Evaluation of a Walking School Bus Program: A Cluster Randomized Controlled Trial

步行校车项目的评估：整群随机对照试验

• 批准号: 8849861
• 负责人: Jason A Mendoza
• 金额: $ 61.23万
• 依托单位: SEATTLE CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-09 至 2016-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8849861
• 关键词: Acculturation; Address; Adult; Advocacy; Affect; Age; Behavior; Body mass index; Child; Childhood Injury; Communities; Community Health Education; Commuting; Crime; Data; Data Analyses; Educational process of instructing; Effectiveness; Epidemic; Epidemiology; Evaluation; Future; Generations; Goals; Health; Health Promotion; Individual; Injury; Intervention; Intervention Trial; Link; Low income; Malignant Neoplasms; Mediating; Mediator of activation protein; Modeling; Neighborhoods; Obesity; Observational Study; Outcome; Parents; Physical activity; Psychology; Public Health; Randomized Controlled Trials; Recruitment Activity; Reporting; Research; Research Personnel; Risk; Safety; Schools; Self Efficacy; Survey Methodology; Testing; Time; Travel; Walking; Weight; behavior change; built environment; cancer prevention; cost; design; effectiveness trial; efficacy trial; elementary school; ethnic minority population; expectation; experience; fifth grade; fourth grade; high risk; injury prevention; innovation; instrument; interdisciplinary approach; lifetime risk; obesity in children; obesity prevention; obesity risk; pedestrian injury; pedestrian safety; prevent; programs; racial and ethnic; skills; social; social cognitive theory; socioeconomic disadvantage; socioeconomics

DESCRIPTION (provided by applicant): Physical activity decreases the risk of multiple cancers and is important for obesity prevention, which in turn is important for cancer prevention. Children's active commuting to school (ACS), previously common (42 percent in 1969-1970) is now uncommon (13 percent in 2009). This decline coincided with the obesity epidemic, which disproportionately affects low-income and ethnic minority children. Programs to increase children's moderate- to-vigorous physical activity (MVPA) and lower obesity risk are necessary. The walking school bus (WSB) is an innovative program in which children walk to and from school led by adults, who teach pedestrian safety. The WSB provides additional time for MVPA, and this team's pilot WSB study reported increases to children's ACS and MVPA in the short-term. No randomized controlled trials (RCTs) have reported on long-term (i.e. over one school year) efficacy of WSB programs on children's ACS, MVPA, pedestrian safety, and adiposity. Few studies have included children from disadvantaged socioeconomic or racial/ethnic backgrounds. The Primary Goal is to conduct a cluster RCT to evaluate the long-term efficacy of a WSB program to increase low-income, ethnic minority children's ACS and MVPA. The investigators will take an interdisciplinary approach and use a social ecological model to consider multiple correlates of ACS and levels of analysis: (1) individual-level influences e.g. acculturation and constructs from social cognitive theory, (2) schools, and (3) macro-environmental influences e.g. neighborhood walkability and safety. To achieve the project goals among 3-5th grade children, the Specific Aims include: SA1) To recruit 770 child-parent dyads from 22 elementary schools over 4 years and conduct a cluster RCT to assess the efficacy of a WSB program on children's ACS, MVPA, and BMI z-score over a school-year SA2) To collect and analyze data on individual-, school-, and macro-level influences on changes to children's ACS resulting from the WSB program The Primary Hypotheses to be tested include: H1) The WSB program will increase children's ACS over a school-year. H1a) Parents' outcome expectations and self-efficacy will mediate the relationship between the WSB and changes to children's ACS. H1b) Walkability, safety, and acculturation will moderate changes to children's ACS. H2) The WSB program will increase children's MVPA and decrease BMI z-scores over a school-year. H3) The WSB program will increase school-level pedestrian safety behaviors over a school-year. The proposed research will allow for optimal assessment of changes to children's ACS, test moderators and mediators of children's ACS, evaluate long term changes to MVPA and BMI z-score, and provide crucial planning information for a future community effectiveness trial.

描述（由申请人提供）：体力活动降低多种癌症的风险，对预防肥胖很重要，而预防肥胖又对预防癌症很重要。儿童积极通勤上学（ACS），以前很常见（1969-1970年为42%），现在不常见（2009年为13%）。这一下降与肥胖症流行相吻合，肥胖症对低收入和少数民族儿童的影响不成比例。有必要制定计划，增加儿童的中度到剧烈的体力活动（MVPA），降低肥胖风险。步行校车（WSB）是一个创新的项目，在这个项目中，孩子们在成年人的带领下步行上学和放学，成年人教授行人安全。WSB为MVPA提供了额外的时间，该团队的试点WSB研究报告了短期内儿童ACS和MVPA的增加。没有随机对照试验（RCT）报告WSB项目对儿童ACS，MVPA，行人安全和肥胖的长期（即超过一个学年）疗效。很少有研究包括来自弱势社会经济或种族/民族背景的儿童。 主要目标是进行一项群组随机对照试验，以评估WSB计划提高低收入、少数民族儿童ACS和MVPA的长期疗效。研究人员将采取跨学科的方法，并使用社会生态模型来考虑ACS的多种相关性和分析水平：（1）个人层面的影响，例如文化适应和社会认知理论的构建，（2）学校，（3）宏观环境影响，例如邻里步行能力和安全性。 为了在3- 5年级儿童中实现项目目标，具体目标包括：SA 1）在4年内从22所小学招募770名儿童-家长配对，并进行一项群集RCT，以评估WSB计划在一学年内对儿童ACS、MVPA和BMI z评分的有效性SA 2）收集和分析个人、学校、和宏观层面的影响，儿童的ACS的变化所造成的WSB计划的主要假设进行测试包括：H1）WSB计划将增加儿童的ACS在一个学年。 H1 a）父母的结果期望和自我效能感将介导WSB和儿童ACS变化之间的关系。 H1b）步行能力、安全性和文化适应将缓和儿童ACS的变化。H2）WSB计划将增加儿童的MVPA，并在一学年内降低BMI Z分数。H3）WSB计划将在一个学年内增加学校层面的行人安全行为。拟议的研究将允许对儿童ACS的变化进行最佳评估，测试儿童ACS的调节剂和介导剂，评估MVPA和BMI z评分的长期变化，并为未来的社区有效性试验提供关键的规划信息。