trial. At baseline, control and intervention groups spent more than 65% of class time sitting, this changed to 71.7% and 59.1% at follow-up, respectively (group effect p < 0.001). The proportion of class time spent standing and stepping, along with the proportion of time in light activity increased in the intervention group and decreased in the control group. There was no evidence of any compensatory effects from the intervention after school. Incorporating sit–stand desks to change the classroom environment at primary school appears to be an acceptable strategy for reducing children’s sedentary behaviour and increasing light activity especially during class time. Trial registration: ISRCTN12915848 (registered: 09/11/16).
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Chrisman MS, Wright R, Purdy W. College Classroom Instructors Can Effectively Promote Standing among Students Provided with Standing Desks. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094464. [PMID: 33922334 PMCID: PMC8122831 DOI: 10.3390/ijerph18094464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/08/2021] [Accepted: 04/21/2021] [Indexed: 02/06/2023]
Abstract
Standing desks may reduce sedentary behaviors in college students. Students at one mid-size urban university in the Midwestern United States were randomized into intervention (n = 21) and control groups (n = 27) to assess standing time when given access to standing desks. The intervention group received visual and oral instructor prompts to stand, while the control received no prompts during a 50 min lecture. All students were provided with adjustable tabletop standing desks. ActivPAL accelerometers measured sitting and standing time. A brief survey assessed student preferences, including facilitators and barriers to standing. Mean standing time was greater in the intervention vs. control group (26 vs. 17 min, p = 0.023). Students tended to stand in the corners and edges of the room. Main facilitators for standing included to break up sitting, reduce back pain, and increase attention and focus; main barriers were not wanting to distract others or be the only one standing. In total, 87.5% of intervention group participants found five prompts to stand were adequate. Students increased standing time in class when provided with standing desks and instructor prompts to stand. Findings can inform the layout of classrooms and when and how to promote standing desks during lectures.
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18
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Tassitano RM, Weaver RG, Tenório MCM, Brazendale K, Beets MW. Physical activity and sedentary time of youth in structured settings: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2020; 17:160. [PMID: 33276782 PMCID: PMC7716454 DOI: 10.1186/s12966-020-01054-y] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 11/09/2020] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Structured settings, such as school, childcare, afterschool programs, summer camps, and physical activity/sport programs are crucial to promoting physical activity (PA) opportunities and reducing sedentary (ST) for children and adolescents. However, little is known about how much PA and ST children and adolescents accumulate in structured settings. The aim of this study is to conduct a systematic review and meta-analysis of the absolute amount of time youth spend physically active and sedentary in different structured settings (Prospero number: 42018111804). METHODS Observational and experimental/quasi-experimental studies (baseline data only) with full-text available, written in English and published in a peer-reviewed journal, reporting the total amount of objectively measured PA (light, moderate, vigorous, and/or total physical activity) and/or time spent ST during structured settings among youth (3 to 18 years) were eligible. Adjusted meta-analysis was conducted to estimate the pooled mean of time spent in PA and ST, by settings and sex. RESULTS A total of 187 studies (childcare n=60; school n=91; afterschool programs n=14; summer camp n=4; and Physical activity/ sport programs n=18) from 30 countries (47.9% United States), representing 74,870 youth (mean age 8.6 years old) were included. Overall, there was a high variation between studies in outcomes and settings. The meta-analyses revealed, on average, youth spend 221.8 minutes (36.7 min/hour) in ST and 32.1 minutes (5.1 min/hour) in MVPA during childcare hours, and 223.9 minutes (36.7min/hour) in ST and 27.8 min (4.4 min/hour) in MVPA at school. Relatively, youth are engaged in more MVPA in afterschool programs (11.7 min/hour), PA/ sport programs (20.9 min/hour), and summer camps (6.4 min/hour), when compared to childcare and school. CONCLUSION Total PA accumulated during childcare and MVPA accumulated during schools hours were close to recommendations, despite high proportion of ST. Afterschool programs, summer camp and PA/ sport programs are important settings that can contribute to daily PA and reduced ST. Ensuring all youth have access to these structured settings may be an important step forward for public health.
