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Stand Out in Class: restructuring the classroom environment to reduce sitting time - findings from a pilot cluster randomised controlled trial

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posted on 2020-05-27, 09:27 authored by Stacy A Clemes, Daniel D Bingham, Natalie Pearson, Yu-Ling Chen, Charlotte L Edwardson, Rosemary RC McEachan, Keith Tolfrey, Lorraine Cale, Gerry Richardson, Mike Fray, James Altunkaya, Stephan Bandelow, Nishal Bhupendra Jaicim, Jo Salmon, David W Dunstan, Sally E Barber
Background: Excessive sedentary behaviour (sitting) is a risk factor for poor health in children and adults. Incorporating sit-stand desks in the classroom environment has been highlighted as a potential strategy to reduce children's sitting time. The primary aim of this study was to examine the feasibility of conducting a cluster randomised controlled trial (RCT) of a sit-stand desk intervention within primary school classrooms. Methods: We conducted a two-armed pilot cluster RCT involving 8 primary schools in Bradford, United Kingdom. Schools were randomised on a 1:1 basis to the intervention or usual practice control arm. All children (aged 9-10 years) in participating classes were eligible to take part. Six sit-stand desks replaced three standard desks (sitting 6 children) in the intervention classrooms for 4.5-months. Teachers were encouraged to use a rotation system to ensure all pupils were exposed to the sit-stand desks for > 1 h/day on average. Trial feasibility outcomes (assessed using quantitative and qualitative measures) included school and participant recruitment and attrition, intervention and outcome measure completion rates, acceptability, and preliminary effectiveness of the intervention for reducing sitting time. A weighted linear regression model compared changes in weekday sitting time (assessed using the activPAL accelerometer) between trial arms. Results: School and child recruitment rates were 33% (n = 8) and 75% (n = 176). At follow-up, retention rates were 100% for schools and 97% for children. Outcome measure completion rates ranged from 63 to 97%. A preliminary estimate of intervention effectiveness revealed a mean difference in change in sitting of - 30.6 min/day (95% CI: - 56.42 to - 4.84) in favour of the intervention group, after adjusting for baseline sitting and wear time. Qualitative measures revealed the intervention and evaluation procedures were acceptable to teachers and children, except for some problems with activPAL attachment. Conclusion: This study provides evidence of the acceptability and feasibility of a sit-stand desk intervention and evaluation methods. Preliminary evidence suggests the intervention showed potential in reducing children's weekday sitting but some adaptations to the desk rotation system are needed to maximize exposure. Lessons learnt from this trial will inform the planning of a definitive trial. Trial registration: ISRCTN12915848 (registered: 09/11/16).

Funding

This study was funded by the National Institute for Health Research (NIHR) Public Health Research programme (project number: NIHR PHR 14/231/20) and supported by the NIHR Leicester Biomedical Research Centre – Lifestyle theme and the NIHR Collaboration in Applied Health Research and Care (CLAHRC) Yorkshire and Humber, Healthy Children Healthy Families theme. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.

History

Citation

Clemes, S.A., Bingham, D.D., Pearson, N. et al. Stand Out in Class: restructuring the classroom environment to reduce sitting time – findings from a pilot cluster randomised controlled trial. Int J Behav Nutr Phys Act 17, 55 (2020). https://doi.org/10.1186/s12966-020-00958-z

Version

  • VoR (Version of Record)

Published in

INTERNATIONAL JOURNAL OF BEHAVIORAL NUTRITION AND PHYSICAL ACTIVITY

Volume

17

Issue

1

Pagination

55(16)

Publisher

BMC

issn

1479-5868

eissn

1479-5868

Acceptance date

2020-04-15

Copyright date

2020

Spatial coverage

Bradford, United Kingdom

Language

English

Publisher version

https://ijbnpa.biomedcentral.com/articles/10.1186/s12966-020-00958-z