Feasibility and Physical Health Outcomes of a 1-Year Sport-Based Physical Activity Intervention in Rural Middle School Children

Background/Objective : Rural children face challenges to participating in physical activity (PA). These barriers include lack of facilities, adequate equipment, trained personnel, and transportation limitations. This study’s primary objective assessed the feasibility of a 1-year sport-based PA intervention delivered by trained college students in a rural middle school. The secondary objective examined differences between test and control groups for self-reported and accelerometer-assessed PA. Methods: We conducted a 1-year controlled cohort study of 83 6th-8th grade children attending an under-resourced rural middle school in the Midwestern United States. The intervention, Hoosier Sport, was implemented by trained college students in an undergraduate service-learning course. The test group participated in enhanced PE classes including various sports and positive youth development lessons. The control group participated in standardhealth class curriculum. The primary outcomes were trial- and intervention-related feasibility indicators for children and college student implementers. Secondary outcomes included light, moderate, vigorous, and total PA, self-reported weekly PA, a maximum plank test, and 6-minute walk test. Given the crossover design with repeated measures at three time points (pre-, mid-, and post-intervention) and our primary interest in detecting within-subject changes and between-group differences, analysis focused on linear mixed models with within–between interaction effects. Results: FIM (median=17), AIM (median=18), and IAM (median=17) scores exceeded the success threshold (median >16) when assessed at post-intervention. Total minutes of PA decreased from baseline to mid (β = -42.762, 95% CI(-101.220, 15.696)) and baseline to post (β = -35.952, 95% CI(-89.617, 17.713)), but neither difference was significant ( p = 0.149 & 0.185, respectively). At baseline, the test group estimated 64.91 more total minutes of PA than the control group (t(101.13) = 1.82, p = 0.072, dz = 0.771), with a marginally significant difference. There were no significant differences in change over time of total or self-reported PA between the groups ( p > 0.05). Conclusions : The 1-year intervention was feasible to implement, with high appropriateness and acceptability among rural middle school children. Refinements are needed to continue targeting improvements in children’s PA. Trial Registration : ClinicalTrials.gov ID: NCT06602596 Registration Date: 09.17.2024