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Affiliation(s)
- Rafael M Tassitano
- Department of Physical Education, Federal Rural University of Pernambuco, SN Dom Manoel de Medeiros St, Recife, PE, 52171-900, Brazil.
| | | | - Maria Cecília M Tenório
- Department of Physical Education, Federal Rural University of Pernambuco, SN Dom Manoel de Medeiros St, Recife, PE, 52171-900, Brazil
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Teachers' Perspective on Strategies to Reduce Sedentary Behavior in Educational Institutions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228407. [PMID: 33202898 PMCID: PMC7696757 DOI: 10.3390/ijerph17228407] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/09/2020] [Accepted: 11/09/2020] [Indexed: 12/25/2022]
Abstract
Standing desks and physical activity breaks can counteract the negative consequences of sedentarism at school. However, the implementation of these strategies should not restrict the pedagogical process. The aim of this study was to assess teachers’ perspectives on strategies to reduce sedentary behavior (SB) of students in the classroom. An online survey was conducted, and the answers were analyzed using descriptive statistics and frequency distribution. The relationships between the variables were assessed using Spearman’s coefficient and a chi-square test. Most teachers believed that a student–furniture mismatch was present. The most common reasons given for not using standing desks were concerns about desks being uncommon and their potential to disrupt the class. However, the majority of the teachers believed it feasible to perform physical activity (PA) breaks during classes. Further intervention studies are needed to determine for which courses the use of standing desks are feasible, for what time periods standing desks should be used, and the appropriate number and layout of standing desks in classrooms.
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20
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Sprengeler O, Hebestreit A, Gohres H, Bucksch J, Buck C. Effects of Installing Height-Adjustable Standing Desks on Daily and Domain-Specific Duration of Standing, Sitting, and Stepping in 3rd Grade Primary School Children. Front Public Health 2020; 8:396. [PMID: 32903373 PMCID: PMC7434830 DOI: 10.3389/fpubh.2020.00396] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 07/06/2020] [Indexed: 12/17/2022] Open
Abstract
Background: Aim of this intervention study was to evaluate whether availability of standing desks in classrooms may reduce sitting time and enhance standing and stepping time during lessons and breaks. Further, we evaluated if differences in standing desk use differed by physical fitness (PF) levels of children. Methods: To assess sitting, standing and stepping during a typical school week in 3rd grade primary school children (N = 52), activPAL monitors were used at baseline: T0, 1st follow-up: T1 and 2nd follow-up: T2. At baseline, PF was measured using the standing long jump and the 6-min jog-walk to assign children as having low PF (LPF) or high PF (HPF). Standing desks were assigned randomly to intervention and control groups at T1 (group 1) and T2 (group 2) with a cross-over design. Changes of sitting, standing and stepping were analyzed to investigate intervention effects at follow-up, using linear mixed models. Results: At baseline, children spent about 60 and 30% of time sitting during lessons and breaks, respectively. After installing standing desks (T1), significantly lower proportions of sitting were observed in the intervention group 1 [−13.1%, 95%-CI: (−20.5; −5.72)] and the control group 2 [−9.78%, 95%-CI: (−17.3; −2.28)]. Compared to the baseline measurement (T0), lower proportions of sitting were particularly expressed during school breaks in group 1 and 2 after intervention in T1 [group 1: −10.3%, 95%-CI: (−16.4; −4.25)] or in T2 [group 2: −8.59%, 95%-CI: (−15.2; −1.94)]. In general, children with higher physical fitness were less sedentary and more active, but intervention effects did not differ by fitness levels. Conclusion: Standing desks provide an opportunity to reduce sedentary time during lessons and breaks at school in primary school children, but do not directly increase PA of high intensity such as stepping. Future studies should consider potential bandwagon effects caused by structural interventions.
