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      Integrating physical activity into the primary school curriculum: rationale and study protocol for the “Thinking while Moving in English” cluster randomized controlled trial

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          The current and declining physical activity levels of children is a global concern. Integrating physical activity into the school curriculum may be an effective way not only to improve children’s physical activity levels but also enhance educational outcomes. Given the recent national focus in Australia on improving the literacy levels of children in primary school, and an increasing proportion of time spent on explicitly teaching these skills, integrating physical activity into English could be a viable strategy to improve literacy levels and physical activity at the same time. The aim of this study is to evaluate the impact of the ‘Thinking While Moving in English’ (TWM-E) program on children’s physical activity, on-task behavior in the classroom, academic achievement, and executive function.


          Grade 3–4 children from 10 public schools in New South Wales, Australia will be randomly allocated to intervention ( n = 5) or control ( n = 5) groups. All teachers will receive 1-day workshop of registered professional learning and a TWM-E equipment pack (e.g., chalk, lettered bean bags). Intervention schools will be asked to adapt their English lessons to embed movement-based learning in their daily program for three 40-min lessons per week, over a six-week period. The primary outcome is children’s physical activity levels across the school day (measured using accelerometry). Secondary outcomes are children’s on-task behavior during English lessons, academic achievement in English, and executive function. A detailed process evaluation will be undertaken including questionnaires, fidelity checks, and teacher and student interviews.


          The TWM-E program has the potential to improve primary school children’s physical activity levels, along with academic outcomes (on-task behavior, cognition, and academic achievement), and provide stakeholders with exemplar lessons and guidelines which illustrate how to teach English to children whilst they are moving.

          Trial registration

          Australian and New Zealand Clinical trial Register ACTRN12618001009202

          Date registered: 15/06/2018 retrospectively registered.

          Electronic supplementary material

          The online version of this article (10.1186/s12889-019-6635-2) contains supplementary material, which is available to authorized users.

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          Most cited references 29

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          Multilevel Modeling of Individual and Group Level Mediated Effects.

          This article combines procedures for single-level mediational analysis with multilevel modeling techniques in order to appropriately test mediational effects in clustered data. A simulation study compared the performance of these multilevel mediational models with that of single-level mediational models in clustered data with individual- or group-level initial independent variables, individual- or group-level mediators, and individual level outcomes. The standard errors of mediated effects from the multilevel solution were generally accurate, while those from the single-level procedure were downwardly biased, often by 20% or more. The multilevel advantage was greatest in those situations involving group-level variables, larger group sizes, and higher intraclass correlations in mediator and outcome variables. Multilevel mediational modeling methods were also applied to data from a preventive intervention designed to reduce intentions to use steroids among players on high school football teams. This example illustrates differences between single-level and multilevel mediational modeling in real-world clustered data and shows how the multilevel technique may lead to more accurate results.
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            The effect of acute treadmill walking on cognitive control and academic achievement in preadolescent children.

            The effect of an acute bout of moderate treadmill walking on behavioral and neuroelectric indexes of the cognitive control of attention and applied aspects of cognition involved in school-based academic performance were assessed. A within-subjects design included 20 preadolescent participants (age=9.5+/-0.5 years; eight female) to assess exercise-induced changes in performance during a modified flanker task and the Wide Range Achievement Test 3. The resting session consisted of cognitive testing followed by a cardiorespiratory fitness assessment to determine aerobic fitness. The exercise session consisted of 20 min of walking on a motor-driven treadmill at 60% of estimated maximum heart rate followed by cognitive testing once heart rate returned to within 10% of pre-exercise levels. Results indicated an improvement in response accuracy, larger P3 amplitude, and better performance on the academic achievement test following aerobic exercise relative to the resting session. Collectively, these findings indicate that single, acute bouts of moderately-intense aerobic exercise (i.e. walking) may improve the cognitive control of attention in preadolescent children, and further support the use of moderate acute exercise as a contributing factor for increasing attention and academic performance. These data suggest that single bouts of exercise affect specific underlying processes that support cognitive health and may be necessary for effective functioning across the lifespan.
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              Supporting public health priorities: recommendations for physical education and physical activity promotion in schools.

              Physical activity (PA) provides numerous physiological and psychosocial benefits. However, lifestyle changes, including reduced PA opportunities in multiple settings, have resulted in an escalation of overweight and obesity and related health problems. Poor physical and mental health, including metabolic and cardiovascular problems is seen in progressively younger ages, and the systematic decline in school PA has contributed to this trend. Of note, the crowded school curriculum with an intense focus on academic achievement, lack of school leadership support, funding and resources, plus poor quality teaching are barriers to PA promotion in schools. The school setting and physical educators in particular, must embrace their role in public health by adopting a comprehensive school PA program. We provide an overview of key issues and challenges in the area plus best bets and recommendations for physical education and PA promotion in the school system moving forward.

                Author and article information

                +61249216242 , Myrto.Mavilidi@newcastle.edu.au
                +61249212049 , David.Lubans@newcastle.edu.au
                +61249217265 , philip.morgan@newcastle.edu.au
                +61243484214 , andrew.miller@newcastle.edu.au
                +61249216232 , Narelle.Eather@newcastle.edu.au
                + 61249215457 , frini.karayanidis@newcastle.edu.au
                + 61297392293 , Chris.Lonsdale@acu.edu.au
                +61297014668 , Michael.Noetel@acu.edu.au
                +61249216007 , kylie.shaw@newcastle.edu.au
                +61249854254 , Nicholas.Riley@newcastle.edu.au
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                4 April 2019
                4 April 2019
                : 19
                [1 ]ISNI 0000 0000 8831 109X, GRID grid.266842.c, Priority Research Centre for Physical Activity and Nutrition, , University of Newcastle, ; Callaghan, NSW 2308 Australia
                [2 ]ISNI 0000 0000 8831 109X, GRID grid.266842.c, School of Education, Faculty of Education and Arts, , University of Newcastle, ; University Drive, Newcastle, 2308 Australia
                [3 ]ISNI 0000 0000 8831 109X, GRID grid.266842.c, School of Psychology, Faculty of Science, , University of Newcastle, ; University Drive, Newcastle, 2308 Australia
                [4 ]ISNI 0000 0001 2194 1270, GRID grid.411958.0, Institute for Positive Psychology and Education, Faculty of Health Sciences, , Australian Catholic University, ; Level 9 & 10, 33 Berry Street, North Sydney, 2060 Australia
                © The Author(s). 2019

                Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                Funded by: NSW Department of Education, School Sport Unit
                Award ID: G1700722
                Award Recipient :
                Study Protocol
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                © The Author(s) 2019


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