Grillich Ludwig, Kien Christina, Takuya Yanagida, Weber Michael, Gartlehner Gerald
Department for Evidence-based Medicine and Clinical Epidemiology, Danube University Krems, Dr. Karl Dorrek Straße 30, 3500, Krems an der Donau, Austria.
School of Applied Health and Social Sciences, University of Applied Sciences Upper Austria, Wels, Austria.
BMC Public Health. 2016 Jul 30;16:679. doi: 10.1186/s12889-016-3330-4.
Programmes based on the World Health Organization's Health Promoting Schools framework (HPS) have been implemented in several countries but for evidence-based policy-making more research is required to determine the effectiveness of the HPS approach.
We conducted a cluster randomised controlled trial. The units of randomisation were primary school classes recruited in May 2010. Eligible participants were Year 3 primary school classes in Lower Austria that had not participated in a similar programme during the last two years. After baseline assessment in September 2010, 53 classes from 45 primary schools in Lower Austria were randomly assigned to an intervention (n = 26 classes, 432 children) or waiting control arm (n = 27 classes, 493 children aged 8.7 years +/- 4 months). Over the course of 1.5 academic years, participating teachers received on-the-job training (20 h) and two workshops (8 h) to promote health related behaviour in students such as physical activity during the school day and to improve the quality of regular physical education classes. We assessed 15 outcomes grouped into five categories: Emotional and Social Experience in School, Physical Activity, Well-being, and Attention Performance measured by validated and standardised questionnaire and Motor Skills measured by validated and standardised motoric and coordination tests in the school gym. The primary outcome was Classroom Climate and part of the outcomecategory Emotional and Social Experience in School. The final assessment took place in April 2012. All assessors were blinded to the allocation of classes. Multilevel growth modelling was used to investigate programme effectiveness.
We could not detect any statistically significant differences between groups for the outcomecategories Emotional and Social Experience in school (p = 0.22 to 0.78), Physical Activity, Well-being, and Attention Performance. Significant differences between groups were limited to the outcomecategory Motor Skills (Complex Reaction Ability, Spatial Orientation Skills, Coordination with Precision) which were higher in the intervention group (P < .05).
Despite small statistically significant differences in Motor Skills, our study could not detect any clinically relevant improvements in the Emotional and Social Experience at School (including the primary outcome ClassroomClimate), Physical Activity, Well-being, Motor Skills and Attention Performance of students.
German register of clinical studies: DRKS00000622 . Retrospectively registered: 03.12.2010. Approved by the Ethics Committee of Lower Austria (GS4-EK-4/107-2010).
基于世界卫生组织健康促进学校框架（HPS）的项目已在多个国家实施，但为了进行循证决策，还需要更多研究来确定HPS方法的有效性。
我们进行了一项整群随机对照试验。随机分组的单位是2010年5月招募的小学班级。符合条件的参与者是下奥地利州三年级的小学班级，这些班级在过去两年中未参加过类似项目。在2010年9月进行基线评估后，下奥地利州45所小学的53个班级被随机分配到干预组（n = 26个班级，432名儿童）或等待对照组（n = 27个班级，493名8.7岁±4个月的儿童）。在1.5个学年的时间里，参与的教师接受了在职培训（20小时）和两次工作坊（8小时），以促进学生的健康相关行为，如在校期间的体育活动，并提高常规体育课的质量。我们评估了15项结果，分为五类：学校中的情感和社交体验、体育活动、幸福感、通过经过验证和标准化的问卷测量的注意力表现，以及在学校体育馆通过经过验证和标准化的运动和协调测试测量的运动技能。主要结果是课堂氛围，它是学校情感和社交体验结果类别的一部分。最终评估于2012年4月进行。所有评估人员均对班级分配情况不知情。采用多水平增长模型来研究项目效果。
我们未发现两组在学校情感和社交体验结果类别（p = 0.22至0.78）、体育活动、幸福感和注意力表现方面存在任何统计学上的显著差异。两组之间的显著差异仅限于运动技能结果类别（复杂反应能力、空间定向技能、精确协调能力），干预组的这些技能更高（P < 0.05）。
尽管在运动技能方面存在统计学上的微小显著差异，但我们的研究未发现学生在学校的情感和社交体验（包括主要结果课堂氛围）、体育活动、幸福感、运动技能和注意力表现方面有任何临床相关的改善。
德国临床研究注册库：DRKS00000622。追溯注册日期：2010年12月3日。经下奥地利州伦理委员会批准（GS4-EK-4/107-2010）。