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Affiliation(s)
- Ole Sprengeler
- Department of Epidemiological Methods and Etiologic Research, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Antje Hebestreit
- Department of Epidemiological Methods and Etiologic Research, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Hannah Gohres
- School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Jens Bucksch
- Department of Sociological and Human Sciences, Heidelberg University of Education, Heidelberg, Germany
| | - Christoph Buck
- Department of Biometry and Data Management, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
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Clemes SA, Bingham DD, Pearson N, Chen YL, Edwardson C, McEachan R, Tolfrey K, Cale L, Richardson G, Fray M, Altunkaya J, Bandelow S, Jaicim NB, Barber SE. Sit–stand desks to reduce sedentary behaviour in 9- to 10-year-olds: the Stand Out in Class pilot cluster RCT. PUBLIC HEALTH RESEARCH 2020. [DOI: 10.3310/phr08080] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background
Sedentary behaviour (sitting) is a highly prevalent negative health behaviour, with individuals of all ages exposed to environments that promote prolonged sitting. The school classroom represents an ideal setting for environmental change through the provision of sit–stand desks.
Objectives
The aim of this study was to undertake a pilot cluster randomised controlled trial of the introduction of sit–stand desks in primary school classrooms, to inform a definitive trial. Objectives included providing information on school and participant recruitment and retention, acceptability of the intervention, and outcome measures. A preliminary estimate of the intervention’s effectiveness on the proposed primary outcome (change in weekday sitting time) for inclusion in a definitive trial was calculated, along with a preliminary assessment of potential cost-effectiveness. A full process evaluation was also undertaken.
Design
A two-armed pilot cluster randomised controlled trial with economic and qualitative evaluations. Schools were randomised on a 1 : 1 basis to the intervention (n = 4) or control (n = 4) trial arms.
Setting
Primary schools in Bradford, West Yorkshire, UK.
Participants
Children in Year 5 (i.e. aged 9–10 years).
Intervention
Six sit–stand desks replaced three standard desks (sitting six children) in the intervention classrooms for 4.5 months. Teachers were encouraged to ensure that all pupils were exposed to the sit–stand desks for at least 1 hour per day, on average, using a rotation system. Schools assigned to the control arm continued with their usual practice.
Main outcome measures
Trial feasibility outcomes included school and participant recruitment and attrition, acceptability of the intervention, and acceptability of and compliance with the proposed outcome measures [including weekday sitting measured using activPAL™ (PAL Technologies Ltd, Glasgow, UK) accelerometers, physical activity, adiposity, blood pressure, cognitive function, musculoskeletal comfort, academic progress, engagement and behaviour].
Results
Thirty-three per cent of schools approached and 75% (n = 176) of eligible children took part. At the 7-month follow-up, retention rates were 100% for schools and 97% for children. Outcome measure completion rates ranged from 63% to 97%. A preliminary estimate of intervention effectiveness, from a weighted linear regression model (adjusting for baseline sitting time and wear time) revealed a mean difference in change in sitting of –30.6 minutes per day (95% confidence interval –56.42 to –4.84 minutes per day) between the intervention and control trial arms. The process evaluation revealed that the intervention, recruitment and evaluation procedures were acceptable to teachers and children, with the exception of minor issues around activPAL attachment. A preliminary within-trial economic analysis revealed no difference between intervention and control trial arms in health and education resource use or outcomes. Long-term modelling estimated an unadjusted incremental cost-effectiveness ratio of Stand Out in Class of £78,986 per quality-adjusted life-year gained.
Conclusion
This study has provided evidence of the acceptability and feasibility of the Stand Out in Class intervention and evaluation methods. Preliminary evidence suggests that the intervention may have a positive direction of effect on weekday sitting time, which warrants testing in a full cluster randomised controlled trial. Lessons learnt from this trial will inform the planning of a definitive trial.
