The Active for Life Year 5 (AFLY5) school-based cluster randomised controlled trial: effect on potential mediators

Area of Science:

• Public Health and Health Promotion
• Childhood Obesity Prevention
• Behavioral Science

Background:

• The Active for Life Year 5 (AFLY5) is a school-based intervention designed to promote physical activity and healthy eating in children.
• It aims to enhance self-efficacy, knowledge, and parental support for healthy choices.
• Previous findings indicated no effect on primary outcomes but benefits for screen viewing, snack consumption, and energy drink intake.

Purpose of the Study:

• To evaluate the impact of the AFLY5 intervention on potential mediating factors.
• To understand how the intervention influences children's self-efficacy, knowledge, and parental support related to healthy behaviors.

Main Methods:

• A cluster randomized controlled trial (RCT) was conducted in South West England from 2011 to 2013.
• Participants included 2,221 school children aged 8-9 years at baseline.
• Ten potential mediators, including self-efficacy, parental support, and knowledge, were assessed post-intervention.

Main Results:

• The intervention group showed significantly greater fruit and vegetable self-efficacy, maternal limitation of sedentary behavior, and knowledge compared to the control group.
• Maternal limitation of sedentary behavior and increased child knowledge explained 23% of the intervention's effect on reducing weekend sedentary time.
• No significant effects were observed on other assessed mediators.

Conclusions:

• The AFLY5 intervention's positive effect on reducing weekend screen time was partially mediated by increased maternal efforts to limit sedentary behavior and enhanced child knowledge.
• The findings suggest that theory-driven interventions may not always influence the intended mediators, potentially explaining limited success in improving health outcomes.
• Further research is needed to optimize interventions for sustained behavioral change in children.