Evaluating the Effectiveness of the Dissemination of Action Schools! BC

Study Overview
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Brief Summary
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Childhood obesity is a major public health threat. Physical activity and healthy eating contribute to the maintenance of healthy weights. Individually oriented behaviour change programs may not be able to overcome the influence of what has been called an obesogenic environment. Action Schools! BC (AS! BC) used a socio-ecological approach to enhance opportunities for physical activity and healthy eating in elementary schools and created systemic change at the provincial level. AS! BC helps elementary schools customize action plans, based upon their local context, to contribute to the health and well-being of children and the school community. Pilot research showed that AS! BC was an effective and feasible model. The provincial dissemination of AS! BC has been launched and partners from across many sectors are involved to enhance the sharing of knowledge and increase the implementation of the AS! BC model across British Columbia. The dissemination provides an unprecedented opportunity for evaluating how changing the school environment can promoted healthy weights in children. The dissemination was evaluated using a cluster randomized design; 30 elementary schools (n = 1529 consented children) from four (out of five) provincial health authorities volunteered to participate. The primary goals of the research are: to determine if the Action Schools! BC (AS! BC) model is an effective approach to positively change school environments and health related behaviours of children from diverse geographical regions and cultural groups, and to determine if the supports provided to schools or the community context influence the uptake and use of the AS! BC model. This research will contribute to the science of obesity prevention and knowledge use as well as public health practice.

Official Title
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Evaluating the Effectiveness of the Dissemination of Action Schools! BC: A Socio-ecological Intervention to Increase Physical Activity and Healthy Eating in School Children

Conditions
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Physical Activity, Obesity, Physical Fitness

Intervention / Treatment
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* Behavioral: Action Schools! BC


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 8 Years
Maximum Age: 12 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Usual Practice<br>School continues with regular programming | |
| Experimental: Action Schools! BC<br>School adopts the AS!BC model | Behavioral: Action Schools! BC<br>* AS! BC applies a socioecological, whole school approach to promote healthy living within the elementary school context. Schools are provided with the tools and support needed to create customized action plans that promote physical activity (PA) and healthy living across six Action Zones (School Environment, Scheduled Physical Education (PE), Classroom Action, Family and Community, Extra-curricular, School Spirit). Generalist teachers receive training and resources to implement their Action Plan with the ultimate goal of providing students with 150 minutes of PA/week. The model is choice-based; teachers are asked to provide 15 additional minutes of PA/day within the Classroom Action Zone. The activities require minimal equipment and can be performed in the classroom, hallway or on the school playground.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Physical activity opportunities delivered (minutes/week) | School level; as measured by Weekly Teacher Logs and Interim Reports |  | 
| School environment scores | School level; as measured by a modified School Health Inventory |  | 
| Height (cm) | Student level |  | 
| Weight (kg) | Student level |  | 
| Body mass index (kg/m^2) | Student level |  | 
| Physical fitness (Fitnessgram (C)) | Student level |  | 
| Children's leisure time physical activity (PAQ-C) | Student level |  | 
| Children's dietary intake | Student level; 24 hour recall and food frequency survey |  | 
| Physical activity interventions planned | School level; as measured by Action Plans |  | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Contextual factors surrounding the use of the intervention | School level School and community partnership survey Annual focus groups with school planning teams, regional advisory committees, parent advisory committees, the local healthy living alliance Semi-structured telephone interviews with school administrators, AS! BC regional facilitators, public health nursing staff, local nutritionist, municipal recreation staff and representatives of non-government organizations involved in chronic disease prevention locally Review of AS! BC annual reports and action plans Participant observation form to assess development of communities of practice |  | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Obesity, Physical activity, Healthy weight, Healthy eating, Physical fitness, Children, School based, Community based, Health promotion, Socio-ecological, Environment based