Burke 1998.
| Methods | Design: cluster randomized controlled trial Theoretical framework: unstated Number of intervention groups: 5 Number of control groups: 1 Follow‐up: 6 months post‐intervention | |
| Participants | N (total): 720 Age (mean): 11 years Sex: male and female Ethnicity: unstated |
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| Interventions | Country: Australia Setting: school, home, unstated if urban or rural Provider: teachers, research staff, parents Duration: 9 months Intervention 1: standard physical activity (PA) and nutrition program (WASPAN) in 6 schools, which consisted of classroom lessons to establish a rationale, plus 20‐min fitness sessions daily by means of small group activities that allowed for individual fitness levels and provided a range of options by means of progression through graded activities. Four fitness sessions per week were considered a realistic expectation. The nutrition program aimed to improve children's diets by prompting families to review their diets; reducing consumption of fat, sugar, and salt; increasing fiber intake; and creating links between home and school for health promotion. The nutrition program is built around 4 comic books in which 2 space creatures must discover the dietary habits of humans. It includes a Teachers' Handbook, Home‐based Mission Booklet, Class Activities Booklet, Incentives, and a Recipe Booklet that presents recipes written for children by children. Home‐based Missions and Class Activities are combined in activities such as planning a week's grocery shopping on the basis of advertised prices and in learning strategies to resist peer pressure. The Incentives Booklet includes a progress chart, stickers, and a completion certificate to encourage participation from children and parents. Duration of nutrition class activities aimed for 1 hour per week. Intervention 2: standard WASPAN program plus a PA‐enrichment program for higher‐risk children in 7 schools, which consisted of incorporating the teacher‐parent‐student triad and allowed for PA needs and preferences to be met outside the setting of the whole class. Children kept regular, but not continuous, 7‐day PA diaries, which were used by teachers to identify preferred activities and ways these might be increased in duration or frequency. Teachers and students worked together to establish goals and decide on how these might be attained. Parents were asked to monitor completion of the diaries and to encourage increased levels of PA Control: no program in 5 schools | |
| Outcomes | Television viewing (minutes spent watching television) Mean systolic blood pressure (mmHg) Mean diastolic blood pressure (mmHg) BMI (kg/m2) | |
| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Unclear risk | Comment: randomization process not reported |
| Allocation concealment (selection bias) | Low risk | Comment: criterion not applicable because all participants were allocated at 1 point in time following recruitment, so at time of recruitment allocation was not known |
| Blinding (performance bias and detection bias) All outcomes | Unclear risk | Comment: no information given, likely not done |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | Comment: outcome data complete |
| Selective reporting (reporting bias) | Low risk | Comment: all outcomes identified a priori were reported on |
| Confounders controlled? | Low risk | Comment: all relevant confounders were accounted for |
| Data collection methods valid and reliable? | High risk | Comment: reliability and validity of most outcomes not stated |