Effectiveness of a school-based physical activity injury prevention program: a cluster randomized controlled trial

Arch Pediatr Adolesc Med. 2010 Feb;164(2):145-50. doi: 10.1001/archpediatrics.2009.256.


Objective: To study the effects of a school-based injury prevention program on physical activity injury incidence and severity.

Design: Cluster randomized controlled trial performed from January 1, 2006, through July 31, 2007.

Setting: Forty Dutch primary schools.

Participants: A total of 2210 children (aged 10-12 years).

Intervention: Schools were randomized to receive either the regular curriculum or an intervention program that targeted physical activity injuries.

Outcome measures: Incidence and severity of physical activity injuries per 1000 hours of physical activity participation.

Results: A total of 100 injuries in the intervention group and 104 injuries in the control group were registered. Nonresponse at baseline or follow-up was minimal (8.7%). The Cox regression analyses adjusted for clustering showed a small nonsignificant intervention effect on total (HR, 0.81; 95% confidence interval [CI], 0.41-1.59), sports club (0.69; 0.28-1.68), and leisure time injuries (0.75; 0.36-1.55). However, physical activity appeared to be an effect modifier. In those who were less physically active, the intervention had a larger effect. The intervention reduced the total and leisure time injury incidence (HR, 0.47; 95% CI, 0.21-1.06; and 0.43; 0.16-1.14; respectively). Sports club injury incidence was significantly reduced (HR, 0.23; 95% CI, 0.07-0.75).

Conclusion: We found a substantial and relevant reduction in physical activity injuries, especially in children in the low active group, because of the intervention. This school-based injury prevention program is promising, but future large-scale research is needed.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anthropometry
  • Body Mass Index
  • Child
  • Curriculum
  • Demography
  • Ethnicity / statistics & numerical data
  • Female
  • Health Promotion*
  • Humans
  • Incidence
  • Male
  • Motor Activity*
  • Prevalence
  • Program Development*
  • Program Evaluation
  • School Health Services / standards*
  • Schools
  • Surveys and Questionnaires
  • Wounds and Injuries / epidemiology*
  • Wounds and Injuries / prevention & control*