Hewawitharana Sridharshi C, Woodward-Lopez Gail, Ohri-Vachaspati Punam, Acciai Francesco, Thompson Hannah R, Pugliese John, Gosliner Wendi
University of California, Division of Agriculture and Natural Resources, Nutrition Policy Institute, Oakland, CA, United States of America.
University of California, Division of Agriculture and Natural Resources, Nutrition Policy Institute, Oakland, CA, United States of America.
Prev Med. 2023 Oct;175:107687. doi: 10.1016/j.ypmed.2023.107687. Epub 2023 Aug 28.
To inform Supplemental Nutrition Assistance Program Education (SNAP-Ed) and other school-based interventions aiming to improve youth cardiorespiratory fitness, this study aimed to identify which SNAP-Ed school-based physical activity intervention combinations were associated with better student cardiorespiratory fitness.
This study, utilizing cross-sectional secondary data, included 5th and 7th grade students who attended SNAP-Ed-eligible public schools in California (n = 442,743 students; 4271 schools) and had complete 2016-17 state-mandated fitness test results. Latent class analysis was used to identify underlying school-based intervention combinations. Propensity score methods were used to ensure comparability of intervention and comparison schools, by calculating inverse probability weights. Multilevel models, using those inverse probability weights, assessed the associations between the identified intervention combinations and student cardiorespiratory fitness, as measured by VOmax. The models were adjusted for school-level variables (urbanicity, percent of students eligible for free- or reduced-price meals, total enrollment, and school type), child-level variables (age, gender, and race/ethnicity), and for clustering of students within schools.
We found that students attending schools with interventions focusing on comprehensive policy changes along with improving opportunities for physical activity had, on average, 1.17 mL/kg/min (95% CI: 0.72, 1.62) greater VOmax than students attending schools without any intervention. They also had statistically significantly greater VOmax compared to students attending schools with any other type of intervention combination.
Our results suggest that comprehensive school-based physical activity interventions that include policy changes along with improving physical activity opportunities may be the most effective approach for improving fitness and may warrant prioritization in SNAP-Ed efforts.
为了给补充营养援助计划教育（SNAP-Ed）及其他旨在提高青少年心肺适能的校内干预措施提供信息，本研究旨在确定哪些SNAP-Ed校内体育活动干预组合与学生更好的心肺适能相关。
本研究利用横断面二手数据，纳入了在加利福尼亚州符合SNAP-Ed条件的公立学校就读的五年级和七年级学生（n = 442,743名学生；4271所学校），这些学生有完整的2016 - 17年州规定体能测试结果。潜在类别分析用于确定潜在的校内干预组合。倾向得分法用于通过计算逆概率权重来确保干预学校和对照学校的可比性。使用这些逆概率权重的多水平模型评估所确定的干预组合与通过最大摄氧量（VOmax）测量的学生心肺适能之间的关联。模型针对学校层面变量（城市化程度、符合免费或低价餐条件的学生百分比、总入学人数和学校类型）、儿童层面变量（年龄、性别和种族/族裔）以及学校内学生的聚类情况进行了调整。
我们发现，就读于专注于全面政策变革以及增加体育活动机会的干预学校的学生，其平均最大摄氧量（VOmax）比未接受任何干预的学校的学生高1.17 mL/kg/min（95%可信区间：0.72，1.62）。与就读于其他任何类型干预组合学校的学生相比，他们的最大摄氧量在统计学上也显著更高。
我们的结果表明，包括政策变革以及增加体育活动机会的全面校内体育活动干预可能是提高体能的最有效方法，并且可能值得在SNAP-Ed工作中优先考虑。
