Changes in school-day step counts during a physical activity for Lent intervention: a cluster randomized crossover trial of the Savior’s Sandals

BACKGROUND: Participation in regular physical activity (PA) has many health benefits for school-aged children. However, only about 20% of children worldwide meet recommendations for being sufficiently active. Children spend many hours per day at school and schools have a mandate for promoting PA. Private religious schools could serve as a novel source for religious-themed PA interventions. METHODS: We randomly allocated 2 clusters of 2 Catholic middle (grades 6–8) schools/cluster to a 2-week no treatment/4-week intervention crossover trial to determine the effects of a 20-day Lenten-themed PA intervention on 187 students’ pedometer steps taken at school. Specifically, students independently progressed through a workbook (Savior’s Sandals) that depicted and informed about 11 locations in the Holy Land where Jesus lived, visited, and/or ministered, and included Scripturally-based questions about each place for students to answer. In all, students would accumulate 110,000 steps if they completed the workbook virtual journey. General linear mixed models with restricted maximum likelihood estimation to compensate for missing data were used to compute the intervention effects on mean daily steps. RESULTS: There were significant main effects for the intervention overall and by school and grade level. Follow-up tests isolated that a single school (Mean(diff) = + 2156 steps/day) and grade 6 students (Mean(diff) = + 1678 steps/day) across all four schools experienced the greatest treatment effects. CONCLUSIONS: Religious-themed PA interventions can be effective; however, specific adjustments may be needed to optimize the intervention’s effectiveness for a broader population of students. TRIAL REGISTRATION: Current Controlled Trials ISRCTN10273669. Retrospectively registered 23 Oct 2018.