PMID- 31988481
OWN - NLM
STAT- MEDLINE
DCOM- 20210802
LR  - 20240328
IS  - 1476-5497 (Electronic)
IS  - 0307-0565 (Print)
IS  - 0307-0565 (Linking)
VI  - 44
IP  - 4
DP  - 2020 Apr
TI  - Effectiveness and cost-effectiveness of The Daily Mile on childhood weight 
      outcomes and wellbeing: a cluster randomised controlled trial.
PG  - 812-822
LID - 10.1038/s41366-019-0511-0 [doi]
AB  - BACKGROUND: The Daily Mile is designed to increase physical activity levels with 
      children running or walking around school grounds for 15-min daily. It has been 
      adopted by schools worldwide and endorsed as a solution to tackle obesity, 
      despite no robust evidence of its benefits. We conducted a cluster randomised 
      controlled trial to determine its clinical and cost-effectiveness. METHODS: Forty 
      schools were randomly assigned (1:1) to either the Daily Mile intervention or 
      control group in which only the usual school health and wellbeing activities were 
      implemented. The primary outcome was BMI z-score (BMIz) at 12 months follow-up 
      from baseline, with planned subgroup analysis to examine differential effects. 
      Primary economic analysis outcome was incremental cost per 
      Quality-Adjusted-Life-Year (QALY) gained. RESULTS: Using a constrained 
      randomisation approach, balanced on school size, baseline BMIz and proportion of 
      pupils eligible for free school meals, 20 schools were allocated to intervention 
      (n = 1,153 participants) and 20 to control (n = 1,127); 3 schools withdrew (2 
      intervention, 1 control). At 12 months, BMIz data were available for 18 
      intervention schools (n = 850) and 19 control schools (n = 820 participants). 
      Using intention-to-treat analysis the adjusted mean difference (MD) in BMIz 
      (intervention - control) was -0.036 (95% CI: -0.085 to 0.013, p = 0.146). 
      Pre-specified subgroup analysis showed a significant interaction with sex 
      (p = 0.001) suggesting a moderate size benefit of The Daily Mile in girls (MD 
      -0.097, 95% CI -0.156 to -0.037). This was consistent with the exploratory 
      economic results that showed The Daily Mile to be highly cost-effective in girls 
      ( pound2,492 per QALY), but not in boys, and overall to have a 76% chance of 
      cost-effectiveness for the whole sample, at the commonly applied UK threshold of 
       pound20,000 per QALY. CONCLUSIONS: Overall the Daily Mile had a small but 
      non-significant effect on BMIz, however, it had a greater effect in girls 
      suggesting that it might be considered as a cost-effective component of a 
      system-wide approach to childhood obesity prevention.
FAU - Breheny, Katie
AU  - Breheny K
AD  - Institute of Applied Health Research, University of Birmingham, Birmingham, B15 
      2TT, UK.
AD  - Bristol Medical School, University of Bristol, Bristol, BS8 1NU, UK.
FAU - Passmore, Sandra
AU  - Passmore S
AD  - Services for Education, Birmingham, B7 4AX, UK.
FAU - Adab, Peymane
AU  - Adab P
AD  - Institute of Applied Health Research, University of Birmingham, Birmingham, B15 
      2TT, UK. p.adab@bham.ac.uk.
FAU - Martin, James
AU  - Martin J
AD  - Institute of Applied Health Research, University of Birmingham, Birmingham, B15 
      2TT, UK.
FAU - Hemming, Karla
AU  - Hemming K
AD  - Institute of Applied Health Research, University of Birmingham, Birmingham, B15 
      2TT, UK.
FAU - Lancashire, Emma R
AU  - Lancashire ER
AD  - Institute of Applied Health Research, University of Birmingham, Birmingham, B15 
      2TT, UK.
FAU - Frew, Emma
AU  - Frew E
AUID- ORCID: 0000-0002-5462-1158
AD  - Institute of Applied Health Research, University of Birmingham, Birmingham, B15 
      2TT, UK. e.frew@bham.ac.uk.
LA  - eng
GR  - CDF-2015-08-013/DH_/Department of Health/United Kingdom
GR  - SRF-2017-10-002/DH_/Department of Health/United Kingdom
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20200128
PL  - England
TA  - Int J Obes (Lond)
JT  - International journal of obesity (2005)
JID - 101256108
SB  - IM
MH  - Body Weight/*physiology
MH  - Child
MH  - Child, Preschool
MH  - Cost-Benefit Analysis
MH  - Female
MH  - *Health Promotion/economics/methods/statistics & numerical data
MH  - Humans
MH  - Life Style
MH  - Male
MH  - Quality-Adjusted Life Years
MH  - Walking/*physiology
PMC - PMC7101281
COIS- This study was funded by Birmingham City Council and was facilitated by a 
      collaboration between Birmingham City Council, SportBirmingham, Services for 
      Education and the University of Birmingham. The National Institute for Health 
      Research in England under its Career Development Fellowship fund 
      (CDF-2015-08-013) supported KB and EF. The views expressed in this publication 
      are those of the authors and do not necessarily reflect those of the UK NHS, the 
      National Institute for Health Research, or the Department of Health for England. 
      EF, PA, KH, SP and EL have previously received research grants from the National 
      Institute of Health Research; there are no other relationships or activities that 
      could appear to have influenced the submitted work.
EDAT- 2020/01/29 06:00
MHDA- 2021/08/03 06:00
PMCR- 2020/01/28
CRDT- 2020/01/29 06:00
PHST- 2019/02/04 00:00 [received]
PHST- 2019/12/11 00:00 [accepted]
PHST- 2019/11/22 00:00 [revised]
PHST- 2020/01/29 06:00 [pubmed]
PHST- 2021/08/03 06:00 [medline]
PHST- 2020/01/29 06:00 [entrez]
PHST- 2020/01/28 00:00 [pmc-release]
AID - 10.1038/s41366-019-0511-0 [pii]
AID - 511 [pii]
AID - 10.1038/s41366-019-0511-0 [doi]
PST - ppublish
SO  - Int J Obes (Lond). 2020 Apr;44(4):812-822. doi: 10.1038/s41366-019-0511-0. Epub 
      2020 Jan 28.