Barbeau 2007.

Study characteristics
Methods	Study design: RCT
Participants	Student inclusion criteria: black girls 8 to 12 years of age (Grades 3, 4, and 5) from 8 local elementary schools who weighed < 300 lbs; were not taking any medication known to affect body composition or fat distribution; and were able to participate in regular PA Student exclusion criteria: — Setting: school Age group: children Gender distribution: females Country/Countries where trial was performed: USA
Interventions	Intervention: 10‐month after‐school PA programme on body composition and cardiovascular fitness in young black girls, offered every school day during the school year, with transportation (i.e. school bus service) provided to encourage participation. 30 minutes of homework time while students received a free, healthy snack and 80 minutes of PA. Snacks were individually packaged, and every day offered something salty (e.g. crackers and cheese), something sweet (e.g. low‐fat cookies), or a fruit or vegetable. Students chose 1 snack with the option of another if they wished. The PA included 25 minutes of skill development, 35 minutes of MVPA, with 20 minutes of toning and stretching. Students wore Polar Accurex Plus HR monitors (Port Washington, NY) every day and were instructed to maintain their heart rate above 150 beats/min during MVPA. MVPA activities included games such as basketball, tag, softball, relay races, etc., modified for activity of all students through the 35‐minute period. Students received small weekly prizes for behaviour and attitude, and for having no more than 1 unexcused absence. A student of the month at each school received a slightly larger prize, with prizes intended to reward good behaviour, participation, and effort. Parents were called when students had 2 consecutive unexcused absences, with reasons discussed and parents encouraged to send their daughter back to the programme. Teachers most often worked the intervention at their own school and in some cases were assigned to work at a different school. Teachers received formal training with background information on childhood obesity, PA, and cardiovascular risk factors, study goals, and the study protocol and types of activities appropriate for each segment of the intervention. Role‐playing was a large component of training; teachers were asked to prepare a lesson plan for 1 day and did a shortened simulation of it, so feedback could be provided. A Manual of Procedures for each school included all information needed to implement the intervention, including several potential activities. Teachers hired after training received 1‐on‐1 training on theoretical aspects and observed several sessions before their own implementation Comparator: — Duration of intervention: 10 months Duration of follow‐up: 10 months Number of schools: 8 Theoretical framework: —
Outcomes	BMI Fitness
Study registration	—
Publication details	Language of publication: English Funding: non‐commercial funding (National Institutes of Health) Publication status: peer‐reviewed journal
Stated aim for study	"This study targeted the prevention of further accretion of undesirable levels of adipose tissue in black girls through regular PA"
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Comment: randomisation process not reported
Allocation concealment (selection bias)	Low risk	Comment: allocation occurred after testing; therefore concealed. It was not known or determined at time of study entry which group the next participant would go to
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Comment: no information given; likely not done
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Comment: no information given; likely not done
Incomplete outcome data (attrition bias) Anthropometrics, Fitness	High risk	Comment: incomplete outcome data not addressed
Selective reporting (reporting bias)	Unclear risk	Comment: no protocol published; cannot assess