Article Text

Effect of a school-based peer education intervention on physical activity and sedentary behaviour in Chinese adolescents: a pilot study
  1. Zhaohui Cui1,2,
  2. Smita Shah1,3,
  3. Lijing Yan2,4,
  4. Yongping Pan5,
  5. Aiyu Gao5,
  6. Xiaoyan Shi5,
  7. Yangfeng Wu2,6,
  8. Michael John Dibley1
  1. 1Sydney School of Public Health, Sydney Medical School, University of Sydney, Sydney, Australia
  2. 2The George Institute for Global Health, Beijing, China
  3. 3Primary Health Care Education and Research Unit, Primary Care and Community Health Network, Sydney West Local Health District, Sydney, Australia
  4. 4Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
  5. 5Dongcheng District Institute for Student Healthcare, Beijing, China
  6. 6Peking University Health Science Center, Beijing, China
  1. Correspondence to Dr Zhaohui Cui; cuizhaohui2008{at}


Objective To evaluate the effect on physical activity and sedentary behaviour of a pilot school-based peer education programme in urban Beijing, China.

Design 4 junior high schools were matched by school size and randomised to intervention (n=346) and control group (n=336).

Intervention Trained peer leaders from grade 7 by research staff delivered weekly 40-min lessons to their classmates over four consecutive weeks. Students in control schools received no intervention.

Outcome measures A validated 7-day youth physical activity questionnaire was used to evaluate physical activity and sedentary behaviours at baseline (September 2010), 3 months (December 2010) and 7 months (May 2011). Generalised linear mixed models were applied to evaluate the effect.

Results There was a significant decrease in time in sedentary behaviour on weekdays, 20 min/day at 7 months (p=0.020) reported by students in the intervention schools compared with control schools. This reduction was mainly due to a reduction of 14 min/day in computer usage on weekdays (p=0.0009). There were no significant differences in time on other sedentary behaviours, including television and DVD, video game, extracurricular reading, writing, drawing and listening to music, passive commuting and sitting to talk. There was also no significant difference in time in moderate-to-vigorous physical activity between intervention and control group.

Conclusions Peer education appears to be a promising intervention in reducing sedentary behaviours in adolescents in China. These results need confirmation in a larger study.

Clinical trial registration number ACTRN12612000417886 at

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: and

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Supplementary materials

  • Supplementary Data

    This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.

    Files in this Data Supplement:


  • To cite: Cui Z, Shah S, Yan L, et al. Effect of a school-based peer education intervention on physical activity and sedentary behaviour in Chinese adolescents: a pilot study. BMJ Open 2012;2:e000721. doi:10.1136/bmjopen-2011-000721

  • Contributors MJD, SS and ZC formulated the idea and study design. ZC modified the intervention materials, implemented the intervention, collected and cleaned the data, carried out the data analyses and drafted the manuscript. SS, LY, YW, YP, AG and MJD contributed to the implementation of the intervention. SS, LY and MJD contributed to the interpretations of the results. All authors contributed to revising the paper and approved the final version.

  • Funding This work was supported by the Nestle Foundation. The funders of the research had no role in the analysis nor the decision to publish.

  • Competing interests None.

  • Ethics approval Ethics approval was provided by the Peking University Biomedical Ethics Committee, China; Human Research Ethics Committee, the University of Sydney, Australia.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.