Reed 2008.
| Study characteristics | ||
| Methods | Study design: cluster‐RCT | |
| Participants |
School inclusion criteria: elementary schools from the Vancouver and Richmond School Districts in British Columbia, Canada, not already engaged in PA programmes School exclusion criteria: — Student inclusion criteria: all children in Grades 4 and 5 attending included schools Student exclusion criteria: 3 girls and 2 boys excluded as they had health conditions that could affect normal PA or development Setting: school, community, home, urban Age group: children Gender distribution: females and males Country/Countries where trial was performed: Canada |
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| Interventions |
Intervention: Action Schools! BC model was consistent with the 'active school' framework and emphasised an integrated whole‐school approach rather than traditional classroom‐based health education, targeting 6 Action Zones
School Action Team – comprised school principal, teachers, or both ‐ was convened at each school; an Action Schools! BC facilitator worked with Action Teams to design a programme with activities across the 6 Action Zones. A 1‐day training workshop was held for intervention teachers, who were provided a Classroom Action Bin with resources to support their Action Plan, with the goal for each school to provide students with 150 minutes of PA/week (2 × 40‐minute PE classes and 15 × 5 minutes/d of Classroom Action) Comparator: teachers in usual practice schools continued their regular programmes of PE and school‐based PA Duration of intervention: 11 months Duration of follow‐up: 11 months Number of schools: 8 Theoretical framework: social cognitive theory |
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| Outcomes | BMI Fitness |
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| Study registration | NCT01412203 (retrospectively registered) | |
| Publication details |
Language of publication: English Funding: British Columbia Ministry of Health Publication status: peer‐reviewed journal |
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| Stated aim for study | "Our primary objective was to determine whether Action Schools! BC was an effective model to decrease cardiovascular risk factors in elementary‐school children" | |
| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk |
Quote from publication: "schools were then remotely randomised to either Usual Practice or Intervention by an epidemiologist not involved in the trial" (Reed 2008, p527) Comment: randomisation performed remotely via a random number draw [author communication] |
| Allocation concealment (selection bias) | High risk | Comment: it was reported that it was not possible for schools to be blinded to random assignment; therefore concealment was not attained |
| Blinding of participants and personnel (performance bias) All outcomes | High risk | Comment: participants were not blinded [author communication] |
| Blinding of outcome assessment (detection bias) All outcomes | High risk | Comment: outcome assessors were not blinded [author communication] |
| Incomplete outcome data (attrition bias) Anthropometrics, Fitness | High risk | Comment: incomplete outcome data; not adequately addressed |
| Selective reporting (reporting bias) | Low risk | Comment: all outcomes identified a priori were reported on |
| Cluster RCT ‐ Recruitment bias | High risk | Comment: data collection after randomisation |
| Cluster RCT ‐ Baseline imbalance | Unclear risk | Comment: not described |
| Cluster RCT ‐ Loss of clusters | Low risk | Comment: very low loss to follow‐up, most often due to moving to a different school |
| Cluster RCT ‐ Incorrect analysis | Low risk | Comment: clustering accounted for in analysis |