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Effect of a School-Based Intervention on Physical Activity: Cluster-Randomized Trial


Medicine & Science in Sports & Exercise: October 2011 - Volume 43 - Issue 10 - p 1898-1906
doi: 10.1249/MSS.0b013e318217ebec

Purpose: Physical activity in childhood has many health benefits; however, the majority of children in many countries, including Mexico, are insufficiently active. The objective of this investigation was to test the effect of a school-based environmental intervention on the physical activity and physical fitness of students attending public primary schools in Mexico City.

Methods: Twenty-seven schools were randomly assigned to basic or plus intervention or control. The basic and plus groups were exposed to school environment and policy changes to enhance physical activity. Physical activity was evaluated in 699 randomly selected fourth- and fifth-grade students by measuring school-day and all-day (24 h) steps using pedometers worn for 5 d before and after the 6-month intervention. Physical fitness was assessed by measuring the 9-min run, flexibility, and sit-ups. We calculated the average change in school-day and all-day steps and fitness measures from baseline to follow-up. Using linear regression, we tested the effect of intervention on change controlling for baseline measures and covariates and accounting for the design effect of school. Using logistic regression, we tested the effect of intervention on reaching step cutoffs at baseline and follow-up.

Results: The plus group significantly (P < 0.05) increased school-day steps relative to control (change = 687 vs −639). Significantly (P < 0.05) more participants in the basic (25.8%) and plus (36.4%) groups reached step cutoffs during school relative to control (12.0%). The basic group significantly (P < 0.05) increased all-day steps relative to control (change = 581 vs −419). The plus group significantly (P = 0.05) increased sit-ups relative to control (change = 0.3 vs −1.7).

Conclusions: A school-based environmental intervention improved student physical activity during school in public schools in Mexico City.

1Division of Nutrition, Physical Activity and Obesity, Centers for Disease Control and Prevention, Atlanta, GA; and 2Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, MEXICO

Address for correspondence: Margarita Safdie, M.S., School of Kinesiology & Health Studies, Queen's University, 28 Division Street, Kingston, Ontario, Canada K7L 3N6; E-mail:

Submitted for publication July 2010.

Accepted for publication February 2011.

©2011The American College of Sports Medicine