- Click here for explanation of classification scheme.

To determine the effects of a two-year physical education program, project SPARK (Sports, Play and Active Recreation for Kids) on indicators of relative weight and adiposity in elementary school children.

None provided

None provided

Recruitment

Of 16 elementary schools in district, 12 principals agreed to participate

Intervention Groups:

• Group 1 – certified PE specialists implemented program (2 schools)
• Group 2 – trained classroom teachers implemented program (2 schools)
• Group 3 – usual PE (control; 3 schools)

SPARK Curriculum:

• PE – to promote PA in school
  • Three 30-min classes per week
  • Rotating units (4 weeks/unit) and progression within each unit
  • Three class segments – (1) brief warm-up and daily conditioning exercise to improve muscle strength and endurance, (2) health fitness activities to promote cardiovascular fitness (e.g., walk/run, aerobic dance), (3) sports skills focusing on skills development rather than competition, followed by cool-down with stretching
  • Sufficient equipment provided to schools (including controls)
  • Self-management – to promote PA outside of school
  • One 30-min class per week
• Skills taught – self-monitoring (e.g., keeping daily log of PA), self-evaluation (e.g., weekly goal setting and discussion of progress & problems), self-reinforcement (e.g., self-praise and other low-cost methods), positive self-talk, making time for PA, making PA more enjoyable, and increasing social support
  • New skill taught each week with game format or small group interaction
  • Tangible incentives provided for reaching weekly goals (e.g., pencils, sports water bottles)
  • Parental involvement stimulated through monthly newsletters and parental signatures on weekly goal sheets

Measurements

baseline, end year 1, beginning year 2, end year 2

Statistical Analysis

One-way ANOVA

Dependent Variables

• Physical fitness (FITNESSGRAM protocol)
• Physical activity? (8-page survey)
• BMI (measured weight & height)
• Sum of skinfolds (measured calf and triceps)

Independent Variables

SPARK Program (see above)

Control Variables

Gender (separate analyses), baseline value

Initial N:

All 4^th grade students from 7 elementary schools invited to participate; 98% of students provided informed consent though a passive consent procedure.

740 children completed anthropometric evaluations and 745 completed surveys at baseline

Attrition:

196 children; characteristics not described

Final Sample:

549 children (305 boys, 244 girls; 74% of original sample) provided data at all 4 timepoints (beginning and end of each school year)

Mean age 9.25 y at baseline

Duration:

2 school y (˜18 mo), Fall 1990 – Spring 1992

85% White, 6% Asian and Pacific Islander, 7% Latino, 1% African American, 1% other

Other relevant demographics:

SES:  Not described

Location: San Diego County, CA

Baseline: Initial differences in BMI and skinfolds noted (but data not provided); f/u analyses therefore adjusted for baseline values.

Follow-up:

BMI –  boys

• Group 3 < Group 2 at end of year 1 (p<.05)
• Group 3 < Groups 1 and 2 at beginning of year 2 (p<.05)
• No differences by end of year 2

BMI – girls

• Group 3 < Groups 1 and 2 at end of year 2 (p<.01)
• No differences for other timepoints

Sum of skinfolds – boys

No differences at any timepoints

Trend toward lowest in Group 1 and highest in Group 3

Sum of skinfolds – girls

No difference at any timepoints

Trend toward lowest in Group 2 and highest in Group 3

These results indicate that two years of participation in a special physical activity promotion program did not produce significant reductions in children’s body mass index or adiposity. It may not be appropriate, however, to conclude that the program has no effect on the prevention of childhood obesity.

The present findings suggest that PA alone is not sufficient to reduce adiposity in children over a two-year period (i.e., dietary modifications are required).

There is reason to believe that the increase PA in the intervention conditions could have stimulated greater bone density and more muscle mass, and these changes could be responsible for the higher levels of BMI in the intervention conditions.

The size of the group differences presented here is not trivial.  At the last measurement in the spring of 1992, the mean intervention skinfold score was 4.5% lower than the controls’ scores for boys and 4.8% lower for girls.

Government:

NIH

Strengths: Described measurer certification procedure at baseline, quality of measure assessment during study and specialist and teacher training program, 2 y duration.

Limitations:  No inclusion or exclusion criteria provided, no blinding of measurers, no provision of fitness or physical activity data (in discussion merely state that intervention students did improve in some fitness components), no evaluation of intervention implementation (in discussion stated that group 1 had 16 more minute/wk of moderate to vigorous PA in PE classes than controls and that difference was 13 minutes in group 2), no comparison of groups at baseline on most factors and data not provided for anthropometry, statistical procedures not well described, no power calculations provided.

Other Comments:

Interim report based on the first of two consecutive cohorts of children in the same schools; final sample expected to be roughly double in size. Intended to be 3 y intervention?

SPARK was not designed to be an obesity prevention program.