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Effect on physical activity of a randomized afterschool intervention for inner city children in 3rd to 5th grade
Crouter SE, de Ferranti SD, Whiteley J, Steltz SK, Osganian SK, Feldman HA, Hayman LL
PLoS ONE 2015 Oct;10(10):e0141584
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Less than 45% of US children meet the 60 min/d physical activity (PA) guideline. Structured after-school PA programing is one approach to help increase activity levels. This study aimed to evaluate the feasibility and short-term impact of a supervised after-school PA and nutrition education program on activity levels. METHODS: Forty-two 3rd to 5th graders from an inner-city school in Boston, MA were randomly assigned to a 10-wk after-school program of either: (1) weekly nutrition education, or (2) weekly nutrition education plus supervised PA 3 d/wk at a community-based center. At baseline and follow-up, PA was measured using accelerometry and fitness (VO2max) was estimated using the PACER 15-m shuttle run. Additional measures obtained were non-fasting finger stick total cholesterol (TC) and glucose levels, waist circumference (WC), body mass index (BMI), percent body fat (%BF), and blood pressure (BP). Values are presented as mean +/- SE, unless noted otherwise. RESULTS: Thirty-six participants completed the study (mean +/- SD age 9.7 +/- 0.9 years). Participants attended > 80% of the sessions. After adjusting for accelerometer wear time and other design factors, light and moderate-to-vigorous PA (MVPA) increased in the nutrition+PA group (+21.5 +/- 14.5 and +8.6 +/- 8.0 min/d, respectively) and decreased in the nutrition only group (-35.2 +/- 16.3 and -16.0 +/- 9.0 min/d, respectively); mean difference between groups of 56.8 +/- 21.7 min/d (light PA, p = 0.01) and 24.5 +/- 12.0 min/d (MVPA, p = 0.04). Time spent in sedentary behaviors declined in the nutrition+PA group (-14.8 +/- 20.7 min d-1) and increased in the nutrition only group (+55.4 +/- 23.2 min/d); mean difference between groups of -70.2 +/- 30.9 min/d (p = 0.02). Neither group showed changes in TC, BP, WC, %BF, BMI percentile, or fitness (p > 0.05). CONCLUSIONS: The supervised afterschool community-based nutrition and PA program was well accepted and had high attendance. The changes in light PA and MVPA has potential to promote weight maintenance in inner-city elementary school children, however longer term studies with larger samples are needed. TRIAL REGISTRATION: ClinicalTrials.gov NCT01104038.

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