The Walking School Bus and Children's Physical Activity: A Pilot Cluster Randomized Controlled Trial
Open accessAbstract
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.
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The intervention duration of these studies was variable, with 4 studies lasting 4-10 weeks, others implemented over a longer duration (e.g., 10 months, 1 year, or 2 years).
“Whilst the intervention duration of these studies was variable, with 4 studies lasting 4–10 weeks,55, 58, 66 others were implemented over a longer duration, for example, 10 months,73 1 year,81 or 2 years.70”
From A mixed-studies systematic review and meta-analysis of school-based interventions to promote physical activity and/or reduce sedentary time in children (2020) · cites this paper as [66]
5 RCTs and 2 NR studies reported that the significant effect of the intervention was aligned with preventing, or at least reducing, the decline in physical activity observed in control conditions over time, rather than significantly increasing physical activity in intervention conditions per se.
“In fact, 5 RCTs and 2 NR studies reported that the significant effect of the intervention was aligned with preventing, or at least reducing, the decline in PA observed in control conditions over time, rather than significantly increasing PA in intervention conditions per se.55, 58, 66, 70, 73, 81, 82”
From A mixed-studies systematic review and meta-analysis of school-based interventions to promote physical activity and/or reduce sedentary time in children (2020) · cites this paper as [66]
Some included interventions specifically sought to prevent or reduce the decline in PA observed in control conditions over time, as opposed to significantly increasing PA in intervention conditions.
“some interventions specifically sought to prevent or reduce the decline in PA observed in control conditions over time, as opposed to significantly increasing PA in intervention conditions”
From A mixed-studies systematic review and meta-analysis of school-based interventions to promote physical activity and/or reduce sedentary time in children (2020) · cites this paper as [66]
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“From a methodological perspective, it is important that future intervention studies incorporate a control group to account for age- or time-related changes, not least because some interventions specifically sought to prevent or reduce the decline in PA observed in control conditions over time, as opposed to significan…”
Background
- Authors
- Mendoza, J. A., Watson, K., Baranowski, T., Nicklas, T. A., Uscanga, D. K., & Hanfling, M. J.
- Affiliations
- Agricultural Research Service (US)
- Centers for Disease Control and Prevention (US)
- Baylor College of Medicine (US)
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2011-09-01
- Volume
- 128
- Issue
- 3
- Pages
- e537-e544
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- PMC
- PMC3164094
- OpenAlex
- W2097136927
- Cited by
- 133
- References
- 49
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 11 · 2023: 6 · 2022: 9 · 2021: 10 · 2020: 9 · 2019: 2 · 2018: 17 · 2017: 10 · 2016: 9 · 2015: 10 · 2014: 10 · 2013: 8 · 2012: 10
- FWCI
- 25.89
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- PEDIATRICS (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Agriculture
- Robert Wood Johnson Foundation
- National Institutes of Health (1r21ca133418-01)
- Agricultural Research Service (58-6250-6-001)
- National Cancer Institute (R21 CA133418, K07CA131178, 1R21CA133418)
- Topics
- Social Sciences › Transportation › Urban Transport and Accessibility
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- walking school bus, active commuting, children's physical activity, moderate-to-vigorous physical activity, school-based intervention, fourth grade, neighborhood safety, child self-efficacy, parental self-efficacy, childhood obesity
- MeSH terms
- Child, Female, Health Promotion, Humans, Male, Obesity, Safety, Schools, Students, Texas, Transportation, Walking, Intention to Treat Analysis
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