title: Active Smarter Kids (ASK): Rationale and design of a cluster-randomized controlled trial investigating the effects of daily physical activity on children's academic performance and risk factors for non-communicable diseases.
abstract: BACKGROUND
  Evidence is emerging from school-based studies that physical activity might favorably affect children's academic performance. However, there is a need for high-quality studies to support this. Therefore, the main objective of the Active Smarter Kids (ASK) study is to investigate the effect of daily physical activity on children's academic performance. Because of the complexity of the relation between physical activity and academic performance it is important to identify mediating and moderating variables such as cognitive function, fitness, adiposity, motor skills and quality of life (QoL). Further, there are global concerns regarding the high prevalence of lifestyle-related non-communicable diseases (NCDs). The best means to address this challenge could be through primary prevention. Physical activity is known to play a key role in preventing a host of NCDs. Therefore, we investigated as a secondary objective the effect of the intervention on risk factors related to NCDs. The purpose of this paper is to describe the design of the ASK study, the ASK intervention as well as the scope and details of the methods we adopted to evaluate the effect of the ASK intervention on 5 (th) grade children.
  
  
  METHODS
  The ASK study is a cluster randomized controlled trial that includes 1145 fifth graders (aged 10 years) from 57 schools (28 intervention schools; 29 control schools) in Sogn and Fjordane County, Norway. This represents 95.3 % of total possible recruitment. Children in all 57 participating schools took part in a curriculum-prescribed physical activity intervention (90 min/week of physical education (PE) and 45 min/week physical activity, in total; 135 min/week). In addition, children from intervention schools also participated in the ASK intervention model (165 min/week), i.e. a total of 300 min/week of physical activity/PE. The ASK study was implemented over 7 months, from November 2014 to June 2015. We assessed academic performance in reading, numeracy and English using Norwegian National tests delivered by The Norwegian Directorate for Education and Training. We assessed physical activity objectively at baseline, midpoint and at the end of the intervention. All other variables were measured at baseline and post-intervention. In addition, we used qualitative methodologies to obtain an in-depth understanding of children's embodied experiences and pedagogical processes taking place during the intervention.
  
  
  CONCLUSIONS
  If successful, ASK could provide strong evidence of a relation between physical activity and academic performance that could potentially inform the process of learning in elementary schools. Schools might also be identified as effective settings for large scale public health initiatives for the prevention of NCDs.
  
  
  BACKGROUND
  Clinicaltrials.gov ID nr: NCT02132494 . Date of registration, 6(th) of May, 2014.
authors.affiliation: Faculty of Teacher Education and Sports, Sogn og Fjordane University College, Sogndal, Norway. geirkr@hisf.no.
authors.forename: Geir K
authors.initials: GK
authors.lastname: Resaland
authors.affiliation: Faculty of Teacher Education and Sports, Sogn og Fjordane University College, Sogndal, Norway. vegard.fusche.moe@hisf.no.
authors.forename: Vegard Fusche
authors.initials: VF
authors.lastname: Moe
authors.affiliation: Faculty of Teacher Education and Sports, Sogn og Fjordane University College, Sogndal, Norway. eivind.aadland@hisf.no.
authors.forename: Eivind
authors.initials: E
authors.lastname: Aadland
authors.affiliation: Faculty of Teacher Education and Sports, Sogn og Fjordane University College, Sogndal, Norway. jostein.steene-johannessen@nih.no.
authors.forename: Jostein
authors.initials: J
authors.lastname: Steene-Johannessen
authors.affiliation: Faculty of Teacher Education and Sports, Sogn og Fjordane University College, Sogndal, Norway. oyvind.glosvik@hisf.no.
authors.forename: Øyvind
authors.initials: Ø
authors.lastname: Glosvik
authors.affiliation: Faculty of Health Studies, Sogn og Fjordane University College, Førde, Norway. john.andersen@hisf.no.|Centre of Health Research, Førde Central Hospital, Førde, Norway. john.andersen@hisf.no.
authors.forename: John R
authors.initials: JR
authors.lastname: Andersen
authors.affiliation: Faculty of Health Studies, Sogn og Fjordane University College, Førde, Norway. olav.kvalheim@uib.no.|Department of Chemistry, University of Bergen, Bergen, Norway. olav.kvalheim@uib.no.
authors.forename: Olav M
authors.initials: OM
authors.lastname: Kvalheim
authors.affiliation: Department of Family Practice, Faculty of Medicine, The University of British Columbia, Vancouver, Canada. heather.mckay@ubc.ca.
authors.forename: Heather A
authors.initials: HA
authors.lastname: McKay
authors.affiliation: Faculty of Teacher Education and Sports, Sogn og Fjordane University College, Sogndal, Norway. s.a.anderssen@nih.no.|Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway. s.a.anderssen@nih.no.
authors.forename: Sigmund A
authors.initials: SA
authors.lastname: Anderssen
mesh_terms: D000124:Achievement; D002648:Child; D016000:Cluster Analysis; D015444:Exercise / Q000523:psychology*; D005260:Female; D006293:Health Promotion / Q000379:methods* / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D008297:Male; D009664:Norway; D009765:Obesity / Q000517:prevention & control; D010806:Physical Education and Training; D011322:Primary Prevention; D011788:Quality of Life; D012307:Risk Factors; D012572:School Health Services / Q000706:statistics & numerical data*