Trial registration
Current Controlled Trials ISRCTN12915848.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 8. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Stacy A Clemes
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- National Institute for Health Research Leicester Biomedical Research Centre, Leicester, UK
| | - Daniel D Bingham
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Natalie Pearson
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Yu-Ling Chen
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Charlotte Edwardson
- National Institute for Health Research Leicester Biomedical Research Centre, Leicester, UK
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Rosemary McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Keith Tolfrey
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- National Institute for Health Research Leicester Biomedical Research Centre, Leicester, UK
| | - Lorraine Cale
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | | | - Mike Fray
- Loughborough Design School, Loughborough University, Loughborough, UK
| | | | - Stephan Bandelow
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | | | - Sally E Barber
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
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Blackburn NE, Wilson JJ, McMullan II, Caserotti P, Giné-Garriga M, Wirth K, Coll-Planas L, Alias SB, Roqué M, Deidda M, Kunzmann AT, Dallmeier D, Tully MA. The effectiveness and complexity of interventions targeting sedentary behaviour across the lifespan: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2020; 17:53. [PMID: 32334631 PMCID: PMC7183680 DOI: 10.1186/s12966-020-00957-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 04/13/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Evidence suggests that sedentary behaviour (SB) is associated with poor health outcomes. SB at any age may have significant consequences for health and well-being and interventions targeting SB are accumulating. Therefore, the need to review the effects of multicomponent, complex interventions that incorporate effective strategies to reduce SB are essential. METHODS A systematic review and meta-analysis were conducted investigating the impact of interventions targeting SB across the lifespan. Six databases were searched and two review authors independently screened studies for eligibility, completed data extraction and assessed the risk of bias and complexity of each of the included studies. RESULTS A total of 77 adult studies (n=62, RCTs) and 84 studies (n=62, RCTs) in children were included. The findings demonstrated that interventions in adults when compared to active controls resulted in non-significant reductions in SB, although when compared to inactive controls significant reductions were found in both the short (MD -56.86; 95%CI -74.10, -39.63; n=4632; I2 83%) and medium-to-long term (MD -20.14; 95%CI -34.13, -6.16; n=4537; I2 65%). The findings demonstrated that interventions in children when compared to active controls may lead to relevant reductions in daily sedentary time in the short-term (MD -59.90; 95%CI -102.16, -17.65; n=267; I2 86%), while interventions in children when compared to inactive controls may lead to relevant reductions in the short-term (MD -25.86; 95%CI -40.77, -10.96; n=9480; I2 98%) and medium-to-long term (MD -14.02; 95%CI -19.49, -8.55; n=41,138; I2 98%). The assessment of complexity suggested that interventions may need to be suitably complex to address the challenges of a complex behaviour such as SB, but demonstrated that a higher complexity score is not necessarily associated with better outcomes in terms of sustained long-term changes. CONCLUSIONS Interventions targeting reductions in SB have been shown to be successful, especially environmental interventions in both children and adults. More needs to be known about how best to optimise intervention effects. Future intervention studies should apply more rigorous methods to improve research quality, considering larger sample sizes, randomised controlled designs and valid and reliable measures of SB.
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Affiliation(s)
- Nicole E Blackburn
- Centre for Health and Rehabilitation Technologies, Institute of Nursing and Health Research, School of Health Sciences, Ulster University, Newtownabbey, United Kingdom.
