Pilot and Feasibility Evaluation of a Walking School Bus Program Intervention for

描述（由申请人提供）：肥胖和体育活动与多种癌症的风险降低和预后改善有关。在美国，随着儿童年龄的增长，儿童肥胖正在增加，而体育活动水平却在下降。由于这两种情况在成年后都很严重，因此成年后患肥胖症和癌症的风险也会增加。因此，在美国，预防儿童肥胖和改善体育活动已被选为主要的公共卫生目标，以减少肥胖和癌症的风险和后遗症。步行上学是2010年健康人的一项国家健康目标，这与美国癌症协会建议儿童每天至少进行60分钟的中度至剧烈体育活动是一致的。步行上学与每天24-40分钟的中等到高强度体育活动有关。增加儿童步行活动可能会增加受伤的风险；然而，与成年人一起散步可以将这种风险降低近70%。步行校车（WSB）通过在几个负责任的成年人的监督下提供一段时间的体育活动，并在往返学校的路上提供有关行人安全技能的教学机会，解决了体育活动和安全问题。缺乏关于wsb对儿童学校交通方式、行人安全、日常身体活动和健康的影响的随机对照研究。我们寻求帮助填补这一重要空白。本研究计划的目标是：1)确定学生参与WSB的社会人口预测因素；2)评估WSB计划的影响，以减少家长允许孩子走路上学的障碍，增加行人安全行为，增加步行上学，增加每日中度到剧烈的体育活动，并减少四年级学生的体重增加。3)获得与家长志愿者一起实施WSB计划的经验，并确定家长的接受程度和参与程度。我们的具体目标包括：(1)对四年级学生及其家长进行纵向队列研究，以确定与社会人口统计学数据相关的WSB参与预测因素；(2)从4所公立小学每所学校成功招募30名儿童（n=120）参加WSB干预试点，并进行为期4个月的试验组随机对照试验，以评估其在减少家长感知到的让孩子步行上学的障碍、增加孩子步行上学、增加儿童步行安全行为、增加日常中等至剧烈体育活动方面的影响。减少四年级学生的体重增加；(3)由家长志愿者对WSB项目进行为期4个月的可行性试验，收集过程数据，并对家长进行半结构化定性访谈。公共卫生相关性：步行校车（WSB）旨在增加学生步行上学和放学，行人安全，身体活动，并减少体重增加。WSB将提供一种有针对性的、基于人群的方法，以解决儿童缺乏身体活动和儿童肥胖的流行问题。这反过来又会大大降低成人肥胖和癌症的风险。

DESCRIPTION (provided by applicant): Obesity and physical activity have been associated with decreased risk and improved outcomes for multiple cancers. In the US, childhood obesity is increasing while physical activity levels decline as children age. Since both track strongly into adulthood, the risk of subsequent obesity and presumably cancer in adulthood is increased. As a result, preventing childhood obesity and improving physical activity have been selected as major public health goals to reduce the risk and sequelae of obesity and cancer in the US. Walking to school is a national health objective of Healthy People 2010, and is consistent with the American Cancer Society's recommendation for children to engage in at least 60 minutes per day of moderate to vigorous physical activity. Walking to school is associated with 24-40 more minutes of moderate to vigorous physical activity per day. Increasing child pedestrian activity could increase the risk of injuries; however, walking with an adult reduced this risk by almost 70%. A walking school bus (WSB) addresses both physical activity and safety concerns by providing a period of physical activity supervised by several responsible adults and teaching opportunities around pedestrian safety skills on the way to and from school. Randomized controlled-studies are lacking on the impact of WSBs on children's mode of school transport, pedestrian safety, daily physical activity, and health. We seek to help fill this important gap. The goals of this research plan will be 1) to determine socio-demographic predictors of student participation in the WSB, 2) to evaluate the impact of a WSB program to decrease parental barriers to allowing their children to walk to and from school, to increase pedestrian safety behaviors, to increase walking to school, to increase daily moderate to vigorous physical activity, and to decrease weight gain in 4th grade students, and 3) to gain experience in implementing a WSB program with parent volunteers and determine parental acceptability and participation. Our specific aims include: (1) To conduct a longitudinal cohort study of 4th grade students and their parents to determine predictors of WSB participation related to socio-demographic data; (2) To successfully recruit 30 children per school from four public elementary schools (n=120) to participate in a pilot WSB intervention and conduct a 4-month pilot group randomized controlled trial to assess its impact in decreasing parents' perceived barriers to allowing their children to walk to and from school, to increase children walking to school, to increase child pedestrian safety behaviors, to increase daily moderate to vigorous physical activity, and to decrease weight gain in 4th grade students; and (3) To conduct a 4-month feasibility trial of the WSB program staffed by parent volunteers, collect process data, and conduct semistructured qualitative interviews with parents regarding acceptability. PUBLIC HEALTH RELEVANCE: The walking school bus (WSB) aims to increase students' walking to and from school, pedestrian safety, physical activity, and to decrease weight gain. The WSB will provide a targeted, population-based approach to address children's physical inactivity and the epidemic of childhood obesity. This in turn should lead to a substantial reduction in the risk of adult obesity and cancer.