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A cluster-randomized trial comparing two SWITCH implementation support strategies for school wellness intervention

Richard R Rosenkranz1, Philip M Dixon2, David A Dzewaltowski3

  • 1Department of Food, Nutrition, Dietetics & Health, Kansas State University, Manhattan, KS 66506, USA.

Journal of Sport and Health Science
|December 6, 2021
PubMed
Summary

Group-based implementation of the School Wellness Integration Targeting Child Health (SWITCH) intervention is as effective as individualized support for improving children's physical activity and reducing sedentary screen time.

Keywords:
ChildrenImplementation scienceObesity preventionPhysical activitySchool health

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Area of Science:

  • Child Health
  • Public Health Interventions
  • School Wellness Programs

Background:

  • The School Wellness Integration Targeting Child Health (SWITCH) intervention is a feasible approach for schools to promote student physical activity (PA), reduce sedentary screen time (SST), and improve dietary intake (DI).
  • This study aimed to compare the effectiveness of enhanced (individualized) versus standard (group-based) implementation support for the SWITCH intervention.

Purpose of the Study:

  • To evaluate the comparative effectiveness of individualized versus group-based implementation strategies for the SWITCH intervention.
  • To determine if implementation strategy or student gender influences changes in PA, SST, and DI.

Main Methods:

  • Twenty-two Iowa elementary schools received standardized training and were randomized to either individualized or group implementation support.
  • The physical activity, sedentary screen time, and dietary intake of 1097 students were assessed pre- and post-intervention.
  • Linear mixed models were used to analyze differential changes in outcomes by implementation condition and gender.

Main Results:

  • Both implementation conditions significantly improved PA and SST over time, but DI did not show commensurate improvement.
  • No significant differences in PA, SST, or DI changes were found between the individualized and group implementation conditions.
  • No differential effects were observed based on student gender for any of the outcomes.

Conclusions:

  • Group-based implementation of SWITCH is as effective as individualized implementation for enhancing school wellness programming.
  • The SWITCH intervention appears beneficial for both boys and girls.
  • Further research is needed to identify school-level factors influencing SWITCH implementation and outcomes.