[{"key":"dc.contributor","value":"Vancouver Coastal Health Authority. Research Institute","language":"en"},{"key":"dc.contributor.author","value":"Nettlefold, Lindsay","language":""},{"key":"dc.contributor.author","value":"Naylor, Patti-Jean","language":""},{"key":"dc.contributor.author","value":"Macdonald, Heather M.","language":""},{"key":"dc.contributor.author","value":"McKay, Heather Anne, 1954-","language":""},{"key":"dc.date.accessioned","value":"2021-05-26T23:27:31Z","language":""},{"key":"dc.date.available","value":"2021-05-26T23:27:32Z","language":""},{"key":"dc.date.issued","value":"2021-05-13","language":""},{"key":"dc.identifier","value":"10.3390\/ijerph18105182","language":"en"},{"key":"dc.identifier.citation","value":"International Journal of Environmental Research and Public Health 18 (10): 5182 (2021)","language":"en"},{"key":"dc.identifier.uri","value":"http:\/\/hdl.handle.net\/2429\/78464","language":""},{"key":"dc.description.abstract","value":"Action Schools! BC (AS! BC) was scaled-up from an efficacy trial to province-wide delivery across 11 years (2004\u20132015). In this study we: (1) describe strategies that supported implementation and scale-up; (2) evaluate implementation (teachers\u2019 physical activity (PA) delivery) and student\u2019s PA and cardiorespiratory fitness (CRF) within a cluster randomized controlled trial during years 2 and 3 of scale-up; and (3) assess relationships between teacher-level implementation and student-level outcomes. We classified implementation strategies as process, capacity-building or scale-up strategies. Elementary schools (n = 30) were randomized to intervention (INT; 16 schools; 747 students) or usual practice (UP; 14 schools; 782 students). We measured teachers\u2019 PA delivery (n = 179) using weekly logs; students\u2019 PA by questionnaire (n = 30 schools) and accelerometry (n = 9 schools); and students\u2019 CRF by 20-m shuttle run (n = 25 schools). INT teachers delivered more PA than UP teachers in year 1 (+33.8 min\/week, 95% CI 12.7, 54.9) but not year 2 (+18.8 min\/week, 95% CI \u22120.8, 38.3). Unadjusted change in CRF was 36% and 27% higher in INT girls and boys, respectively, compared with their UP peers (year 1; effect size 0.28\u20130.48). Total PA delivered was associated with change in children\u2019s self-reported MVPA (year 1; r = 0.17, p = 0.02). Despite the \u2018voltage drop\u2019, scaling-up school-based PA models is feasible and may enhance children\u2019s health. Stakeholders must conceive of new ways to effectively sustain scaled-up health promoting interventions if we are to improve the health of students at a population level. Clinical Trials registration: NCT01412203.","language":"en"},{"key":"dc.language.iso","value":"eng","language":"en"},{"key":"dc.publisher","value":"Multidisciplinary Digital Publishing Institute","language":"en"},{"key":"dc.rights","value":"CC BY 4.0","language":""},{"key":"dc.rights.uri","value":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/","language":""},{"key":"dc.subject","value":"scale-up","language":"en"},{"key":"dc.subject","value":"implementation strategies","language":"en"},{"key":"dc.subject","value":"effectiveness","language":"en"},{"key":"dc.subject","value":"children","language":"en"},{"key":"dc.subject","value":"school","language":"en"},{"key":"dc.subject","value":"intervention","language":"en"},{"key":"dc.subject","value":"physical activity","language":"en"},{"key":"dc.subject","value":"fitness","language":"en"},{"key":"dc.title","value":"Scaling up Action Schools! BC: How Does Voltage Drop at Scale Affect Student Level Outcomes? A Cluster Randomized Controlled Trial","language":"en"},{"key":"dc.type","value":"Text","language":"en"},{"key":"dc.type.text","value":"Article","language":"en"},{"key":"dc.description.affiliation","value":"Medicine, Faculty of","language":"en"},{"key":"dc.description.affiliation","value":"Other UBC","language":"en"},{"key":"dc.description.affiliation","value":"Non UBC","language":"en"},{"key":"dc.description.affiliation","value":"Family Practice, Department of","language":"en"},{"key":"dc.description.affiliation","value":"Orthopaedic Surgery, Department of","language":"en"},{"key":"dc.description.reviewstatus","value":"Reviewed","language":"en"},{"key":"dc.description.scholarlevel","value":"Faculty","language":"en"},{"key":"dc.date.updated","value":"2021-05-24T15:05:55Z","language":""}]