J L Hollis 1 , 2 , R Sutherland 1 , 2 , 3 , * , L Campbell 1 , 2 , 3 , P J Morgan 4 , D R Lubans 4 , N Nathan 1 , 2 , 3 , L Wolfenden 1 , 2 , 3 , A D Okely 5 , 6 , L Davies 1 , 3 , A Williams 1 , 2 , K E Cohen 4 , C Oldmeadow 2 , 3 , K Gillham 1 , 3 , J Wiggers 1 , 2 , 3
19 July 2016
Obesity prevention during adolescence is a health priority. The ‘Physical Activity 4 Everyone' (PA4E1) study tested a multi-component physical activity intervention in 10 secondary schools from socio-economically disadvantaged communities. This paper aimed to report the secondary outcomes of the study; to determine whether the intervention impacted on adiposity outcomes (weight, body mass index (BMI), BMI z-score), and whether any effect was moderated by sex, baseline BMI and baseline physical activity level, at 12 and 24 months.
A cluster randomised controlled trial was conducted in New South Wales, Australia. The school-based intervention included seven physical activity strategies targeting the following: curriculum (strategies to maximise physical activity in physical education, student physical activity plans, an enhanced school sport programme); school environment (physical activity during school breaks, modification of school policy); and parents and the community (parent engagement, links with community physical activity providers). Students' weight (kg), BMI and BMI z-score, were collected at baseline (Grade 7), 12 and 24 months. Linear Mixed Models were used to assess between-group mean difference from baseline to 12 and 24 months. Exploratory sub-analyses were undertaken according to three moderators of energy balance.
A total of 1150 students (mean age=12 years) provided outcome data at baseline, 1051 (91%) at 12 months and 985 (86%) at 24 months. At 12 months, there were group-by-time effects for weight (mean difference=–0.90 kg (95% confidence interval (CI)=–1.50, −0.30), P<0.01) and BMI (−0.28 kg m −2 (−0.50, −0.06), P=0.01) in favour of the intervention group, but not for BMI z-score (−0.05 (−0.11; 0.01), P=0.13). These findings were consistent for weight (−0.62 kg (−1.21, 0.03), P=0.01) and BMI (−0.28 kg m −2 (−0.49, −0.06), P=0.01) at 24 months, with group-by-time effects also found for BMI z-score (−0.08 (−0.14; −0.02), P=0.02) favouring the intervention group.
The PA4E1 school-based intervention achieved moderate reductions in adiposity among adolescents from socio-economically disadvantaged communities. Multi-component interventions that increase adolescents' engagement in moderate-to-vigorous physical activity (MVPA) may assist in preventing unhealthy weight gain.