| | - Jason J Wilson
- Centre for Health and Rehabilitation Technologies, Institute of Nursing and Health Research, School of Health Sciences, Ulster University, Newtownabbey, United Kingdom
| | - Ilona I McMullan
- Centre for Health and Rehabilitation Technologies, Institute of Nursing and Health Research, School of Health Sciences, Ulster University, Newtownabbey, United Kingdom
| | - Paolo Caserotti
- Department of Sports Science and Clinical Biomechanics, Center for Active and Healthy Ageing (CAHA), Syddansk Universitet, Odense, Denmark
| | - Maria Giné-Garriga
- Department of Sport Sciences, Faculty of Psychology, Education and Sport Sciences Blanquerna, Universitat Ramon Llull, Barcelona, Spain
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom
| | - Katharina Wirth
- Agaplesion Bethesda Clinic Ulm, Geriatric Centre Ulm/Alb-Donau, Ulm, Germany
- Department of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Laura Coll-Planas
- Fundació Salut i Envelliment-Universitat Autònoma de Barcelona, Barcelona, Spain
- Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain
| | - Sergi Blancafort Alias
- Fundació Salut i Envelliment-Universitat Autònoma de Barcelona, Barcelona, Spain
- Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain
| | - Marta Roqué
- Fundació Salut i Envelliment-Universitat Autònoma de Barcelona, Barcelona, Spain
- Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain
| | - Manuela Deidda
- Health Economics and Health Technology Assessment (HEHTA), Institute of Health and Wellbeing (IHW), University of Glasgow, Glasgow, United Kingdom
| | - Andrew T Kunzmann
- School of Medicine, Dentistry and Biomedical Sciences, Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Dhayana Dallmeier
- Agaplesion Bethesda Clinic Ulm, Geriatric Centre Ulm/Alb-Donau, Ulm, Germany
- Department of Epidemiology, Boston University School of Public Health, Boston, USA
| | - Mark A Tully
- Centre for Health and Rehabilitation Technologies, Institute of Nursing and Health Research, School of Health Sciences, Ulster University, Newtownabbey, United Kingdom
- Institute of Mental Health Sciences, School of Health Sciences, Ulster University, Newtownabbey, United Kingdom
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van Delden ALEQ, Band GPH, Slaets JPJ. A good beginning: study protocol for a group-randomized trial to investigate the effects of sit-to-stand desks on academic performance and sedentary time in primary education. BMC Public Health 2020; 20:70. [PMID: 31941471 PMCID: PMC6964001 DOI: 10.1186/s12889-019-8135-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 12/30/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Sedentary behavior is associated with health risks and academic under-achievement in children. Still, children spend a large part of their waking hours sitting at a desk at school. Recent short-term studies demonstrated the potential of sit-to-stand desks to reduce sitting time in primary education. The program of "A Good Beginning" was conceived to assess the long-term effects of sit-to-stand desks on sitting time in primary education, and to examine how sit-to-stand desks versus regular desks relate to academic performance, and measures of executive functioning, health and wellbeing. The present paper describes the design of this group-randomized trial, which started in 2017 and will be completed in 2019. METHODS Children of two grade-three groups (age 8-9) following regular primary education in Leiden, The Netherlands, were recruited. A coin toss determined which group is the experimental group; the other group is the control group. All children in the experimental group received sit-to-stand desks. They are invited and motivated to reduce sedentary time at school, however, it is their own choice to sit or stand. Children in the control group use regular desks. Otherwise, both groups receive regular treatment. Outcomes are assessed at baseline (T0) and at five follow-up sessions (T1-T5) alternately in winter and summer seasons over three academic years. Primary outcome measures are academic performance, and the proportion of sitting time at school, measured with a 3D accelerometer. Secondary outcome measures are a number of measures related to executive functioning (e.g., N-back task for working memory), health (e.g., height and weight for BMI), and wellbeing (e.g., KIDSCREEN-52 for Quality of Life). DISCUSSION A Good Beginning is a two-and-a-half-year research program, which aims to provide a better understanding of the long-term effects of sit-to-stand desks on sedentary time at school and the relation between sitting time reduction and academic performance, executive functioning, health and wellbeing. The findings may serve as useful information for policy making and practical decision making for school and classroom environments. TRIAL REGISTRATION The program of "A Good Beginning" is registered at the Netherlands Trial Register (NTR, https://www.trialregister.nl), number NL6166, registration date 24 November 2016.
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Affiliation(s)
- A Lex E Q van Delden
- Leyden Academy on Vitality and Ageing, Leiden, The Netherlands.
