Participants

A detailed description of the rationale, design, and methods of A+PAAC (20), as well as primary outcomes (4), has been previously published. A+PAAC was a 3-year, adequately powered, cluster randomized controlled trial designed to evaluate the influence of classroom-based physical activity lessons on academic achievement. The trial incorporated 17 elementary schools in northeast Kansas from 4 school districts. Schools were stratified by school district (N=3) to receive A+PAAC (9 schools) or serve as controls (8 schools). A+PAAC provided academic lessons delivered by classroom teachers using MVPA (100 minutes/week, >3 METs) to increase total daily MVPA while maintaining academic instruction time. A+PAAC instruction time began when the students were in 2^nd or 3^rd grade and ended in 5^th or 6^th grade, respectively. The primary outcome was academic achievement measured by Weschler Individual Achievement Test-III, WIAT-III (21). Parents and students provided consent and assent, respectively, prior to initiation of A+PAAC. The investigation was approved by The University of Kansas Human Subjects Committee.