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The process of urbanization and the rapid development of information technology have greatly reduced the space and time available for children's outdoor activities. In this study, we expect to study the effects of the addition of physical education classes after school on the academic performance, mental health, physical fitness, and myopia among primary school children.
Urbanization has led to a shrinking of the space suitable for residential activities and a dramatic change in the behavioural patterns, which is particularly evident in children. The spread and development of information technology has reduced children's time for physical activity. Previous studies have found that physical activity is essential for the growth and development of adolescents, preventing and reducing obesity, slowing the development of myopia, and is closely linked to mental health. However, parents in China are concerned that increased outdoor activity will reduce the amount of time spent studying and affect academic performance. Currently, there is a lack of strong evidence on the impact of physical activity on academic performance. In this study, we propose to provide after-school physical education classes for students in primary schools in a rapidly urbanizing area, and assess the effects of the intervention on children's academic performance, physical fitness, myopia, and mental health to provide evidence for the development of educational programs and arrangements for after-school activities.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Extra sports group | Experimental | The group follows the schedule of school teaching programme. Extra-curricular sports classes will be organized and provided in this group of schools in the afternoon after school until 6 p.m. (Monday to Friday). |
|
| Conventional group | No Intervention | The group follows the schedule of school teaching programme. Students arrange their own after-school time after school. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Extra-curricular sports | Behavioral | The group follows the schedule of school teaching programme. Extra-curricular sports classes will be organized and provided in this group of schools in the afternoon after school until 6 p.m. (Monday to Friday). |
| Measure | Description | Time Frame |
|---|---|---|
| Mathematics test scores at the end of the first academic year | The test paper will follow the design principles of International Mathematics and science learning, and referring to the local unified examination papers of grade three and grade four, the unified examination questions are formulated to evaluate the students' learning in school | 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| Combined physical fitness test score at the end of the first academic year | Total scores of physical fitness tests according to 2018 National Physical Fitness Survey Monitoring Programme | 1 year |
| Incidence of myopia in the first school year |
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Inclusion Criteria:
Exclusion Criteria:
Exclusion criteria for school
Exclusion criteria for students 4. Two or more days Monday to Friday not available to participate in studies under the project programme; 5. Unsuitability for health or physical reasons to participate in sports activities; 6. Refusal to sign informed consent.
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| Name | Affiliation | Role |
|---|---|---|
| Yangfa Zeng, Master | Zhongshan Ophthalmic Center, Sun Yat-sen University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Yudu | Ganzhou | Jiangxi | 342300 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28332101 | Background | Nunes HEG, Silva DAS, Goncalves ECA. Prevalence and factors associated with stages of behavior change for physical activity in adolescents: a systematic review. World J Pediatr. 2017 Jun;13(3):202-209. doi: 10.1007/s12519-017-0027-4. Epub 2017 Mar 22. | |
| 30356639 | Background | Cai Y, Zhu X, Wu X. Overweight, obesity, and screen-time viewing among Chinese school-aged children: National prevalence estimates from the 2016 Physical Activity and Fitness in China-The Youth Study. J Sport Health Sci. 2017 Dec;6(4):404-409. doi: 10.1016/j.jshs.2017.09.002. Epub 2017 Sep 6. |
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| ID | Term |
|---|---|
