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Increasing physical activity levels of primary school-aged children and its effects on physical health and psychological well-being: Evaluations of a home-based and a school-based behavioural self-management intervention

Price, Cath (2015) Increasing physical activity levels of primary school-aged children and its effects on physical health and psychological well-being: Evaluations of a home-based and a school-based behavioural self-management intervention. PhD thesis, Murdoch University.

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Physical activity (PA) has been a focus for both treatment and prevention programs for obesity and other related health problems in childhood. The aims of the present research were to assess the extent to which children can self-manage increases in physical activity under free living conditions (at home and school) as a result of daily self-monitoring with a pedometer and education in the use of additional behavioural strategies packaged in a home-based intervention – the Moving It Program (MIP) and a school-based intervention - The Health and Programmed Physical Education (H.A.P.P.E.) Classroom Project. A secondary aim was to assess to what extent beneficial outcomes in physical health and psychological well-being can be monitored as a result of increases in PA. Study I presents four single-case evaluations of the MIP with inactive and overweight primary school-aged children at home over a monitoring period of approximately 5 months. Study II presents four separate quasi-experimental evaluations of The HAPPE Classroom ‘Climb Mt Fuji Challenge’ conducted with a total of 127 primary school children, in groups aged 7-8 years, 9-10 years and 11-12 years, from two Western Australian metropolitan primary schools. Each HAPPE evaluation was conducted during one school term (approximately 9-weeks). Primary dependent variables were mean steps monitored on weekdays (including steps in-school and out-of-school in the HAPPE evaluations) and on weekends with pedometers on a continuous, daily basis. In Study I, all children made notable changes in their daily activity levels in the MIP, though not all maintained these increases. Two of the children made greater gains in mean steps on weekdays compared to weekends, while the other two made greater gains to steps on weekends compared to weekdays. Participants also showed positive changes in measures of body composition and psychological well-being. In Study II, proportions of children meeting recommended daily step counts on weekdays and weekends increased significantly in the control and experimental groups compared to baseline. Increases in mean daily steps on weekdays and out-of-school in the experimental ‘Ped + HAPPE’ condition significantly exceeded increases in mean daily steps in the Comparison ‘Ped Only’ condition in 3 of the 4 trials. Pre versus post analysis of health indicators revealed both groups made significant increases in height without significant increases in weight or BMI, as well as significant decreases in resting heart rate. Raw scores on the Child Depression Inventory and Revised Child Manifest Anxiety Scale (RCMAS) in the control group and raw scores on the RCMAS in the experimental group all reduced significantly. Educating children in the use of pedometers to self-monitor steps on a daily basis, in combination with additional behavioural strategies enabled‘at risk’and typical children to self-manage increases in PA to currently recommended levels, with increases in PA generalising across the home and school contexts. However, caution must be applied when attributing the changes in physical health and psychological well-being from the pre- to post-measurements to increases in PA. Further research is needed to determine the extent to which self-managed increases in children’s PA are maintained and, using alternative PA monitoring methods, further clarify the extent to which changes in health and well-being in childhood is related to acute/short-term increases in the different types (intensities) of PA. The preliminary success of a low cost, minimalist behavioural selfmanagement intervention delivering reliable improvements in children’s PA in the short-term, and with the potential to benefit health and well-being at the individual level provides a hopeful outlook in the context of the global threat from NCD. It is anticipated that if the HAPPE is delivered to all school children as part of a widespread ongoing initiative, then population-based targets to increase PA levels will be achieved.

Item Type: Thesis (PhD)
Murdoch Affiliation(s): School of Psychology and Exercise Science
Supervisor(s): Gouldthorp, Bethanie
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