Increasing children’s physical activity through a teaching-assistant led extracurricular intervention: process evaluation of the action 3:30 randomised feasibility trial

Abstract

BackgroundMany children do not engage in recommended levels of physical activity (PA), highlighting the need to find ways to increase children’s PA. Process evaluations play an important role in improving the science of randomised controlled trials. We recently reported the results of the Action 3:30 cluster randomised feasibility trial illustrating higher levels of moderate to vigorous intensity PA among boys but not girls. The aim of this paper is to report the process evaluation results including intervention fidelity, implementation, context and how intervention components and trial design could be improved before proceeding to a definitive RCT.MethodsChildren’s session enjoyment was assessed every two weeks. Reasons for non-attendance were provided by questionnaire at the end of the intervention. Post intervention interviews were held with participating teaching assistants (TAs) and school key contacts (KCs), and focus groups were conducted with children in all 10 intervention schools. Interviews and focus groups examined how recruitment and session attendance might be improved and established which elements of the programme that were and were not well received.ResultsData indicated good intervention fidelity with TA’s adopting enjoyment-focussed teaching styles and the sessions improving children’s skills and self-esteem. Several positive aspects of implementation were identified, including high session variety, the opportunity to work in teams, the child-led sessions and the engaging leader style. In terms of context there was evidence that TA’s faced difficulties managing challenging behaviour and that further training in this area was needed. TAs and KCs felt that recruitment could be improved by providing taster sessions during PE lessons and clarifying the days that the clubs would run at the point of recruitment. The programme could be improved to enhance interest for girls, by including training for managing disruptive behaviour and making some activities more age-group appropriate.ConclusionsAction 3.30 showed promise but could be improved by ensuring age appropriate activities, providing more appeal to girls and improving recruitment through taster sessions and early establishment of days of the week it is to be offered on.Trial registrationISRCTN58502739.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-1501-3) contains supplementary material, which is available to authorized users.

Bristol Girls Dance Project: a cluster randomised controlled trial of an after-school dance programme to increase physical activity among 11- to 12-year-old girls

“…Similarly to the findings of previous research, 94,95 participants enjoyed the after-school sessions. Exposing girls to activities that they find enjoyable is crucial, as girls are more likely to participate in PA over the longer term if they find the activity enjoyable.…”

“…Girls have previously reported that they would be more likely to attend a session if their friends encouraged them to go. 19 In the current study, girls described enjoying 39,94,95 Aspects that were enjoyed by girls included learning new dance material, group work and dancing to current music. The perceived levels of exertion for dance sessions were low, similar to findings from the BGDP feasibility trial in which average exertion was 3.5 (out of 10).…”

“…These findings are comparable to previous interventions with young people. 91,94 Friendship groups were seen both to challenge and to encourage attendance. Some girls would attend sessions because their friends did; however, this meant that some stopped attending if friends missed sessions.…”

Delivery and Receipt of a Self-Determination-Theory-Based Extracurricular Physical Activity Intervention: Exploring Theoretical Fidelity in Action 3:30

“…We have reported the design , randomized controlled feasibility trial outcomes (Jago et al, 2014), and aspects of process evaluation (Jago et al, 2015) of an extracurricular intervention (Action 3:30) aimed at increasing the physical activity of children in Years 5 and 6 of UK primary school (i.e., 9-11 years of age). Action 3:30 was conducted in 20 schools (10 intervention, 10 control) 5-day training program to develop the skills and resources needed to deliver an after-school physical activity club.…”

“…We have previously published part of the Action 3:30 process evaluation (Jago et al, 2015) that was restricted to analysis of data on trial recruitment, intervention attendance, participant perceptions of enjoyment, reasons for nonattendance, fidelity to session objectives, and school context, including competing after-school activities. Recent UK guidance on process evaluation of complex interventions supports the publication of multiple process evaluation papers to ensure sufficient coverage of the range of data and evidence collected (Moore et al, 2014).…”