Article Text

Time-efficient intervention to improve older adolescents’ cardiorespiratory fitness: findings from the ‘Burn 2 Learn’ cluster randomised controlled trial
  1. David R Lubans1,
  2. Jordan J Smith1,
  3. Narelle Eather1,
  4. Angus A Leahy1,
  5. Philip J Morgan1,
  6. Chris Lonsdale2,
  7. Ronald C Plotnikoff1,
  8. Michael Nilsson3,
  9. Sarah G Kennedy1,
  10. Elizabeth G Holliday4,
  11. Natasha Weaver4,
  12. Michael Noetel2,5,
  13. Tatsuya T Shigeta6,
  14. Myrto F Mavilidi1,7,
  15. Sarah R Valkenborghs1,8,
  16. Prajwal Gyawali9,
  17. Frederick R Walker3,8,
  18. Sarah A Costigan1,10,
  19. Charles H Hillman6,11
  1. 1Priority Research Centre for Physical Activity and Nutrition, Faculty of Education and Arts, University of Newcastle, Callaghan, New South Wales, Australia
  2. 2Institute for Positive Psychology and Education, Faculty of Health Sciences, Australian Catholic University, North Sydney, New South Wales, Australia
  3. 3Centre for Rehab Innovations and Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Callaghan, New South Wales, Australia
  4. 4School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
  5. 5School of Behavioural and Health Sciences, Australian Catholic University, Banyo, Queensland, Australia
  6. 6Department of Psychology, Northeastern University, Boston, Massachusetts, USA
  7. 7Early Start, School of Education, University of Wollongong, Wollongong, New South Wales, Australia
  8. 8School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, New South Wales, Australia
  9. 9School of Health and Wellbeing, Faculty of Health, Engineering and Sciences, University of Southern Queensland, Toowoomba, Queensland, Australia
  10. 10School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
  11. 11Department of Physical Therapy, Movement and Rehabilitation Sciences, Northeastern University, Boston, Massachusetts, USA
  1. Correspondence to Dr David R Lubans, Priority Research Centre for Physical Activity and Nutrition, Faculty of Education and Arts, The University of Newcastle, Callaghan, New South Wales, Australia; david.lubans{at}newcastle.edu.au

Abstract

Background Cardiorespiratory fitness (CRF) is an important marker of current and future health status. The primary aim of our study was to evaluate the impact of a time-efficient school-based intervention on older adolescents’ CRF.

Methods Two-arm cluster randomised controlled trial conducted in two cohorts (February 2018 to February 2019 and February 2019 to February 2020) in New South Wales, Australia. Participants (N=670, 44.6% women, 16.0±0.43 years) from 20 secondary schools: 10 schools (337 participants) were randomised to the Burn 2 Learn (B2L) intervention and 10 schools (333 participants) to the control. Teachers in schools allocated to the B2L intervention were provided with training, resources, and support to facilitate the delivery of high-intensity interval training (HIIT) activity breaks during curriculum time. Teachers and students in the control group continued their usual practice. The primary outcome was CRF (20 m multi-stage fitness test). Secondary outcomes were muscular fitness, physical activity, hair cortisol concentrations, mental health and cognitive function. Outcomes were assessed at baseline, 6 months (primary end-point) and 12 months. Effects were estimated using mixed models accounting for clustering.

Results We observed a group-by-time effect for CRF (difference=4.1 laps, 95% CI 1.8 to 6.4) at the primary end-point (6 months), but not at 12 months. At 6 months, group-by-time effects were found for muscular fitness, steps during school hours and cortisol.

Conclusions Implementing HIIT during curricular time improved adolescents’ CRF and several secondary outcomes. Our findings suggest B2L is unlikely to be an effective approach unless teachers embed sessions within the school day.

Trial registration number Australian New Zealand Clinical Trials Registry (ACTRN12618000293268).

  • aerobic fitness
  • physical activity
  • physical fitness
  • exercise
  • intervention effectiveness
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Footnotes

  • Twitter @mnoetel, @SarahValko

  • Contributors DRL: conceptualisation, methodology, investigation, resources, writing-original draft, supervision, funding acquisition. JJS: methodology, investigation, resources, writing-review and editing, funding acquisition. NE: methodology, investigation, resources, writing-review and editing, funding acquisition. AAL: investigation, resources, data curation, writing-review and editing. PM: methodology, resources, writing-review and editing, funding acquisition. CL: methodology, resources, writing-review and editing, funding acquisition. RP: methodology, writing-review and editing, funding acquisition. MN: methodology, writing-review and editing, funding acquisition. SK: investigation, data curation, writing-review and editing, project administration. EGH: formal analysis, writing- review and editing, funding acquisition. NW: writing- review and editing, formal analysis. MN: resources, writing- review and editing. TTS: software, writing-review and editing. MM: investigation, data curation, software, writing-review and editing. SRV: investigation, data curation, writing-review and editing. PG: investigation, data curation, writing-review and editing. FRW: investigation, data curation, writing-review and editing. SAC: resources, writing-review and editing. CHH: methodology, software, resources, writing-review and editing, funding acquisition.

  • Funding The study was funded by the National Health and Medical Research Council (APP1120518) and the New South Wales Department of Education School Sport Unit. DRL is supported by a National Health and Medical Research Council Research Fellowship (APP1154507).

  • Competing interests None declared.

  • Patient and public involvement statement The need for a time-efficient physical activity intervention for older adolescents was identified through consultation with the New South Wales Department of Education School Sport Unit, who provided initial funding to evaluate feasibility of the B2L intervention. We conducted a pilot study in two secondary schools, and participants (ie, students and teachers) were invited to provide feedback on the intervention. This feedback was then used to refine the B2L intervention components and implementation strategies. Study findings will be disseminated through institutional websites, press releases, and tailored messages to schools, educational organisations, and governing bodies.

  • Patient consent for publication Not required.

  • Ethics approval This study received approval from the University of Newcastle (H-2016-0424) and the NSW Department of Education (SERAP: 2017116) human research ethics committees.

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

  • Data availability statement Data are available upon reasonable request. Requests for access to data from the study should be addressed to the corresponding author at david.lubans@newcastle.edu.au. The study protocol has been published. All proposals requesting data access will need to specify how it is planned to use the data, and all proposals will need approval of the trial co-investigator team before data release.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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