| D009043 | Motor Activity |
| ID | Term |
|---|---|
| D001519 | Behavior |
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open,non-inferiority cluster randomized controlled trial
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Spherical equivalent after mydriasis ≤ -0.5 D in either eye
| 1 year |
| Happiness Assessment at the end of the first academic year | Happiness score is rated by Chinese version of the WHO-5 including 5 items with ratings: 0, at no time-5, all of the time. The total raw score, ranging from 0 to 25, is multiplied by 4 to give the final score, with 0 representing the worst imaginable well-being and 100 representing the best imaginable well-being | 1 year |
| Mathematics test scores at the end of the second school year | The test paper will follow the design principles of International Mathematics and science learning, and referring to the local unified examination papers of grade three and grade four, the unified examination questions are formulated to evaluate the students' learning in school | up to 2 years |
| Combined physical fitness test scores at the end of the second academic year | Total scores of physical fitness tests according to 2018 National Physical Fitness Survey Monitoring Programme | up to 2 years |
| Cumulative incidence of myopia over two school years | Spherical equivalent after mydriasis ≤ -0.5 D in either eye | up to 2 years |
| Happiness assessment at the second school year | Happiness score is rated by Chinese (September, 2007) version of the WHO-5 including 5 items with ratings: 0, at no time-5, all of the time. The total raw score, ranging from 0 to 25, is multiplied by 4 to give the final score, with 0 representing the worst imaginable well-being and 100 representing the best imaginable well-being | up to 2 years |
| Satisfaction assessment | Satisfaction of pupils in the intervention group with the addition of PE after school will be measured by a questionnaire which is designed by reaserchers. | 1 year |
| 14985292 | Background | He M, Zeng J, Liu Y, Xu J, Pokharel GP, Ellwein LB. Refractive error and visual impairment in urban children in southern china. Invest Ophthalmol Vis Sci. 2004 Mar;45(3):793-9. doi: 10.1167/iovs.03-1051. |
| 26062039 | Background | Gray C, Gibbons R, Larouche R, Sandseter EB, Bienenstock A, Brussoni M, Chabot G, Herrington S, Janssen I, Pickett W, Power M, Stanger N, Sampson M, Tremblay MS. What Is the Relationship between Outdoor Time and Physical Activity, Sedentary Behaviour, and Physical Fitness in Children? A Systematic Review. Int J Environ Res Public Health. 2015 Jun 8;12(6):6455-74. doi: 10.3390/ijerph120606455. |
| 30001713 | Background | Grgic J, Dumuid D, Bengoechea EG, Shrestha N, Bauman A, Olds T, Pedisic Z. Health outcomes associated with reallocations of time between sleep, sedentary behaviour, and physical activity: a systematic scoping review of isotemporal substitution studies. Int J Behav Nutr Phys Act. 2018 Jul 13;15(1):69. doi: 10.1186/s12966-018-0691-3. |
| 23672971 | Background | French AN, Morgan IG, Mitchell P, Rose KA. Risk factors for incident myopia in Australian schoolchildren: the Sydney adolescent vascular and eye study. Ophthalmology. 2013 Oct;120(10):2100-8. doi: 10.1016/j.ophtha.2013.02.035. Epub 2013 May 11. |
| 26372583 | Background | He M, Xiang F, Zeng Y, Mai J, Chen Q, Zhang J, Smith W, Rose K, Morgan IG. Effect of Time Spent Outdoors at School on the Development of Myopia Among Children in China: A Randomized Clinical Trial. JAMA. 2015 Sep 15;314(11):1142-8. doi: 10.1001/jama.2015.10803. |
| 21807669 | Background | Biddle SJ, Asare M. Physical activity and mental health in children and adolescents: a review of reviews. Br J Sports Med. 2011 Sep;45(11):886-95. doi: 10.1136/bjsports-2011-090185. Epub 2011 Aug 1. |
| 29175972 | Background | Alvarez-Bueno C, Pesce C, Cavero-Redondo I, Sanchez-Lopez M, Garrido-Miguel M, Martinez-Vizcaino V. Academic Achievement and Physical Activity: A Meta-analysis. Pediatrics. 2017 Dec;140(6):e20171498. doi: 10.1542/peds.2017-1498. |
| 37721735 | Derived | Wang D, Xiong R, Zhang J, Han X, Jin L, Liu W, Qu Y, Chen Q, Chen S, Chen X, Li Y, He M, Zeng Y, Liu Y. Effect of Extracurricular After-School Physical Activities on Academic Performance of Schoolchildren: A Cluster Randomized Clinical Trial. JAMA Pediatr. 2023 Nov 1;177(11):1141-1148. doi: 10.1001/jamapediatrics.2023.3615. |