主动游戏在 ASP 中的应用 - 一项匹配对群组随机试验，旨在调查一项干预措施在课后项目中支持儿童身体活动的有效性。
Active play in ASP -a matched-pair cluster-randomized trial investigating the effectiveness of an intervention in after-school programs for supporting children's physical activity.
机构信息
Department of Physiotherapy, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, PO Box 4, St. Olavs plass, N-0130, Oslo, Norway.
Department of Primary and Secondary Teacher Education, Faculty of Education and International Studies, OsloMet - Oslo Metropolitan University, PO Box 4, St. Olavs plass, N-0130, Oslo, Norway.
出版信息
BMC Public Health. 2020 Apr 15;20(1):500. doi: 10.1186/s12889-020-08645-1.
BACKGROUND
Interventions directed at after school programs (ASPs) have the potential to support physical activity (PA) in young children. Research has indicated that interventions that emphasize competence building among the ASP staff can lead to increased PA among the children. The present study evaluates the effectiveness of the Active Play in ASP intervention-a program for ASP staff aimed at supporting physical activity among first graders in ASP.
METHODS
We used a matched-pair cluster randomized design and included 456 first graders from 14 schools in Norway. From these, 7 ASPs received the intervention (N = 229), while 7 acted as controls (N = 227). Measurements were taken at baseline, immediately post intervention (7 month follow-up) and after a year (19 month follow-up). The primary outcome was moderate to vigorous physical activity (MVPA), which was estimated with predefined cut points of counts per minute (CPM) and expressed as minutes/hour. Secondary outcomes were vigorous and light intensity physical activity (VPA and LPA) and sedentary behavior. The analyses of intervention effects were based on between-group differences in outcome changes between the 3 measurement points and were conducted using a mixed-effects model for repeated measures using categorical time. In exploratory analyses, we investigated gender, baseline body mass index, and baseline CPM as potential effect modifiers.
RESULTS
No significant intervention effects was observed on MVPA (0.55 min/hour [99% CI -0.55:1.64]) or on the secondary outcomes, min/hour of LPA, VPA or sedentary behavior. Exploratory analyses indicated that among the 50% least physically active children at baseline, children in intervention ASPs reduced sedentary time from baseline to 19 months follow up by 1.67 min/hour (95% CI -3.12:-0.21) compared to the controls.
CONCLUSIONS
Although the intervention did not significantly increase the mean MVPA among the children in the intervention ASPs compared to controls, it did seem to have a small effect by reducing sedentary behavior time among the least active children. An even stronger emphasis on how to identify less active children and support their activity may be needed in order to increase their PA and further reduce sedentary behavior time.
TRIAL REGISTRATION
ClinicalTrials; NCT02954614, Registered 3 November 2016, -Retrospectively registered, first participant enrolled August 2016.
背景
针对课后项目（ASPs）的干预措施有可能支持幼儿的身体活动（PA）。研究表明，强调 ASP 工作人员能力建设的干预措施可以导致儿童 PA 的增加。本研究评估了积极参与 ASP 干预计划的效果 - 这是一项针对 ASP 工作人员的计划，旨在支持 ASP 中一年级学生的身体活动。
方法
我们使用了配对的群组随机设计，纳入了来自挪威 14 所学校的 456 名一年级学生。其中，7 个 ASP 接受了干预（N=229），而 7 个作为对照组（N=227）。在基线、干预后立即（7 个月随访）和 1 年后（19 个月随访）进行测量。主要结果是中等到剧烈的身体活动（MVPA），这是通过每分钟计数（CPM）的预设切点估计的，并以分钟/小时表示。次要结果是剧烈和低强度身体活动（VPA 和 LPA）和久坐行为。干预效果的分析基于 3 个测量点之间的组间差异，使用分类时间的重复测量混合效应模型进行。在探索性分析中，我们调查了性别、基线体重指数和基线 CPM 作为潜在的效应修饰剂。
结果
MVPA （0.55 分钟/小时[99%CI-0.55：1.64]）或次要结果，LPA、VPA 或久坐行为的分钟/小时，均未观察到干预的显著效果。探索性分析表明，在基线时最不活跃的 50%儿童中，与对照组相比，干预 ASP 中的儿童从基线到 19 个月随访时减少了 1.67 分钟/小时的久坐时间（95%CI-3.12：-0.21）。
结论
尽管与对照组相比，干预并未显著增加干预 ASP 中儿童的平均 MVPA，但通过减少最不活跃儿童的久坐时间，似乎产生了较小的影响。为了增加他们的 PA 并进一步减少久坐时间，可能需要更加强调如何识别不活跃的儿童并支持他们的活动。
试验注册
ClinicalTrials；NCT02954614，2016 年 11 月 3 日注册，第一个参与者于 2016 年 8 月入组。
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