DEVELOPMENT AND PREVENTION OF CHILDHOOD OBESITY
Location: Children Nutrition Research Center (Houston, Tx)
Title: The Walking School Bus and children's physical activity: A pilot cluster randomized controlled trial
| Mendoza, Jason - |
| Watson, Kathy - |
| Baranowski, Tom - |
| Nicklas, Theresa - |
| Uscanga, Doris - |
| Hanfling, Marcus - |
Submitted to: Pediatrics
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: May 5, 2011
Publication Date: September 1, 2011
Citation: Mendoza, J.A., Watson, K., Baranowski, T., Nicklas, T.A., Uscanga, D.K., Hanfling, M.J. 2011. The Walking School Bus and children's physical activity: A pilot cluster randomized controlled trial. Pediatrics. 128(3):e537-e544.
Interpretive Summary: Most children in the United States are not meeting the national physical activity recommendation for at least one hour daily of moderate-to-vigorous physical activity. In a study of 4th graders at eight low-income elementary schools in the Houston Independent School District, students whose schools were randomly chosen to participate in a Walking School Bus program had increased rates of walking to school, decreased rates of being driven to school by motor vehicle, and increased daily minutes of moderate-to-vigorous physical activity. The walking school bus program helped school children increase their walking to school and physical activity, and thereby may decrease risk for obesity.
To evaluate the impact of a "walking school bus" program on children's rates of active commuting to school and physical activity. We conducted a pilot cluster randomized controlled trial among 4th-graders from 8 schools in Houston, Texas (N = 149). Random allocation to treatment or control conditions was at the school level. Study staff walked with children to and from school up to 5 days/week. Outcomes were measured the week before (time 1) and during weeks 4 and 5 of the intervention (time 2). The main outcome was the weekly rate of active commuting, and a secondary outcome was moderate-to-vigorous physical activity. Covariates included sociodemographics, distance from home to school, neighborhood safety, child BMI z score, parent self-efficacy/outcome expectations, and child self-efficacy for active commuting. A mixed-model repeated measures regression accounted for clustering by school, and stepwise procedures with backward elimination of nonsignificant covariates were used to identify significant predictors. Intervention children increased active commuting (mean +/- SD) from 23.8% +/- 9.2% (time 1) to 54% +/- 9.2% (time 2), whereas control subjects decreased from 40.2% +/- 8.9% (time 1) to 32.6% +/- 8.9% (time 2) (P < .0001). Intervention children increased their minutes of daily moderate-to-vigorous physical activity from 46.6 +/- 4.5 (time 1) to 48.8 +/- 4.5 (time 2), whereas control children decreased from 46.1 +/- 4.3 (time 1) to 41.3 +/- 4.3 (time 2) (P = .029). The program improved children's active commuting to school and daily moderate-to-vigorous physical activity.