From efficacy to maintenance to implementation: translating the Transform-Us! study to reduce children's sitting time in school and home

Abstract

PURPOSE: Physical activity confers important benefits to child health, and recent evidence suggests that sedentary behaviours may be adversely associated with children’s weight status, independent of participation in physical activity. With children accumulating over 70% of their waking sedentary time during school hours, the classroom environment is an important setting for reducing sitting time in children. However, the translation of a large efficacy trial from research to practice has not been systematically assessed. The purpose of this presentation is to explore some of the key learnings from the longer-term maintenance effects and translating the findings of a large efficacy trial (the Transform-Us! study) to practice using pedagogical and environmental approaches for reducing children’s sitting time. METHODS: The program involved both pedagogical (e. g., training teachers to deliver 30 min standing lessons and provide 2-min standing breaks every 30 mins) and environmental approaches (e.g., access to novel play equipment, playground line markings) over a 2.5 year period among 8-10 year old children living in mid and low socioeconomic position (SEP) areas of Melbourne. All 20 schools participated in the follow-up of the Transform-Us! study, with teachers completing an on-line survey (data currently being collected). Two local government areas in low SEP areas are working with the researchers to disseminate the program to primary schools in their area. Outcome variables will include the number of children and teachers engaged in the program, satisfaction with the program, perceived changes to sitting time, and effectiveness of strategies on learning and other cognitive outcomes. RESULTS: Preliminary results suggest that the Transform-Us! program appears sustainable; however, there are challenges in translating the full program in terms of teacher training, equipment costs and so on. The program was distilled into 3 key areas: classroom approaches, teacher pedagogical approaches, and playground environmental approaches. CONCLUSIONS: This study will enhance understanding of how best to translate research into practice. Particular challenges include trying to maintain the integrity of the program once it is disseminated, and in particular the retention of key features considered essential for reducing children’s sitting time.