Walter 1988.

Methods	Design: cluster randomized controlled trial Theoretical framework: PRECEDE, Health Belief Model, Social Learning Theory Number of intervention groups: 2 Number of control groups: 2 Follow‐up: immediately post‐intervention
Participants	N (intervention in lower income inner city area): 1590 (14 schools) N (intervention in middle/upper income suburb): 485 (8 schools) N (control in lower income inner city area): 693 (8 schools) N (control in middle/upper income suburb): 620 (7 schools) Age (mean): 9 years Sex: male and female Ethnicity: White, Hispanic, African‐American
Interventions	Country: US Setting: school, community, urban Provider: teachers Duration: 6 years Intervention: special curriculum targeting voluntary changes in risk behavior in the area of diet, physical activity, and smoking. Curriculum content was designed to provide the information and motivation necessary for behavioral changes, as well as training in the skills necessary to make such changes. The intervention foci (perceived susceptibility to, and severity of health problems, perceived benefits of and barriers to adopting and maintaining risk‐reduction types of behavior) were derived from the Health Belief Model, skills training strategies were derived from Social Learning Theory. Cognitive‐development theory provided a framework for the appropriate tailoring of these constructs to the children's changing maturational stages ad the study progressed over a 5‐year period. The physical activity component of the intervention fostered the adoption of a regular program of endurance exercise. The special curriculum was taught in classrooms by specially trained regular teachers for approximately 2 hours per week throughout each school year. Control: not specified
Outcomes	Mean systolic blood pressure (mmHg) Mean diastolic blood pressure (mmHg) Mean blood cholesterol level (mg/dL) Body mass index (kg/m2) Pulse rate (beats/minute)
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: analyses were done to see if bias would be introduced due to attrition and average values of the risk values were imputed
Selective reporting (reporting bias)	Low risk	Comment: all outcomes identified a priori were reported on
Confounders controlled?	Low risk	Comment: all relevant confounders controlled for
Data collection methods valid and reliable?	Unclear risk	Comment: reliability and validity of data collection methods not specifically stated