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An 11-week school-based ‘health education through football programme’ improves health knowledge related to hygiene, nutrition, physical activity and well-being—and it’s fun! A scaled-up, cluster-RCT with over 3000 Danish school children aged 10–12 years old
  1. Malte Nejst Larsen1,
  2. Anne-Marie Elbe2,
  3. Mads Madsen1,
  4. Esben Elholm Madsen1,3,
  5. Christina Ørntoft4,
  6. Knud Ryom5,
  7. Jiri Dvorak6,
  8. Peter Krustrup1
  1. 1 Department of Sports Science and Clinichal Biomechanics, University of Southern Denmark Faculty of Health Sciences, Odense M, Funen, Denmark
  2. 2 Institute of Sport Psychology and Physical Education, Faculty of Sport Science, Leipzig University, Leipzig, Sachsen, Germany
  3. 3 Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, University College Copenhagen, Kobenhavn, Hovedstaden, Denmark
  4. 4 Team Danmark, Brondby, Denmark
  5. 5 Department of Public Health, Section of Health Promotion and Global Health, Aarhus University, Aarhus, Denmark
  6. 6 Spine Unit, Schulthess Clinic, Zurich, Switzerland
  1. Correspondence to Professor Peter Krustrup, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark Faculty of Health Sciences, 5230 Odense, Denmark; pkrustrup{at}health.sdu.dk

Objectives

Our large-scale cluster randomised controlled trial aimed to investigate the effects on health knowledge and enjoyment of an 11 week ‘health education through football’ programme for children aged 10–12 years old.

Methods

3127 Danish school children (49% girls) aged 10–12 years from a total of 154 schools located in 63% of the Danish municipalities (69 of 98) took part in the analysis. A 5:1 cluster randomisation was performed at school level for the intervention group (IG) or the control group (CG). The twice-weekly 45 min intervention was the ‘11 for Health in Denmark’ programme, which includes health education, football drills and small-sided games. The health education element focused on hygiene, nutrition, physical activity and well-being. Outcomes: The participants completed a 34-item multiple-choice computer-based health knowledge questionnaire preintervention and postintervention. IG also evaluated whether the programme was enjoyable.

Results

Between-group differences (p<0.05) were observed in overall health knowledge in favour of IG (+7.2% points, 95% CI 6.1% to 8.4%, effect size, ES:0.59), with similar effects for girls (+7.4% points, 95% CI 5.9% to 9.0%, ES:0.57) and for boys (+7.0% points, 95% CI 5.3% to 8.7%, p<0.05, ES:0.51). Marked between-group differences were observed in favour of IG, for health knowledge related to hygiene (IG vs CG:+13.9% points, 95% CI 11.1% to 16.7%, ES:0.53), nutrition (+10.3% points, 95% CI 8.5% to 12.1%, ES:0.53), physical activity (+5.9% points, 95% CI 4.1% to 7.7%, ES:0.36) and well-being (+4.4% points, 95% CI 2.7% to 6.1%, ES:0.28). Both girls and boys gave the programme moderate to high scores for enjoyment (3.6±1.0 and 3.7±1.1, respectively).

Conclusion

Health education through sport, using the ‘11 for Health’ model, was enjoyable for girls and boys aged 10–12 years old, and improved health knowledge related to hygiene, nutrition, physical activity and well-being.

  • Health

Data availability statement

Data are available on reasonable request. Data are available on reasonable request. Deidentified participant data can be shared in respect of data protection and ethical approval. Please contact: 11forhealth@sdu.dk.

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Data availability statement

Data are available on reasonable request. Data are available on reasonable request. Deidentified participant data can be shared in respect of data protection and ethical approval. Please contact: 11forhealth@sdu.dk.

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Footnotes

  • Twitter @ElbeAnne, @ProfJiriDvorak, @sdusport

  • Contributors MNL modified the 'FIFA 11 for Health' programme for the Danish context ('11 for Health in Denmark'), contributed to the education manual, conducted testing, analysed the data, prepared the first draft of the paper, revised the manuscript and approved the final version of the paper. A-ME contributed to the design of the study, provided statistical analysis of the data, revised the manuscript and approved the final submission. MM, EEM, CØ and KR implemented the intervention, conducted testing, analysed the data, revised the manuscript and approved the final submission. JD modified the '11 for Health' programme for the European context ('FIFA 11 for Health in Europe'), contributed to the study design, commented on the manuscript and approved the final submission. PK modified the '11 for Health' programme for the European context ('FIFA 11 for Health in Europe') and subsequently for the Danish context ('11 for Health in Denmark'), designed the study, applied for funding, implemented the intervention, analysed the data, prepared the first draft of the paper, revised the manuscript and approved the final version of the paper.

  • Funding The Nordea-Foundation (Nordea-fonden), the Danish Football Association (DBU) and Aase and Ejnar Danielsens Foundation.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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