Effectiveness of the GoActive intervention to increase physical activity in adolescents aged 13–14 years: a cluster randomised controlled trial

Abstract

Background Adolescent physical activity levels are low and are associated with rising disease risk and social disadvantage at increasingly early ages. We aimed to assess the effectiveness of a school-based programme (GoActive) to increase moderate-to-vigorous physical activity (MVPA) in adolescents.Methods In this cluster randomised controlled trial, non-fee-paying, co-educational schools including Year 9 students (aged 13-14 years) in Cambridgeshire or Essex, UK, were eligible for inclusion; within participating schools, all Year 9 students were eligible. Schools were computer-randomised (1:1) to either the control or intervention group, stratified by school-level pupil premium (below vs above county-specific median) and county (Cambridgeshire vs Essex). Measurement staff were masked to allocation; investigators were not masked because of necessary school contact. The iteratively developed, feasibility-tested and refined 12-week intervention trained older adolescents (mentors) and in-class peer leaders to encourage classes to undertake two new weekly activities. Training sessions consisted of an initial session between facilitators and mentors lasting at least 1 h followed by six 30 min meetings every week during the first six weeks and meetings approximately every 2 weeks thereafter. Mentors met with peer leaders weekly. Students and classes gained points and rewards for activity in and out of school. The primary outcome was mean daily minutes of accelerometerassessed MVPA at 10 months post-intervention, assessed in the complete case population (ie, all students who had a 10-month post-intervention measurement and [in the intervention group] wore the accelerometer) under the intentionto-treat principle, and in the per-protocol population (ie, students who also reported weekly class activities and logged points). Ethical approval was granted from the University of Cambridge Psychology Ethics Committee (PRE.126.2016). This study is registered with the International Standard Randomised Controlled Trials registry, number ISRCTN31583496. Findings Of 103 eligible schools, 16 enrolled in the study. 2862 Year 9 students were eligible, of whom 1319 were in the eight control schools (mean of 165 [SD 62] students per school) and 1543 were in the eight intervention schools (mean 193 [SD 43] per school; intraclass correlation coefficient=0•03 for school-level MVPA). 2167 (76%) of 2862 students had a 10-month post-intervention measurement; we analysed the primary outcome in 1874 participants (65%) due to expected low levels of accelerometer wear (871 [66%] in control schools; 1003 [65%] in intervention schools); analyses were adequately powered to detect an effect. At 10 months, time spent doing MVPA did not differ significantly between adolescents at intervention schools versus those at control schools (mean difference -1•91 min [95% CI -5•53 to 1•70]; p=0•32). In the per protocol population (285 students in intervention schools and 871 in control schools at 10 months), results were similar (mean difference -1•87 min [-6•80...

Pathways to Increasing Adolescent Physical Activity and Wellbeing: A Mediation Analysis of Intervention Components Designed Using a Participatory Approach

“…The primary outcome was average daily minutes of accelerometer-assessed moderate-to-vigorous physical activity (MVPA assessed using Axivity) at 10 months post-intervention. Although the intervention did not show a direct effect on overall MVPA (primary outcome) or wellbeing (secondary outcome) [22], particular engagement with components may be associated with mediators and outcomes, for example, encouragement provided by older adolescent mentors could be associated with increased self-efficacy and social support, which may be associated with changes in physical activity and wellbeing as proposed previously [23,24].…”

“…These monitors have been validated to assess physical activity energy expenditure [41]. Monitor output was processed to provide minutes spent in MVPA to be equivalent to ≥2000 ActiGraph cpm [21]; further details on accelerometer data processing can be found elsewhere [22].…”

Peer-led physical activity intervention for girls aged 13 to 14 years: PLAN-A cluster RCT

“…Existing literature in this area suggests that other peer-led interventions delivered at scale had no lasting effect on MVPA levels in adolescent girls 112,124 or in a mixed-gender school setting. 125 Harrington et al 112 found evidence of a small (i.e. 2-3 additional minutes of MVPA per day), short-term (i.e.…”

“…In a randomised controlled trial of an intervention that trained older adolescents (i.e. mentors) and in-class peer leaders to encourage classes to undertake two new weekly activities, Corder et al 125 reported no difference in MVPA between the control and intervention groups at follow-up. Moreover, although a peer-led walking intervention in schools 124 resulted in an increase in daily light-intensity physical activity of 8.27 minutes among adolescent girls, it had no significant effect on MVPA.…”

“…It is, relatively speaking, straightforward to evaluate a well-defined, one-dimensional, school-based physical activity intervention such as those conducted in recent years by our group and others. 51,78,123,125 The intervention can be clearly described, fidelity can be assessed, and its effect compared using a control group within a traditional cluster-randomised controlled trial design; again, we can achieve good depth, but limited breadth. It is not clear how best to evaluate broader whole-school approaches, which act on multiple domains of physical activity, nor how to determine which elements are and are not effective, or how interventions may interact with pupil-level factors (e.g.…”