Exercise as it relates to Disease/The effect of JUMP-in, in promoting physical activity in primary school students

This factsheet is a critic of the effectiveness of an intervention in promoting physical activity in primary school students. The paper under review is 'Effectiveness of JUMP-in, a Dutch primary school- based community intervention aimed at the promotion of physical activity'written by Judith S B de Meij et al.

What is the background of this research?

The Dutch physical activity guidelines 2017 state that children aged between 4-18 years should participate in a minimum of 1 hour a day of moderate to vigorous activity everyday, muscle and bone strengthening activity at least 3 times a week and avoid sitting down for long periods of time. Dutch primary school children only spend 6% of their day in PE classes or participating in aerobic activities. JUMP-in is a school-based intervention aimed at increasing physical activity and sports participation among primary school children of all social classes. The program involves monitored organised sports participation and education at home for both the children and parents.

Benefits of physical activity for children
Improves cardiorespiratory fitness.
Strengthen's muscles and bones.
Helps attain/maintain healthy weight.
Reduces likelihood of developing risk factors for later diseases including high blood cholesterol, high blood pressure and type 2 diabetes
Reduces symptoms of anxiety and depression
Improves motor skills and co-ordination

Where is the research from?

This paper was completed through the Department of Epidemiology, Documentation and Health Promotion, Municipal Health Service of Amsterdam, Amsterdam, The Netherlands and EMGO Insitite for Health and Care Research and Department of Public & Occupational Health, VU University Medical center, Amsterdam, The Netherlands.

The main author Judith SB de Meij has a Doctorate in Public Health from Vanderbilt University, Amsterdam. De Meij, currently has published 14 research papers all in the area of physical activity promotion. Co-author Mai J M Chinapaw is the University Research Chair professor at Vanderbilt University Medical Center in Amsterdam and has a PhD in Allied Science from Vanderbilt University, Amsterdam. Mai J M Chinapaw has 143 published research papers all with a focus on determinants and health consequences of physical activity and sedentary behaviour in youth.

What kind of research was this?

This study is a controlled trial. This trial was not conducted randomly as several months were needed to liaise with the school, teachers, and community prior to the intervention starting to ensure full commitment to the program and allow the most accurate results to be collected. To ensure bias was not an issue the control schools children and parents were not made aware of the control group. The control group were also selected from geo-graphically separated city districts from the 9 intervention schools. The separate district limited the possible crossover between the intervention and control schools.

What did the research involve?

A total of 2848 children aged between 6 and 12 years participated (50.4% boys) across 19 primary schools. The aim of the study was to investigate the effectiveness of the JUMP-in programme on sports participation, overall physical activity, shuttle run score and body composition. The JUMP-in intervention has 6 main components and responsible implementers as seen in the table below. .

Components	Description
Pupil follow-up system	Monitoring system to assess yearly the participants level of physical activity, BMI and motor skills.
School sports activities	Easily accessible sport activities on a daily basis outside of school hours. Exisiting local sports clubs are involved.
‘The Class Moves!’	Recurrent breaks during classes at school involving physical activity, relaxation and posture exercises all adapted to the level of motor skills the children have. This aims to create physical activity a daily habit whilst still enjoyable and contributing to a healthier individual.
‘This is your way to Move!’	Workbooks for each child and their parents include assignments to be completed at both home and school. This is aimed at raising awareness of the importance of physical activity, improving self-efficacy, social support, self-regulation and planning skills all of both the children and parents.
Parental information services	Including information meetings for both parents and teachers, courses and sports activities for parents. Personal approaches to children indicated as high risk through the pupil follow up system, both formal and informal to maximise attendance.
Extra care for children at risk	High risk children with motor and development disabilities or hampering factors in their physical activity behaviour (overweight), receive additional adapted physical education lessons. If necessary, parents of overweight or obese children receive an invitation for consultation from the youth healthcare or hospital.

What were the basic results?

Baseline characteristics in the intervention and control schools.

The study emphasised that a significant difference was seen in organised sport participation however no difference in shuttle run scores and anthropometry.Organised sports participation improved from 27.4% at baseline in the intervention group to 65.2% at a 20 month follow up.

Significant differences and consistency’s were shown between the 2 groups in the Baseline characteristics in the intervention and control schools table. Organised sport participation and physical activity was significantly higher for the Intervention group, whereas across both groups BMI and waist circumference was consistent.

How did the researchers interpret the results?

The researchers of this study have interpreted that the JUMP-in program is effective in promoting sports participation in young people. Furthermore whilst there were not significant improvements in shuttle run scores and waist circumference scores, observations were made that children who began and/or maintained organised sport had better outcomes than those who did not. Schools were identified as a key setting for health promotion and recognised as a successful basis for introducing said organised/maintained sport.     

What conclusions can we take from this research

The authors of this study concluded that a holistic program focusing on improving dietary habits, physical activity participation and education regarding healthy habits is crucial in reducing the high prevalence of childhood obesity. As well as focusing physical activity in every day life not just organised sport, such as promoting active transport to school, encouraging active play during classroom breaks.

The JUMP-in program is a useful tool for improving fitness and sport participation among children. Regardless of results an increase in physical activity in children is better than a decrease.

Practical advice?

For a clinician working in the school environment. An organised sports program is a useful tool at improving participation rates amongst children which in turn has positive lasting health benefits.

Further information and reading?

• http://www.who.int/en/
• https://www.healthykids.nsw.gov.au/teachers-childcare/physical-activity-primary-school.aspx
• https://www.government.nl/topics/health-insurance