Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, 125 Nashua St, Suite 860, Boston, MA 02114. Email:
Division of Endocrinology, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, Massachusetts.
Prev Chronic Dis. 2020 Oct 1;17:E116. doi: 10.5888/pcd17.190445.
Our aim was to evaluate the implementation of a widely available, before-school, physical activity program in a low-resource, racially/ethnically and socioeconomically diverse, urban school setting to identify adaptations needed for successful implementation.
We used a collaborative effort with stakeholders to implement the Build Our Kids' Success (BOKS) program in 3 schools in Revere, Massachusetts. Program structure followed a preexisting curriculum, including 60-minute sessions, 3 mornings per week, over 2 sessions (spring and fall 2018). Programs had a capacity of 40 students per school per session and the ability to adapt as needed.
We used a mixed-methods approach, guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. RE-AIM domains were assessed by use of baseline and follow-up student measures, parent interviews, and program administrative records.
From a district of 11 schools, 3 schools (2 elementary, 1 middle) implemented the BOKS program. Program enrollment reached 82% capacity (188 of 230 potential participants). Of the 188 enrolled students, 128 (68%) had parental consent for study participation. Among the 128 study participants, 61 (48%) were male, 52 (41%) identified as Hispanic/Latino, and mean age was 9.3 years (SD, 2.2). Program duration varied by school (25-60 minutes), with a mean of 33% (SD, 16%) of the session spent in actigraphy-measured moderate-to-vigorous physical activity (MVPA), or mean 16.3 (SD, 9.3) minutes of MVPA. Participants attended a median 90% (interquartile range [IQR], 56%-97%) of sessions. We observed no change in body mass index (BMI) z score or self-reported quality of life from baseline to follow-up assessment. Parents reported positive program effects. Enrollment was sustained in elementary schools and decreased in the middle school during the study period, expanding to 3 additional schools for spring 2019.
Implementation and evaluation of an evidence-based physical activity program, in a low-resource setting, are feasible and yield relevant information about program adaptations and future dissemination of similar programs.
本研究旨在评估在资源有限、种族/族裔和社会经济多样化的城市学校环境中实施一项广泛应用的、课前的身体活动项目的情况，以确定成功实施所需的调整。
我们与利益相关者合作，在马萨诸塞州雷维尔的 3 所学校实施了“建立我们孩子的成功（BOKS）”项目。该项目结构遵循现有的课程，包括每周 3 天、每天 60 分钟、2 个学期（2018 年春季和秋季）。每个学校每个班的课程容量为 40 名学生，并能够根据需要进行调整。
我们使用混合方法，以 Reach、Effectiveness、Adoption、Implementation 和 Maintenance（RE-AIM）框架为指导。RE-AIM 领域通过使用基线和后续学生测量、家长访谈和项目管理记录进行评估。
在一个由 11 所学校组成的地区，有 3 所学校（2 所小学，1 所中学）实施了 BOKS 项目。该项目的入学率达到了 82%（230 名潜在参与者中有 188 名）。在注册的 188 名学生中，有 128 名（68%）获得了家长同意参与研究。在 128 名参与研究的学生中，有 61 名（48%）是男性，52 名（41%）是西班牙裔/拉丁裔，平均年龄为 9.3 岁（标准差，2.2 岁）。项目持续时间因学校而异（25-60 分钟），平均有 33%（标准差，16%）的时间用于计步器测量的中等到剧烈的身体活动（MVPA），或平均 16.3（标准差，9.3）分钟的 MVPA。参与者平均参加了 90%（中位数，56%-97%）的课程。我们在基线和随访评估中没有观察到体重指数（BMI）z 评分或自我报告的生活质量的变化。家长报告了积极的项目效果。在研究期间，该项目在小学阶段持续招生，而在中学阶段则有所减少，并在 2019 年春季扩展到另外 3 所学校。
在资源有限的环境中实施和评估一项基于证据的身体活动项目是可行的，并为项目调整和未来类似项目的传播提供了相关信息。
