Active Transport Educational Program Based on the Ecological Model on Improving the Physical and Mental Health: MOV-ES Project

Official title

Effectiveness of the Active Transport Educational Program Based on the Ecological Model on Improving the Physical and Mental Health of Secondary Students: Study Protocol for a Randomized Controlled Trial (Mov-Es Project)

Overview

The epidemic of physical inactivity affects the entire world and is responsible for more than 5 million deaths per year. The call of the United Nations, through the 2030 Agenda and the Sustainable Development Goals, encourages the creation of favorable environments for physical activity based on the ecological model of physical activity. Given this context, active transportation can be an accessible, economical, and sustainable method to increase daily physical activity. The rate of school children who use active transport has decreased, being replaced by motorized transport, causing congestion and high levels of pollution in cities. In the Chilean context, there are studies of active transportation in the Chilean population; however, they are scarce in the school population and none of them is an intervention study, demonstrating the incipient development of this area in the country. The benefits of promoting active transportation not only favor the lifestyles of school children but also include additional co-benefits such as the improvement of mental health and better academic performance, in addition to the reduction of exhaust and greenhouse gas emissions. Objectives. This proposal consists of three phases with the following objectives: Phase I: i) to synthesize the evidence about interventions aimed at estimating the effect on health of active transport in the secondary students; and ii), using qualitative techniques, to explore, from the basis of grounded theory, barriers and facilitators perceived by professors, students and parents about the development and implementation of the MOV-ES intervention. Phase II. Pilot and feasibility trial: a) to test the effect of MOV-ES intervention on improving body composition (body fat percentage and muscle mass), physical fitness (aerobic capacity and muscular strength), executive function and mental fitness (mood disorders, cognitive functioning) in the secondary students; and b), to examine the acceptability by professors, parents and students of the intervention by using ad hoc questionnaires. Phase III: to test the effectiveness of the MOV-ES intervention on physical activity, physical fitness, cognition and mental health through a cluster randomized controlled trial. Expected results: This project will give rise to the following master\'s and doctoral theses, with their corresponding articles of high scientific impact: 1) Barriers and facilitators of teachers, parents and students for active transport from a qualitative approach; 2) Association between the built environment, urban features, and active transportation in high school students, 3) Effectiveness of an active transportation educational intervention on physical fitness and body composition, 4) Effectiveness of an active transportation educational intervention on the cognition of schoolchildren. It is expected that the results of the MOV-ES Project will transcend the physical health of schoolchildren and will have an impact on the school community, especially by decongesting the school environment. Through these results, the Ministry of Education, regional DAEM, municipalities, and educational establishments will be able to propose public policies that favor the practice of physical activity and the acquisition of healthy habits at school age. All of the above is based on quality indicators proposed by the Education Quality Agency.

Interventions

• Other Active transport educational program based on the ecological model
  The intervention is structured according to the following units: Unit I: benefits of physical activity on health and healthy habits in schoolchildren; Unit II: Active Transportation: Experiences from other countries; Unit III: Analysis of the environmental characteristics of the school environment of each establishment; and Unit VI: Road safety for pedestrians and cyclists. This last topic will be broken down considering analysis and prevention of accidents with automobiles, pedestrian regulatio

Primary outcome measures

• Body composition change (fat mass) by bioimpedance at 16 weeks [Time frame: 4 months]
• Change from Body Composition (fat-free mass) by bioimpedance at 16 weeks [Time frame: 4 months]
• Changes in Executive Function (inhibition) at 16 weeks [Time frame: 4 months]
• Changes in Executive Function (cognitive flexibility) at 16 weeks [Time frame: 4 months]
• Changes in executive function (working memory) at 16 weeks [Time frame: 4 months]

Secondary outcome measures (12)

