Scaling up Action Schools! BC: How Does Voltage Drop at Scale Affect Student Level Outcomes? A Cluster Randomized Controlled Trial

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dc.contributor.authorNettlefold, Lindsay
dc.contributor.authorNaylor, Patti-Jean
dc.contributor.authorMacdonald, Heather M.
dc.contributor.authorMcKay, Heather A.
dc.date.accessioned2021-05-18T20:46:05Z
dc.date.available2021-05-18T20:46:05Z
dc.date.copyright2021en_US
dc.date.issued2021
dc.description.abstractAction Schools! BC (AS! BC) was scaled-up from an efficacy trial to province-wide delivery across 11 years (2004–2015). In this study we: (1) describe strategies that supported implementation and scale-up; (2) evaluate implementation (teachers’ physical activity (PA) delivery) and student’s PA and cardiorespiratory fitness (CRF) within a cluster randomized controlled trial during years 2 and 3 of scale-up; and (3) assess relationships between teacher-level implementation and student-level outcomes. We classified implementation strategies as process, capacity-building or scale-up strategies. Elementary schools (n = 30) were randomized to intervention (INT; 16 schools; 747 students) or usual practice (UP; 14 schools; 782 students). We measured teachers’ PA delivery (n = 179) using weekly logs; students’ PA by questionnaire (n = 30 schools) and accelerometry (n = 9 schools); and students’ CRF by 20-m shuttle run (n = 25 schools). INT teachers delivered more PA than UP teachers in year 1 (+33.8 min/week, 95% CI 12.7, 54.9) but not year 2 (+18.8 min/week, 95% CI −0.8, 38.3). Unadjusted change in CRF was 36% and 27% higher in INT girls and boys, respectively, compared with their UP peers (year 1; effect size 0.28–0.48). Total PA delivered was associated with change in children’s self-reported MVPA (year 1; r = 0.17, p = 0.02). Despite the ‘voltage drop’, scaling-up school-based PA models is feasible and may enhance children’s health. Stakeholders must conceive of new ways to effectively sustain scaled-up health promoting interventions if we are to improve the health of students at a population level. Clinical Trials registration: NCT01412203.en_US
dc.description.reviewstatusRevieweden_US
dc.description.scholarlevelFacultyen_US
dc.description.sponsorshipWe gratefully acknowledge funding support from the BC Ministry of Health, 2010 Legacies Now, the BC Ministry of Education, BC Ministry of Tourism, Sport, and the Arts, the Provincial Health Services Authority, the Heart and Stroke Foundation of Canada (BC Heart PG05-0327) and the Canadian Institutes of Health Research (OCO 74248).en_US
dc.identifier.citationNettlefold, L., Naylor, P., Macdonald, H. M., McKay, H. A. (2021). Scaling up Action Schools! BC: How Does Voltage Drop at Scale Affect Student Level Outcomes? A Cluster Randomized Controlled Trial. International Journal of Environmental Research and Public Health, 18(10), 1-23. https://doi.org/10.3390/ijerph18105182.en_US
dc.identifier.urihttps://doi.org/10.3390/ijerph18105182
dc.identifier.urihttp://hdl.handle.net/1828/12983
dc.language.isoenen_US
dc.publisherInternational Journal of Environmental Research and Public Healthen_US
dc.subjectscale-up
dc.subjectimplementation strategies
dc.subjecteffectiveness
dc.subjectchildren
dc.subjectschool
dc.subjectintervention
dc.subjectphysical activity
dc.subjectfitness
dc.subject.departmentSchool of Exercise Science, Physical and Health Education
dc.titleScaling up Action Schools! BC: How Does Voltage Drop at Scale Affect Student Level Outcomes? A Cluster Randomized Controlled Trialen_US
dc.typeArticleen_US

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