The walking school bus and children's physical activity: a pilot cluster randomized controlled trial

Pediatrics. 2011 Sep;128(3):e537-44. doi: 10.1542/peds.2010-3486. Epub 2011 Aug 22.

Abstract

Objective: To evaluate the impact of a "walking school bus" program on children's rates of active commuting to school and physical activity.

Methods: We conducted a pilot cluster randomized controlled trial among 4th-graders from 8 schools in Houston, Texas (N = 149). Random allocation to treatment or control conditions was at the school level. Study staff walked with children to and from school up to 5 days/week. Outcomes were measured the week before (time 1) and during weeks 4 and 5 of the intervention (time 2). The main outcome was the weekly rate of active commuting, and a secondary outcome was moderate-to-vigorous physical activity. Covariates included sociodemographics, distance from home to school, neighborhood safety, child BMI z score, parent self-efficacy/outcome expectations, and child self-efficacy for active commuting. A mixed-model repeated measures regression accounted for clustering by school, and stepwise procedures with backward elimination of nonsignificant covariates were used to identify significant predictors.

Results: Intervention children increased active commuting (mean ± SD) from 23.8% ± 9.2% (time 1) to 54% ± 9.2% (time 2), whereas control subjects decreased from 40.2% ± 8.9% (time 1) to 32.6% ± 8.9% (time 2) (P < .0001). Intervention children increased their minutes of daily moderate-to-vigorous physical activity from 46.6 ± 4.5 (time 1) to 48.8 ± 4.5 (time 2), whereas control children decreased from 46.1 ± 4.3 (time 1) to 41.3 ± 4.3 (time 2) (P = .029).

Conclusions: The program improved children's active commuting to school and daily moderate-to-vigorous physical activity.

Trial registration: ClinicalTrials.gov NCT00758615.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Child
  • Female
  • Health Promotion / trends*
  • Humans
  • Intention to Treat Analysis
  • Male
  • Obesity / prevention & control
  • Safety
  • Schools
  • Students* / statistics & numerical data
  • Texas
  • Transportation / statistics & numerical data*
  • Walking*

Associated data

  • ClinicalTrials.gov/NCT00758615