Centre for Physical Activity and Nutrition Research, Faculty of Health, Medicine, Nursing and Behavioral Sciences, Deakin University, Victoria, Australia.
BMC Public Health. 2011 Oct 4;11:759. doi: 10.1186/1471-2458-11-759.
Physical activity (PA) is associated with positive cardio-metabolic health and emerging evidence suggests sedentary behavior (SB) may be detrimental to children's health independent of PA. The primary aim of the Transform-Us! study is to determine whether an 18-month, behavioral and environmental intervention in the school and family settings results in higher levels of PA and lower rates of SB among 8-9 year old children compared with usual practice (post-intervention and 12-months follow-up). The secondary aims are to determine the independent and combined effects of PA and SB on children's cardio-metabolic health risk factors; identify the factors that mediate the success of the intervention; and determine whether the intervention is cost-effective.
METHODS/DESIGN: A four-arm cluster-randomized controlled trial (RCT) with a 2 × 2 factorial design, with schools as the unit of randomization. Twenty schools will be allocated to one of four intervention groups, sedentary behavior (SB-I), physical activity (PA-I), combined SB and PA (SB+PA-I) or current practice control (C), which will be evaluated among approximately 600 children aged 8-9 years in school year 3 living in Melbourne, Australia. All children in year 3 at intervention schools in 2010 (8-9 years) will receive the intervention over an 18-month period with a maintenance 'booster' delivered in 2012 and children at all schools will be invited to participate in the evaluation assessments. To maximize the sample and to capture new students arriving at intervention and control schools, recruitment will be on-going up to the post-intervention time point. Primary outcomes are time spent sitting and in PA assessed via accelerometers and inclinometers and survey.
To our knowledge, Transform-Us! is the first RCT to examine the effectiveness of intervention strategies for reducing children's overall sedentary time, promoting PA and optimizing health outcomes. The integration of consistent strategies and messages to children from teachers and parents in both school and family settings is a critical component of this study, and if shown to be effective, may have a significant impact on educational policies as well as on pedagogical and parenting practices.
ACTRN12609000715279; Current Controlled Trials ISRCTN83725066.
身体活动（PA）与积极的心脏代谢健康有关，新出现的证据表明，久坐行为（SB）可能对儿童的健康有害，而与 PA 无关。Transform-Us！研究的主要目的是确定在学校和家庭环境中进行为期 18 个月的行为和环境干预是否会导致 8-9 岁儿童的 PA 水平更高，SB 率更低，与常规做法（干预后和 12 个月随访）相比。次要目的是确定 PA 和 SB 对儿童心脏代谢健康风险因素的独立和综合影响；确定成功干预的中介因素；并确定干预是否具有成本效益。
方法/设计：一项四臂聚类随机对照试验（RCT），采用 2×2 析因设计，以学校为随机分组单位。20 所学校将被分配到四个干预组之一，即久坐行为（SB-I）、身体活动（PA-I）、SB 和 PA 联合（SB+PA-I）或现行做法对照（C），该试验将在澳大利亚墨尔本的 2010 年 3 年级（8-9 岁）的约 600 名儿童中进行评估。所有干预学校 2010 年 3 年级（8-9 岁）的儿童将在 18 个月内接受干预，2012 年将进行维持“助推”，所有学校的儿童都将受邀参加评估。为了最大限度地增加样本，并捕获到达干预和对照学校的新学生，将持续招募直至干预后时间点。主要结果是通过加速度计和倾斜计以及调查评估的久坐时间和 PA 时间。
据我们所知，Transform-Us！是第一个检验干预策略有效性的 RCT，以减少儿童整体久坐时间，促进 PA 并优化健康结果。在学校和家庭环境中，教师和家长向儿童提供一致的策略和信息，这是该研究的一个关键组成部分，如果证明有效，可能会对教育政策以及教学和育儿实践产生重大影响。
ACTRN12609000715279；当前对照试验 ISRCTN83725066。