• Change from Anthropometric measurements at 16 weeks [Time frame: 4 months]
• Changes in objective physical activity at 16 week [Time frame: 4 months]
• Change from Physical Fitness (Aptitud cardiorrespiratoria (VO2 máx) at 16 weeks [Time frame: 4 months]
• Change from Physical Fitness (lower body strength) at 16 weeks [Time frame: 4 months]
• Change from Physical-Functional Fitness (strenght on the upper body) at 16 weeks [Time frame: 4 months]
• Change from mental health (depression) at 16 weeks [Time frame: 4 months]
• Change from mental health (Anxiety) at 16 weeks [Time frame: 4 months]
• Change from mental health (Stress) at 16 weeks [Time frame: 4 months]
• Changes in overall academic performance once the intervention is completed [Time frame: 5 months]
• Changes in health-related quality of life at 16 weeks [Time frame: 4 months]
• Changes in the Perception of urban environmental characteristics at 16 weeks [Time frame: 4 months]
• Changes in physical activity barriers at 16 weeks [Time frame: 4 months]

Eligibility criteria

Inclusion criteria

• Students in their third year of high school enrolled in schools in the province of Talca

Exclusion criteria

• Students who have some motor problem to carry out autonomous transportation.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: Yes

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Single blind

Primary purpose

Prevention

Study locations

Center list to be confirmed — check the primary protocol.

Publications

• Kohl HW 3rd, Craig CL, Lambert EV, Inoue S, Alkandari JR, Leetongin G, Kahlmeier S; Lancet Physical Activity Series Working Group. The pandemic of physical inactivity: global action for public health. Lancet. 2012 Jul 21;380(9838):294-305. doi: 10.1016/S0140-6736(12)60898-8. PMID 22818941
• Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT; Lancet Physical Activity Series Working Group. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet. 2012 Jul 21;380(9838):219-29. doi: 10.1016/S0140-6736(12)61031-9. PMID 22818936
• Aubert S, Barnes JD, Abdeta C, Abi Nader P, Adeniyi AF, Aguilar-Farias N, Andrade Tenesaca DS, Bhawra J, Brazo-Sayavera J, Cardon G, Chang CK, Delisle Nystrom C, Demetriou Y, Draper CE, Edwards L, Emeljanovas A, Gaba A, Galaviz KI, Gonzalez SA, Herrera-Cuenca M, Huang WY, Ibrahim IAE, Jurimae J, Kamppi K, Katapally TR, Katewongsa P, Katzmarzyk PT, Khan A, Korcz A, Kim YS, Lambert E, Lee EY, Lof M, PMID 30475137
• Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1.9 million participants. Lancet Glob Health. 2018 Oct;6(10):e1077-e1086. doi: 10.1016/S2214-109X(18)30357-7. Epub 2018 Sep 4. PMID 30193830
• Aguilar-Farias N, Miranda-Marquez S, Martino-Fuentealba P, Sadarangani KP, Chandia-Poblete D, Mella-Garcia C, Carcamo-Oyarzun J, Cristi-Montero C, Rodriguez-Rodriguez F, Delgado-Floody P, Von Oetinger A, Balboa-Castillo T, Pena S, Cuadrado C, Bedregal P, Celis-Morales C, Garcia-Hermoso A, Cortinez-O'Ryan A. 2018 Chilean Physical Activity Report Card for Children and Adolescents: Full Report and In PMID 32668409
• Celis-Morales C, Salas C, Martinez MA, Leiva AM, Garrido-Mendez A, Diaz-Martinez X. [The economic burden of physical inactivity in Chile]. Rev Med Chil. 2017 Aug;145(8):1091-1092. doi: 10.4067/s0034-98872017000801091. No abstract available. Spanish. PMID 29189871
• Aznar S, Naylor PJ, Silva P, Perez M, Angulo T, Laguna M, Lara MT, Lopez-Chicharro J. Patterns of physical activity in Spanish children: a descriptive pilot study. Child Care Health Dev. 2011 May;37(3):322-8. doi: 10.1111/j.1365-2214.2010.01175.x. Epub 2010 Nov 18. PMID 21083695
• Stanley RM, Maher C, Dollman J. Modelling the contribution of walking between home and school to daily physical activity in primary age children. BMC Public Health. 2015 May 1;15:445. doi: 10.1186/s12889-015-1765-7. PMID 25928079

Identifiers

NCT: NCT06357065 · UCatolicaMaule · 11240343

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