Active Smarter Kids: A Cluster-randomized Controlled Trial

Overview

The relationship between physical activity and academic performance has received widespread attention owing to the pressure on schools to graduate pupils who meet accepted academic standards. As important, there are global concerns regarding the increased prevalence of lifestyle-related non-communicable diseases (NCDs). First, Norway has a history of mediocre scores on international comparative academic performance tests such as Trends in International Mathematics and Science Study (TIMSS) and the Programme for International Student Assessment (PISA) [1]. It is therefore important to develop and evaluate strategic programs that may enhance pupil's academic performance. It is increasingly evident that a physical activity strategy that brings about enhanced cognitive function, better blood flow, and more, plays a key role in this effort [2]. Second, the prevalence of NCDs, such as diabetes mellitus type 2, is increasing worldwide, and such NCDs affect people of all ages [3]. Hence, healthcare costs are escalating to unaffordable levels. The best means to deal with this immense problem is through primary prevention, and physical activity is a powerful common denominator known to play a key role in preventing a host of NCDs [4]. Consequently, both World Health Organization (WHO) and the Norwegian health authorities call for effective primary prevention strategies to promote physical activity in children and adolescents [5, 6]. Prop. 90 L (2010-2011) Act on public health work [6] emphasizes that physical activity in school can benefit both the learning process and public health prevention. Therefore, the objective of the ASK-study is to investigate the effects on academic performance of 60 minutes of daily physical activity during one school year. Furthermore, due to the complexity in the relationship between physical activity and academic performance, it is necessary to identify possible mediating and moderating variables as cognitive performance, quality of life (QoL), classroom behavior, motor skills and motivation. Also, we aim to investigate changes in risk factors related to NCDs and factors that influence NSDs, such as physical activity, sedentary behavior and health-related fitness. In addition a qualitative part of the ASK-Study will be conducted to get an in-depth understanding of the children's embodied experiences and the meaning of the social learning culture in school physical activity (PA). This will give us an in-depth description of the intervention context, offer insight in how the intervention possibly influences children's overall development and enables us to estimate potential long term effects of the intervention. If successful, the ASK cluster-randomized controlled trial (RCT) could provide much needed solutions to enhancing schoolchildren's academic performance and position the school as an effective setting for a massive public health intervention concerning the prevention of NCDs.

Full Title of Study: “Active Smarter Kids: A Cluster-randomized Controlled Trial Investigating the Effect of Daily Physical Activity on Children’s Academic Performance and on Risk Factors for Lifestyle-related Non-communicable Diseases”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Prevention
    • Masking: None (Open Label)
  • Study Primary Completion Date: June 2015

Interventions

  • Behavioral: Physical activity

Arms, Groups and Cohorts

  • Experimental: Physical activity
    • 60 minutes of daily physical activity during one school year
  • No Intervention: Control

Clinical Trial Outcome Measures

Primary Measures

  • Academic performance
    • Time Frame: October 2014 – June 2015 (8 months)
    • Academic performance will be measured by Norwegian “national tests” in Numeracy, Norwegian and English

Secondary Measures

  • Risk factors for lifestyle-related non-communicable diseases (NCDs)
    • Time Frame: August 2014 – June 2015 (10 months)
    • We will measure physical activity, sedentary behavior, health-related physical fitness, measures of adiposity, blood pressure and biomarkers for metabolic health
  • Executive functions
    • Time Frame: August 2014 – June 2015 (10 months)
    • Inhibition, working memory and cognitive flexibility will be assessed by pen-and-paper testing
  • Qualitative study of embodied experiences and interpersonal relations
    • Time Frame: August 2014 – June 2015 (10 months)
    • Qualitative methods will be used to explore how children act in the context of physical education and the ASK-intervention, and how their experiences are constructed in the interaction between individual and social factors. We will also explore to what extent children are capable to reflect over their bodily and social experiences.

Participating in This Clinical Trial

Inclusion Criteria

  • all children attending 5th grade at the invited schools in Sogn og Fjordane county (Norway) during the school-year 2014/2015 Exclusion Criteria:

  • those children whom for language barriers are unable to perform national tests in Numeracy, Norwegian and English

Gender Eligibility: All

Minimum Age: 8 Years

Maximum Age: 11 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Western Norway University of Applied Sciences
  • Collaborator
    • The Research Council of Norway
  • Provider of Information About this Clinical Study
    • Principal Investigator: Eivind Aadland, Associate professor – Western Norway University of Applied Sciences
  • Overall Official(s)
    • Sigmund A Anderssen, PhD, Principal Investigator, Sogn og Fjordande University College

References

1. Kjærnsli, M., Tid for tunge løft: norske elevers kompetanse i naturfag, lesing og matematikk i PISA 2006. 2007, Oslo: Universitetsforl.

Singh A, Uijtdewilligen L, Twisk JW, van Mechelen W, Chinapaw MJ. Physical activity and performance at school: a systematic review of the literature including a methodological quality assessment. Arch Pediatr Adolesc Med. 2012 Jan;166(1):49-55. doi: 10.1001/archpediatrics.2011.716.

3. WHO, World Health Organization. Prevention and control of noncommunicable diseases: implementation of the global strategy. 2008, WHO: Geneva.

4. WHO, World Health Organization [cited 2013 15.08]; Available from: http://www.euro.who.int/en/what-we-do/health-topics/disease-prevention/physical-activity/facts-and-figures/10-key-facts-on-physical-activity-in-the-who-european-region. 2011, WHO.

5. WHO, World Health Organization. Global Strategy on Diet, Physical Activity and Health. 57th World Health Assembly. 2004, WHO: Geneva.

6. PttSL, (2010-2011) Act on public health work.Lov om Folkehelsearbeid. 2010

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