Utilizing a web-based intervention to improve cardiorespiratory fitness

The cost of an intervention can sometimes be too high for a practice, hospital or school to consider, but can become affordable if spread across a number of settings. A report in JAMA Pediatrics examined whether the use of a web-based teacher intervention led to improvements in cardiorespiratory fitness in children when offered in a variety of schools.1

The researchers included 22 government primary schools and 1,188 students in grades 3 and 4 in the state of New South Wales, Australia. Eleven of the schools received a control intervention and 11 of the schools received the intervention, including standardized online learning for the teachers and minimal personal support from a mentor. Study assistants blinded to treatment allocation conducted follow-up assessments at both 12 and 24 months. A 20-meter multistage shuttle run was used to assess cardiorespiratory fitness.

There were slightly more boys in the cohort and the mean age of the participants was 8.85 years. At the 12-month follow-up assessment, the intervention schools saw the number of 20-meter shuttle runs increase by 3.32 laps (95% CI, 2.44-4.20 laps), while the laps increased by 2.11 laps (95 % CI, 1.38-2.85 rounds) in the control schools (adjusted difference = 1.20 rounds; 95% CI, 0.17-2.24 rounds). After 24 months of follow-up, the adjusted difference had increased to 2.22 rounds (95% CI, 0.89-3.55 rounds). The cost of the intervention was AU $ 33, which is about $ 26 per student in the United States.

The researchers concluded that the school-based intervention has led to improvements in children’s respiratory schools, even when delivered to a large number of schools. The sustained effect over 24 months and the low total cost indicated that it could be scalable to the population level.


1. Lonsdale C, Sanders T, Parker P, et al .; Effect of a scalable school-based intervention on cardiorespiratory fitness in children. JAMA Pediatr. May 3, 2021. Epub awaiting print. doi: 10.1001 / jamapediatrics.2021.0417

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