title: A school-based intervention to reduce overweight and inactivity in children aged 6-12 years: study design of a randomized controlled trial.
abstract: BACKGROUND
  Effective interventions to prevent overweight and obesity in children are urgently needed especially in inner-city neighbourhoods where prevalence of overweight and inactivity among primary school children is high. A school based intervention was developed aiming at the reduction of overweight and inactivity in these children by addressing both behavioural and environmental determinants.
  
  
  METHODS
  The main components of the intervention (Lekker Fit!) are the re-establishment of a professional physical education teacher; three (instead of two) PE classes per week; additional sport and play activities outside school hours; fitness testing; classroom education on healthy nutrition, active living and healthy lifestyle choices; and the involvement of parents. The effectiveness of the intervention is evaluated through a cluster randomized controlled trial in 20 primary schools among grades 3 through 8 (6-12 year olds). Primary outcome measures are BMI, waist circumference and fitness. Secondary outcome measures are assessed in a subgroup of grade 6-8 pupils (9-12 year olds) through classroom questionnaires and constitute of nutrition and physical activity behaviours and behavioural determinants. Multilevel regression analyses are used to study differences in outcomes between children in the intervention schools and in control schools, taking clustering of children within schools into account.
  
  
  CONCLUSIONS
  Hypotheses are that the intervention results in a lower prevalence of children being overweight and an improved mean fitness score, in comparison with a control group where the intervention is not implemented. The results of our study will contribute to the discussion on the role of physical education and physical activity in the school curriculum.
  
  
  BACKGROUND
  [ISRCTN84383524].
authors.affiliation: Department of Public Health, Erasmus MC, Rotterdam, The Netherlands. jansenw@ggd.rotterdam.nl
authors.forename: Wilma
authors.initials: W
authors.lastname: Jansen
authors.forename: Hein
authors.initials: H
authors.lastname: Raat
authors.forename: Evelien Joosten-van
authors.initials: EJ
authors.lastname: Zwanenburg
authors.forename: Ivo
authors.initials: I
authors.lastname: Reuvers
authors.forename: Ron
authors.initials: R
authors.lastname: van Walsem
authors.forename: Johannes
authors.initials: J
authors.lastname: Brug
mesh_terms: D002648:Child; D015444:Exercise; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D050177:Overweight / Q000517:prevention & control*; D010806:Physical Education and Training; D010809:Physical Fitness; D012044:Regression Analysis; D012572:School Health Services; D013177:Sports; D000078329:Workforce