Does School-Based Health Promotion Affect Physical Activity on Weekends? And, Does It Reach Those Students Most in Need of Health Promotion?

<div><p>Objective</p><p>To determine whether a school-based health promotion program affects children’s weekend physical activity and whether this effect varies according to socioeconomic-status.</p><p>Methods</p><p>This was a quasi-experimental trial of school-based programs on physical activity levels implemented in disadvantaged neighborhoods in Alberta, Canada. In 2009 and 2011, 7 full days of pedometer data were collected from cross-sectional samples of grade 5 students (age 10–11 years) from 10 intervention schools in low-socioeconomic neighbourhoods and 20 comparison schools in middle-socioeconomic neighbourhoods. Multilevel models assessed differences in step-counts between intervention and comparison groups over-time by weight (objectively measured) and socioeconomic status subgroups.</p><p>Results</p><p>In 2009, children from intervention schools were less active on weekends relative to comparison schools (9212 vs. 11186 steps/day p<0.01). Two years later, daily step-counts on weekend days among children in low socioeconomic intervention schools increased such that they approximated those of children from middle socioeconomic comparison schools (12148 vs. 12121 steps/day p = 0.96). The relative difference in steps between intervention and comparison schools on weekends reduced from -21.4% to 0.2% following the intervention. The normalization of weekend step counts was similar for normal weight (–21.4% to +2.0%) and overweight (-19.1 to +3.9%) children, and was balanced across socioeconomic subgroups.</p><p>Conclusions</p><p>These data suggest that school-based health promotion is effective for reducing inequities in physical activity levels outside school hours. Investments in school-based health promotion lead to behavior modification beyond the school environment.</p><p>Trial Registration</p><p>ClinicalTrials.gov <a href="http://www.clinicaltrials.gov/ct2/show/NCT01914185" target="_blank">NCT01914185</a></p></div

Description of enrollment of schools in the study and participation of grade 5 students in data collection, their pedometer usage, and analyses.

<p>Description of enrollment of schools in the study and participation of grade 5 students in data collection, their pedometer usage, and analyses.</p

Mean number of steps taken among all students from APPLE Schools and comparison schools in 2009 and 2011 on a) school days; b) weekend days; c) school hours; and d) non-school hours.

<p>Mean number of steps taken among all students from APPLE Schools and comparison schools in 2009 and 2011 on a) school days; b) weekend days; c) school hours; and d) non-school hours.</p

Characteristics of grade 5 students attending APPLE Schools and comparison schools in 2009 and 2011.

<p>^a: APPLE Schools = Alberta Project Promoting active Living and healthy Eating Schools</p><p>Characteristics of grade 5 students attending APPLE Schools and comparison schools in 2009 and 2011.</p

Inequity in physical activity levels (steps/day) on school days (Monday-Friday) and weekend days (Saturday, Sunday, holidays) by grade 5 students attending APPLE Schools and comparison schools over a two-year interval (2009–2011) of a Comprehensive School Health intervention.

<p>^a; CI = Confidence interval</p><p>^b: |relative difference in 2009|+Relative difference in 2011</p><p>^c:adjustments for potential confounders included: gender, parental education, and household income</p><p>^d: adjustments for potential confounders included: gender</p><p>Note: bolded 95% CI indicate statistical significance at p<0.05.</p><p>Inequity in physical activity levels (steps/day) on school days (Monday-Friday) and weekend days (Saturday, Sunday, holidays) by grade 5 students attending APPLE Schools and comparison schools over a two-year interval (2009–2011) of a Comprehensive School Health intervention.</p

Inequity in physical activity levels (steps/hour) during school (8:00am–3:59pm) and non-school hours (7:00–7:59am & 4:00–8:59pm) by grade 5 students attending APPLE Schools and comparison schools over a two-year interval (2009–2011) of a Comprehensive School Health intervention.

<p>^a; CI = Confidence interval</p><p>^b: |relative difference in 2009|+Relative difference in 2011</p><p>^c:adjustments for potential confounders included: gender, parental education, and household income</p><p>^d: adjustments for potential confounders included: gender</p><p>Note: bolded 95% CI indicate statistical significance at p<0.05.</p><p>Inequity in physical activity levels (steps/hour) during school (8:00am–3:59pm) and non-school hours (7:00–7:59am & 4:00–8:59pm) by grade 5 students attending APPLE Schools and comparison schools over a two-year interval (2009–2011) of a Comprehensive School Health intervention.</p