A multilevel school-based intervention on sedentary time in children: effectiveness and socioeconomic moderation results from the CIPRES cluster-RCT
Abstract
Background: Children’s sedentary behavior is a major public health priority. While school-based programs are common, research must explore more effective approaches using robust theoretical frameworks. The CIPRES cluster-randomized controlled trial evaluated a 6-week multi-component school-based intervention combining the Socio-Ecological perspective and Trans-Contextual Model to reduce children’s sedentary time (ST) and increase moderate-to-vigorous physical activity (MVPA). Methods: Four French municipalities were cluster-randomized to either the CIPRES or Control group. Participants were children in 3rd and 4th grades. The intervention was multilevel, using co-constructed activity booklets to target school, after-school, and home settings to reduce ST. Activities were driven by TCM principles. Device-based ST and MVPA were assessed via 7-day accelerometry (accelerometers GT3X+) at baseline and post-intervention. Intervention effects and the moderating role of the Ecological Deprivation Index were analyzed using multiple constrained linear mixed models on three distinct periods (entire week, after-school and non-school days). Results: A total of 543 children (49.2% girls; mean age 9.2 years; 76.2% highly deprived) participated. The intervention yielded significant group*time interaction effects over the whole week, preventing the increase in relative ST ( β = −1.2 percentage points [pp], p = 0.033) and improving relative MVPA ( β = +0.7 pp., p = 0.034) in the CIPRES group. These effects were primarily driven by the after-school period (relative ST: β = −2.5 pp., p = 0.002; relative MVPA: β = +1.4 pp., p = 0.003). No significant intervention effects were observed during non-school days. Crucially, deprivation level significantly moderated efficacy during the after-school period: the intervention significantly decreased ST and increased MVPA primarily among highly deprived participants, while slightly deprived participants exhibited behavioral deterioration. Conclusion: The theory-based CIPRES intervention effectively curbed the weekly accumulation of ST, driven by improvements during the after-school period. By predominantly benefiting highly deprived youth, it offers a promising strategy to reduce social health inequalities, though further strategies are required to effectively alter routines during non-school days.
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BibTeX
@article{laujac2026multilevel,
title = {{A multilevel school-based intervention on sedentary time in children: effectiveness and socioeconomic moderation results from the CIPRES cluster-RCT}},
author = {Steven Laujac and Olivier Gavarry and Sophie Lafond and Josselin Franceschi and Axel Rozand and Laurence Pallier and Cyrille Delpierre and Marion Carayol},
journal = {Frontiers in Public Health},
year = {2026},
month = jun,
doi = {10.3389/fpubh.2026.1839833},
url = {https://hal.science/hal-05742774v1},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - A multilevel school-based intervention on sedentary time in children: effectiveness and socioeconomic moderation results from the CIPRES cluster-RCT
AU - Steven Laujac
AU - Olivier Gavarry
AU - Sophie Lafond
AU - Josselin Franceschi
AU - Axel Rozand
AU - Laurence Pallier
AU - Cyrille Delpierre
AU - Marion Carayol
PY - 2026
DA - 2026/06/15
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.1839833
UR - https://hal.science/hal-05742774v1
AB - Background: Children’s sedentary behavior is a major public health priority. While school-based programs are common, research must explore more effective approaches using robust theoretical frameworks. The CIPRES cluster-randomized controlled trial evaluated a 6-week multi-component school-based intervention combining the Socio-Ecological perspective and Trans-Contextual Model to reduce children’s sedentary time (ST) and increase moderate-to-vigorous physical activity (MVPA). Methods: Four French municipalities were cluster-randomized to either the CIPRES or Control group. Participants were children in 3rd and 4th grades. The intervention was multilevel, using co-constructed activity booklets to target school, after-school, and home settings to reduce ST. Activities were driven by TCM principles. Device-based ST and MVPA were assessed via 7-day accelerometry (accelerometers GT3X+) at baseline and post-intervention. Intervention effects and the moderating role of the Ecological Deprivation Index were analyzed using multiple constrained linear mixed models on three distinct periods (entire week, after-school and non-school days). Results: A total of 543 children (49.2% girls; mean age 9.2 years; 76.2% highly deprived) participated. The intervention yielded significant group*time interaction effects over the whole week, preventing the increase in relative ST ( β = −1.2 percentage points [pp], p = 0.033) and improving relative MVPA ( β = +0.7 pp., p = 0.034) in the CIPRES group. These effects were primarily driven by the after-school period (relative ST: β = −2.5 pp., p = 0.002; relative MVPA: β = +1.4 pp., p = 0.003). No significant intervention effects were observed during non-school days. Crucially, deprivation level significantly moderated efficacy during the after-school period: the intervention significantly decreased ST and increased MVPA primarily among highly deprived participants, while slightly deprived participants exhibited behavioral deterioration. Conclusion: The theory-based CIPRES intervention effectively curbed the weekly accumulation of ST, driven by improvements during the after-school period. By predominantly benefiting highly deprived youth, it offers a promising strategy to reduce social health inequalities, though further strategies are required to effectively alter routines during non-school days.
SN - 2296-2565
SN - 2296-2565
ER -