Transform-Us! reduces sedentary behavior and adiposity indicators in children

1. In this randomized control trial, Transform-Us! had stronger effects on sedentary behavior (SB) than physical activity (PA) habits in children.

2. Additionally, the intervention showed a decrease in children’s body mass index (BMI) but demonstrated mixed effects on blood parameters.

Evidence Rating Level: 1 (Excellent)

Many children do not get the recommended amount of physical activity, despite the knowledge that regular physical activity is beneficial for many aspects of children’s health. Prior studies have demonstrated the effectiveness of school-based interventions in improving this outcome. Currently long-term interventions delivered at school and at home to increase children’s physical activity (PA) and reduce sedentary behavior (SB) are lacking. As a result, the objective of the present study was to determine the efficacy of the Transform-Us! school and home-based intervention to improve health outcomes in children compared with usual practice.

Transform-Us! was a 30-month cluster randomized controlled trial delivered in 20 (n=148 year 3 classes) primary schools in Australia between February 2010-December 2022. It consisted of a mix of educational, pedagogical, behavioral, social, and environmental strategies delivered by classroom teachers to either increase PA, reduce SB, or both in children. Additionally, newsletters were sent home to encourage family involvement. Schools from various socioeconomic areas were randomly ordered with probabilistic weighting according to enrolment number. Primary outcomes were sedentary time and physical activity time, which were assessed at baseline, 18 months, and 30 months. Secondary outcomes included body mass index (BMI), blood pressure (BP). Data was analyzed using Generalized Linear Mixed Models.

Results demonstrated that at 18 months, there was a decrease in children’s weekday SB for the PA intervention group, and an increase in children’s average day PA for the SB intervention group. Furthermore, BMI was lower in both the SB and PA groups, and positive effects were seen on waist circumference at both 18 and 30 months in the SB group. However, there were mixed effects on various blood parameters. The study was limited by the high attrition rate, which may have impacted the results. Nonetheless, these findings provide initial data to consider adopting and implementing programs to promote children’s PA and reduce SB through active pedagogy.

Click to read the study in British Journal of Sports Medicine

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