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
| | - Guido P H Band
- Cognitive Psychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition (LIBC), Leiden, The Netherlands
| | - Joris P J Slaets
- Leyden Academy on Vitality and Ageing, Leiden, The Netherlands
- Center for Geriatric Medicine, University Medical Center Groningen, Groningen, The Netherlands
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24
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Moura BP, Rufino RL, Faria RC, Amorim PRS. Effects of isotemporal substitution of sedentary behavior with light-intensity or moderate-to-vigorous physical activity on cardiometabolic markers in male adolescents. PLoS One 2019; 14:e0225856. [PMID: 31770423 PMCID: PMC6879145 DOI: 10.1371/journal.pone.0225856] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 11/13/2019] [Indexed: 12/13/2022] Open
Abstract
Increasing prevalence of sedentary behavior (SB) combined with low levels of physical activity (PA) in children and adolescents has become a growing public health concern. Therefore, this study aimed to identify the daily behavioral pattern of adolescents and examine the isotemporal substitution effects of SB with light-intensity PA (LIPA) or moderate-to-vigorous PA (MVPA) on cardiometabolic markers. In this cross-sectional study, the daily behavioral pattern of Brazilian male adolescents was objectively measured for 7 days. Vector magnitude activity counts were used to estimate SB, LIPA, and MVPA with cut-points specifically validated for youth. The isotemporal substitution model was used to assess the effects of replacing different SB bouts (5, 10, 30, and 60 min) with LIPA or MVPA on cardiometabolic markers [body mass index, waist circumference, body fat percentage (BF%), total cholesterol, high-density lipoprotein cholesterol (HDL-C), non-HDL-C, low-density lipoprotein cholesterol, triglyceride (TG), glucose, insulin, homeostatic model assessment of insulin resistance (HOMA2-IR), insulin sensitivity (HOMA2-S), beta cell function (HOMA2-β), systolic-blood pressure (SBP), diastolic-blood pressure, and cardiometabolic risk score]. Male adolescents (n = 84; age, 16.7 ± 0.9 years) wore the GT3X+ for 6.7 ± 0.6 days, during 15.2 ± 2.3 h, and spent 72.9% of the time in SB, 17.3% in LIPA, and 9.8% in MVPA. SB replacement with LIPA was associated with increased HDL-C, TG, HOMA2-IR, and HOMA2-S and decreased SBP. In contrast, SB replacement with MVPA was associated with decreased BF%. Therefore, our findings suggest that replacing SB with LIPA showed positive results on HDL-C, HOMA2-S and SBP, while replacing SB with MVPA was associated with only one obesity indicator (BF%). Moreover, participants met the daily MVPA recommendations, but they still had a daily behavioral pattern with high SB. In this context, LIPAs can be considered an effective alternative to reduce SB and improve the health indicators of this population.
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Affiliation(s)
- Bruno P Moura
- Medical Science Graduate Program, Medical Sciences Faculty, Rio de Janeiro State University, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rogério L Rufino
- Medical Science Graduate Program, Medical Sciences Faculty, Rio de Janeiro State University, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ricardo C Faria
- Department of Physical Education, Federal University of Viçosa, Viçosa, Minas Gerais, Brazil
| | - Paulo Roberto S Amorim
- Department of Physical Education, Federal University of Viçosa, Viçosa, Minas Gerais, Brazil
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Standing Desks in a Grade 4 Classroom over the Full School Year. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193590. [PMID: 31557874 PMCID: PMC6801749 DOI: 10.3390/ijerph16193590] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 09/12/2019] [Accepted: 09/18/2019] [Indexed: 12/12/2022]
Abstract
School-aged children are spending increasingly long periods of time engaged in sedentary activities such as sitting. Recent school-based studies have examined the intervention effects of introducing standing desks into the classroom in the short and medium term. The aim of this repeated-measures crossover design study was to assess the sit-stand behaviour, waking sedentary time and physical activity, and musculoskeletal discomfort at the start and the end of a full school year following the provision of standing desks into a Grade 4 classroom. Accelerometry and musculoskeletal discomfort were measured in both standing and traditional desk conditions at the start and at the end of the school year. At both time points, when students used a standing desk, there was an increase in standing time (17–26 min/school day) and a reduction in sitting time (17–40 min/school day). There was no significant difference in sit-stand behaviour during school hours or sedentary time and physical activity during waking hours between the start and the end of the school year. Students were less likely to report discomfort in the neck and shoulders when using a standing desk and this finding was consistent over the full school year. The beneficial effects of using a standing desk were maintained over the full school year, after the novelty of using a standing desk had worn off.
