Please select the eligibility criteria that correspond to the clinical trial below.
Title: The Effects of an In-school Physical Activity Intervention on Adolescents' Brain Structure and Function ('Fit to Study' Brain Imaging Sub-study)
Brief Summary: Physical activity has shown beneficial effects for cognitive and brain health, suggesting it may provide a highly scalable intervention to improve academic achievement. This project is part of a large-scale randomised controlled trial called Fit to Study (ClinicalTrials.gov ID: NCT03286725). The main Fit to Study trial aims to test the effect of a school-based physical activity intervention on academic performance (as well as cognition and physical measures) across Year 8 pupils in 100 secondary schools. The current study - the Fit to Study - Brain imaging sub-study - will target a sub-sample of participants in the large-scale trial, in order to test pre- to post intervention changes in hippocampal volume, as well as cognitive performance, mental health and brain organisation. We hypothesise that the intervention will change anterior hippocampal volume of Year-8 pupils, as well as mental health, cognitive performance, and more generally, brain structure and function. We further hypothesise that changes in brain organisation (e.g. hippocampal volume) may mediate changes in cognitive performance and mental health.


Options:
A: Inclusion Criteria:

* Student attends a school that has agreed to participate in the study
* Student's classroom teacher has agreed to participate in the study
* Student is in grade 4 or 5 at start of study
* Student participates in regular physical education classes at school
* Student's parents provide consent

Exclusion Criteria:

* Student does not attend a school that has agreed to participate in the study
* Student's classroom teacher does not agree to participate in the study
* Student is not in grade 4 or 5 at start of study
* Student does not participate in regular physical education classes at school
* Student's parents do not provide consent
B: Inclusion Criteria:

* Children from public schools with canteen services located in the South Madrid Area of Education, having from 1st to 6th grades and at least two classrooms in 1st grade.

Exclusion Criteria:

* The coordination team of the SHE Foundation establishes the adherence criteria and the schools not reaching the minimum considered can be excluded. Questionnaires scoring from students with special educational needs will be excluded from the analysis of questionnaires, as well as repeat students.
C: 1. Cohort 1:

   School level:

   Inclusion criteria
   * Enrolled in the the Fit to Study Main trial
   * Within a 75 miles radius from Oxford
   * Lower lower socio-economic background, as indicated by percentage of free school meal (FSM)-eligible pupils or postcode-derived index of multiple deprivation

   Pupil level:

   Inclusion criteria
   * Enrolled in the Fit to Study Main Trial
   * English speaking

   Exclusion criteria
   * Contraindication to MRI
   * Contraindication to VO2max fitness test
2. Cohort 2

School level:

Inclusion criteria

* High completion rates of baseline cognitive, questionnaire and fitness data relative to other schools
* Responsive to messages from the Fit to Study research team
* Lower socio-economic background, as indicated by the percentage of FSM or postcode-derived index of multiple deprivation
* For intervention schools only: adherence to the intervention.

From those schools that met criteria, a sub-sample of 10 schools is chosen by the trial manager.

Pupil level:

Inclusion criteria

* Low fitness compared to other pupils of their school who expressed an interest, based on their baseline fitness assessment (part of Fit to Study Main Trial)
* Enrolled in the Fit to Study Main Trial
* English speaking

Exclusion criteria

- Contraindication to MRI

If selected schools are not interested in the brain-imaging sub-study, these schools are replaced by other schools from the Fit to Study sample that are within reasonable travel distance (max 1.5h) from the brain imaging centre.
D: School inclusion criteria:

* Public middle schools in which a majority of students lived in the surrounding community
* Enrollment of at least 90 8th-grade girls
* Yearly withdrawal rates less than 28%
* At least one semester of physical education required for each grade
* Willingness to sign a memorandum of understanding and accept random assignment of the school

Student exclusion criteria:

* Limited English-speaking skills
* Unable to participate in physical education classes due to a medical condition or disability
* Contraindications for participating in a submaximal exercise test

Answer: C