Introduction
Most children do not meet the recommendations for school-time and daily moderate-to-vigorous
physical activity, with significant demographic disparities and declines over the
elementary school years. Investigators examined the impact of Fueling Learning through
Exercise study school-based physical activity programs on school-time and total daily
moderate-to-vigorous physical activity among lower-income school children.
Design, Participants, and Intervention
Urban elementary schools (N=18) were cluster randomized to 100 Mile Club, Just Move,
or control. Data collection and analyses occurred from 2015 to 2019 among third- and
fourth-grade school children (N=1,008) across 2 academic years.
Main outcome measures
Student's moderate-to-vigorous physical activity was measured by 7-day accelerometry
(Actigraph GT3X+) at baseline (before intervention), midpoint (6 months), and endpoint
(18 months). Mixed-effects linear regression models examined program impact on school-time
and daily moderate-to-vigorous physical activity, adjusting for clustering, demographics,
weight status, free/reduced-price lunch eligibility, school physical activity environment,
wear time, and weather. Program reach by sex, weight status, race/ethnicity, and baseline
activity levels was explored.
Results
Of the 979 participants analyzed (aged 8.7 [SD=0.7] years, 44% male, 60% non-White,
40% overweight/obese, 55% eligible for free/reduced-price lunch), 8.4% (18.2 [SD=7.9]
minutes per day) and 19.8% (45.6 [SD=19.4] minutes per day) fulfilled the 30-minute
school-time and 60-minute daily moderate-to-vigorous physical activity recommendations
at baseline, respectively. Overall, daily moderate-to-vigorous physical activity decreased
from baseline to 18 months (p<0.001, −5.3 minutes, 95% CI= −8.2, −2.4) with no effect of programming. However,
for school-time moderate-to-vigorous physical activity, intervention schools maintained
school-time moderate-to-vigorous physical activity across the 2 academic years, whereas
school-time moderate-to-vigorous physical activity decreased in control schools (p=0.004, −2.3 minutes, 95% CI= −4.3, −0.4). Program reach on school-time moderate-to-vigorous
physical activity appeared equitable by sex and weight status but was different by
race/ethnicity (p<0.001).
Conclusions
Two different school-based physical activity programs were effective in preventing
the decline in school-time moderate-to-vigorous physical activity that is typical
across the elementary years, with similar reach by sex and weight status. Multiple
opportunities for physical activity during school are needed to promote meeting school-time
moderate-to-vigorous physical activity recommendations among diverse children.
Trial registration
This study is registered at www.clinicaltrials.gov NCT02810834.
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Article Info
Publication History
Published online: March 26, 2021
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© 2021 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