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Agreement Between GT3X Accelerometer and ActivPAL Inclinometer for Estimating and Detecting Changes in Different Contexts of Sedentary Time Among Adolescents. J Phys Act Health 2019; 16:780-784. [DOI: 10.1123/jpah.2018-0178] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 04/22/2019] [Accepted: 05/12/2019] [Indexed: 11/18/2022]
Abstract
Background: This investigation aimed to analyze the agreement between the GT3X accelerometer and the ActivPAL inclinometer for estimating and detecting changes in sedentary behavior of different contexts among adolescents. Methods: Secondary data from an intervention using standing desks in the classroom conducted within 2 sixth-grade classes (intervention [n = 22] and control [n = 27]) were used. The intervention took place over 16 weeks, with activity assessments (ActivPAL and GT3X) being performed 7 days before and in the last week of the intervention. Baseline information from both groups was considered for cross-sectional analysis (209 valid days), while data from 20 participants (intervention group) were used for longitudinal analysis. Results: The authors observed that GT3X overestimated sedentary time at school (16.8%), after school (13.5%), and during weekends (7.3%) compared with ActivPAL (P < .05). Outside the school (after school [r = −.188] and on weekends [r = −.260]), there was a trend to higher overestimation among adolescents with less sedentary behavior. Longitudinally, the GT3X was unable to detect changes resulting from an intervention in school hours (ActivPAL = −34.7 min·9 h−1 vs GT3X = +6.7 min·9 h−1; P < .05). Conclusions: The authors conclude that GT3X (cut-point of <100 counts·min−1) overestimated sedentary time of free-living activities and did not detect changes resulting from a classroom standing desk intervention in adolescents.
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Moura BP, Rufino RL, Faria RC, Sasaki JE, Amorim PRS. Can Replacing Sitting Time with Standing Time Improve Adolescents' Cardiometabolic Health? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16173115. [PMID: 31461890 PMCID: PMC6747710 DOI: 10.3390/ijerph16173115] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 08/12/2019] [Accepted: 08/23/2019] [Indexed: 11/16/2022]
Abstract
This study aimed to assess the effects of isotemporal replacement of sitting time (SIT) with standing (STA) on cardiometabolic biomarkers. In this cross-sectional study, male adolescents wore the GT3X+ activity monitor for 7 days to measure the SIT and STA. Moderate-to-vigorous physical activity (MVPA) was estimated by a youth-specific cut-off point. An isotemporal substitution approach was used to examine the effects of replacing different periods of SIT (15, 30, 60, and 120 min) with STA on cardiometabolic biomarkers [total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c), non-HDL-c, low-density lipoprotein cholesterol (LDL-c), triglycerides (TG), glucose, insulin, HOMA2-β, HOMA2-S, and HOMA2-IR]. Analysis of covariance (ANCOVA) with a post-hoc Bonferroni test was used to compare the adjusted means between the four subgroups that were clustered according to SIT and STA amount. Adolescents (n = 84; age, 16.7 ± 0.9 years) wore GT3X+ for 15.2 ± 2.3 h, for 6.7 ± 0.6 days. Isotemporal substitution of SIT with STA was associated with TC, non-HDL-c, LDL-c, and TG. ANCOVA results showed a statistically significant difference for TC, non-HDL-c, and LDL-c. These findings showed that for male adolescents, sitting less and standing more may be an effective alternative to reduce cardiometabolic biomarker levels related to lipid metabolism, regardless of MVPA.
