Department of Pediatrics, University Hospitals-Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, 11100 Euclid Avenue, RBC 737, Cleveland, OH 44106.
Department of Pediatrics, University of Wisconsin-Madison School of Medicine and Public Health, 600 Highland Avenue, CSC H4/407, Madison, WI 53792.
J Sch Health. 2019 Mar;89(3):159-164. doi: 10.1111/josh.12724. Epub 2019 Jan 10.
The US Centers for Disease Control and Prevention (CDC) promotes school-based strategies to increase physical activity (PA). Implementation feasibility and effect of these interventions on cardiovascular fitness (CVF) is unknown.
Forty-nine low-SES schools were randomly assigned to either (1) continue routine PA programs (N = 24 schools, 2399 students) or (2) implement 4 CDC-based PA strategies (N = 25 schools, 2495 students). CVF assessed by PACER (Progressive Aerobic Cardiovascular Endurance Run) was obtained at the beginning and end of the school year. A post-study questionnaire was administered at each school to assess adherence.
Overall, PACER z-scores were not augmented by CDC-based PA strategies. In boys, PACER z-scores increased similarly in both intervention and control schools. In girls, increased mean PACER z-score was greater in control schools (p < .01). Fifty-two percent of intervention school's staff reported inability to implement or sustain 4 CDC-based PA strategies.
Planned implementation of school-based CDC PA strategies did not increase CVF compared to routine PA programming. Lack of efficacy in girls suggests need for sex-specific targeted strategies. These findings highlight limited efficacy of CDC-based PA recommendations alone in low-SES schools. Schools may require additional support to successfully implement recommendations and meaningfully affect health outcomes.
美国疾病控制与预防中心（CDC）提倡在学校实施策略来增加身体活动（PA）。这些干预措施在实施可行性和对心血管健康（CVF）的影响方面尚不清楚。
49 所低收入家庭背景的学校被随机分配到以下两组：（1）继续常规 PA 项目（N=24 所学校，2399 名学生）或（2）实施 4 项基于 CDC 的 PA 策略（N=25 所学校，2495 名学生）。在学年开始和结束时，通过 PACER（渐进式有氧运动心血管耐力跑）评估 CVF。在每所学校进行一项研究后的问卷调查，以评估依从性。
总体而言，基于 CDC 的 PA 策略并未增加 PACER 的 z 分数。在男孩中，干预组和对照组的 PACER z 分数都有类似的增加。在女孩中，对照组的 PACER z 分数增加幅度更大（p<0.01）。52%的干预学校工作人员报告无法实施或维持 4 项基于 CDC 的 PA 策略。
与常规 PA 项目相比，计划实施基于学校的 CDC PA 策略并没有增加 CVF。女孩的效果不佳表明需要有针对性的性别特定策略。这些发现突出了基于 CDC 的 PA 建议在低收入家庭背景的学校中的疗效有限。学校可能需要额外的支持才能成功实施建议并对健康结果产生有意义的影响。
