Promoting physical literacy and 24-hour movement in Hong Kong primary school children through a blended classroom-based intervention: protocol and baseline characteristics of the “Stand+Move” cluster-randomized controlled trial

Abstract

\n BackgroundAs traditional classroom furniture contributes to children’s predominant sitting during class, the study aimed to demonstrate the design and baseline characteristics of a three-armed intervention program, which targeting on enhancements in children’s physical literacy, physical activity, sleep and executive function through constructing an active classroom environment in primary schools. The blended approach involves an organized physical activity participation during recess combining with the environmental changes during class in response to the 24-Hour Movement Guidelines in children and the emphasis on nurturing children’s physical literacy in Hong Kong primary schools.MethodsThis blended “Stand\u2009+\u2009Move” intervention adopted a cluster-randomized controlled trial (RCT) design to investigate its effectiveness on health-related aspects and to compare: 1) a PA recess intervention group; 2) a blended (sit-stand desks and PA recess) experimental group; and 3) a control group. In total, 81 students were recruited and randomly assigned to the three groups for a period of 13 weeks (from March to September, 2019). The primary outcome is the children’s physical literacy and physical activity. The secondary outcome is the children’s sleep and executive functions.ResultsAmong 81 participants enrolled at baseline, 40.7% of participants were boys and 59.3% were girls. The mean of age is 9.6 years [SD\u2009=\u20090.61, range 9.0–12.0]. There was no evidence of significant differences between trial arms at baseline concerning both the primary outcomes and secondary outcomes (all P\u2009=\u20090.06–0.89). Of all, 22.4% met the recommended PA guideline, 36.8% met the sleep guideline, resulting in only 10.5% met both guidelines, and children’s executive functions were evaluated in three aspects of inhibition, executive control, and planning. Over a half of the participants reported satisfactory in their perceived sleep quality.DiscussionThe designed intervention is regarded as an innovative strategy to reconstruct children’s traditional classroom environment in Hong Kong. The baseline results suggest that the implementation of this study design was satisfactory. Therefore, it is expected to benefit the children’s behavior-related health as well as the stakeholders in schools and families, and also provide the desired evidence to support policymaking reforms in teaching and learning strategies.Trial RegistrationChiCTR, ChiCTR2000035038. Registered 29 July 2020 – Retrospectively registered, http://www.chictr.org.cn/hvshowproject.aspx?id=46038