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Affiliation(s)
- Bruno P Moura
- Medical Science Graduate Program, Medical Sciences Faculty, Rio de Janeiro State University, Rio de Janeiro 20550-170, Rio de Janeiro, Brazil
| | - Rogério L Rufino
- Medical Science Graduate Program, Medical Sciences Faculty, Rio de Janeiro State University, Rio de Janeiro 20550-170, Rio de Janeiro, Brazil
| | - Ricardo C Faria
- Department of Physical Education, Viçosa Federal University, Viçosa 36570-900, Minas Gerais, Brazil
| | - Jeffer E Sasaki
- Graduate Program in Physical Education, Federal University of Triângulo Mineiro, Uberaba 38025-180, Minas Gerais, Brazil
| | - Paulo Roberto S Amorim
- Department of Physical Education, Viçosa Federal University, Viçosa 36570-900, Minas Gerais, Brazil.
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Verloigne M, Ridgers ND, De Bourdeaudhuij I, Cardon G. Effect and process evaluation of implementing standing desks in primary and secondary schools in Belgium: a cluster-randomised controlled trial. Int J Behav Nutr Phys Act 2018; 15:94. [PMID: 30261883 PMCID: PMC6161341 DOI: 10.1186/s12966-018-0726-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 09/19/2018] [Indexed: 12/30/2022] Open
Abstract
Background Children and adolescents spend a lot of time sitting at school. Implementing standing desks in the classroom is one potential strategy to reduce and break up sitting time. The first aim was to evaluate the effect of implementing standing desks in classrooms in primary and secondary schools on pupils’ sitting-related behaviour and determinants. The second aim was to quantitatively and qualitatively evaluate the process of implementing the desks in the classroom. Methods We conducted a cluster-randomised controlled trial with a pre-, mid-, and post-test design including 10 intervention schools (5 primary, 5 secondary schools) and 9 control schools (5 primary, 4 secondary schools) across Flanders, Belgium. Three standing desks were placed in one class in each intervention school for 6 months. At pre-, mid- and post-test, all pupils (n = 311; 54.5% girls) completed a questionnaire whilst a subsample of three pupils per class wore an activPAL inclinometer for one school week. Focus groups with pupils and interviews with teachers were conducted at mid-test. Process evaluation questions were added to the mid- and post-test questionnaire for the intervention group. Qualitative data were analysed using NVivo 11. Multilevel regression analyses were conducted in MLwiN 2.31. Results Few significant intervention effects were observed, although activPAL data showed favourable intervention effects on primary school pupils’ sitting and standing time and bouts. Focus groups and interviews showed a generally positive attitude towards using standing desks in both teachers and pupils, although some barriers and suggestions for future implementation were noted, for example regarding the amount of desks per classroom. Quantitative process evaluation data showed a low individual use of standing desks (between 57 and 83 min per week), which significantly decreased across the school year for primary school pupils only. Conclusions Although pupils and teachers were generally positive about the desks, relatively few intervention effects were found. Future studies should consider how to optimise the use of standing desks in classrooms to impact on sitting time, by for example, determining the most feasible intervention design and by encouraging the continued use of standing desks throughout the school year. Moreover, additional intervention strategies (e.g. educational strategies) might be needed. Trial registration NCT03163004. ClinicalTrials.gov. Registered 22 May 2017 (retrospectively registered). Electronic supplementary material The online version of this article (10.1186/s12966-018-0726-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Maïté Verloigne
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium. .,Research Foundation (FWO), Egmontstraat 1, 1000, Brussel, Belgium.
| | - Nicola D Ridgers
- Deakin University, Geelong, Australia, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, 221 Burwood Hwy, Burwood, VIC, 3125, Australia
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium
| | - Greet Cardon
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium
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