Burke 1998.
| Study characteristics | ||
| Methods | Study design: cluster‐RCT | |
| Participants |
School inclusion criteria: — School exclusion criteria: — Student inclusion criteria: — Student exclusion criteria: — Setting: school, home Age group: children Gender distribution: females and males Country/Countries where trial was performed: Australia |
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| Interventions |
Intervention 1: standard PA and nutrition programme (West Australian Schools Physical Activity and Nutrition project) in 6 schools, which consisted of classroom lessons to establish a rationale, plus 20‐minute 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. 4 fitness sessions/week was considered a realistic expectation. The nutrition programme aimed to improve children’s diets by prompting families to review their diet; reducing consumption of fat, sugar, and salt; increasing fibre intake; and creating links between home and school for health promotion. The nutrition programme is built around 4 comic books in which 2 space creatures must discover the dietary habits of humans. It includes a Teachers’ Handbook, a Home‐based Mission Booklet, a 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 of children and parents. Duration of nutrition class activities aimed for 1 hour/week Intervention 2: standard West Australian Schools Physical Activity and Nutrition programme plus a PA‐enrichment programme for higher‐risk children in 7 schools, which consisted of incorporating the teacher‐parent‐student triad and allowed 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 diaries and to encourage increased levels of PA Comparator: no programme in 5 schools Duration of intervention: 9 months Duration of follow‐up: 15 months Number of schools: 18 Theoretical framework: — |
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| Outcomes | BMI Fitness |
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| Study registration | — | |
| Publication details |
Language of publication: English Funding: non‐commercial funding (supported by a Program Grant from the National Health and Medical Research Council of Australia and by the Australian Rotary Health Research Fund) Publication status: peer‐reviewed journal |
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| Stated aim for study | "In the present study, we therefore aim standard West Australian Schools Physical Activity and Nutrition program to involve higher risk children by means of principles of educational reinforcement, combining an 'enrichment' program with the previously reported..." | |
| 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: all participants were allocated at a single point in time following recruitment, so at time of recruitment, allocation was not known |
| 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 | Low risk | Comment: outcome data complete |
| Selective reporting (reporting bias) | Unclear risk | Comment: no protocol published or trial registry |
| Cluster RCT ‐ Recruitment bias | Unclear risk | Comment: no indication participants were registered before randomisation |
| Cluster RCT ‐ Baseline imbalance | Low risk | Comment: baseline differences adjusted for in analysis |
| Cluster RCT ‐ Loss of clusters | Low risk | Comment: no clusters lost |
| Cluster RCT ‐ Incorrect analysis | Low risk | Comment: clustering was accounted for in analysis |