Process Evaluation of a School-Based High-Intensity Interval Training Program for Older Adolescents: The Burn 2 Learn Cluster Randomised Controlled Trial

Abstract

Process evaluations can help to optimise the implementation of school-based physical activity interventions. The purpose of this paper is to describe the process evaluation of a school-based high-intensity interval training (HIIT) program for older adolescent students, known as Burn 2 Learn (B2L). B2L was evaluated via a cluster randomised controlled trial in 20 secondary schools (10 intervention, 10 control) in New South Wales, Australia. Teachers (n = 22 (55% female)) from the 10 intervention schools, delivered the program over three phases (Phases 1 and 2, 6 months; Phase 3, 6 months) to older adolescent students (n = 337 (50% female); mean ± standard deviation (SD) age = 16.0 ± 0.4 years). Process evaluation data were collected across the 12-month study period. Teachers delivered 2.0 ± 0.8 and 1.7 ± 0.6 sessions/week in Phases 1 and 2 respectively (mean total 25.9 ± 5.2), but only 0.6 ± 0.7 sessions/week in Phase 3. Observational data showed that session quality was high, however heart rate (HR) data indicated that only half of the students reached the prescribed threshold of ≥85% predicted HRmax during sessions. Over 80% of teachers reported they intended to deliver the B2L program to future student cohorts. Almost 70% of students indicated they intended to participate in HIIT in the future. Teachers considered the program to be adaptable, and both students and teachers were satisfied with the intervention. B2L was implemented with moderate-to-high fidelity in Phases 1 and 2, but low in Phase 3. Our findings add to the relatively scant process evaluation literature focused on the delivery of school-based physical activity programs.

Evaluating the reach, effectiveness, adoption, implementation and maintenance of the Resistance Training for Teens program

“…Similarly, teachers delivering a program for senior students were provided with initial (professional learning) and ongoing (observation and feedback) support [79]. Findings from these evaluations indicated that external support likely contributed to improvements in teachers' implementation of the policy [78,80,81].…”

The effect of a one-year vigorous physical activity intervention on fitness, cognitive performance and mental health in young adolescents: the Fit to Study cluster randomised controlled trial

“…The "Burn 2 Learn" cluster randomised trial, which delivered HIIT activity breaks twice a week for six months during curriculum time in 10 intervention schools (compared to 10 control), showed a significant improvement in older adolescents' (mean age = 16) CRF at six, but not 12 months. In contrast to previous studies, however, it observed no significant improvements in cognitive and mental health outcomes [37,51]. More pragmatic and large-scale trials, including those involving younger adolescents, are needed to assess the effectiveness and scalability of HIIT.…”

“…Schools that struggled with delivering all intervention elements were allowed to omit the third infusion occasionally [53], in order to keep schools, teachers and pupils engaged. Such modifications are not desirable, but suggest that flexibility in intervention delivery may be required [51]. Lack of time was the major barrier [53], not only for implementation of the intervention, but also for conducting secondary outcome assessments.…”

“…Variability in IT-facilities further complicated completion of assessments, resulting in great amounts of missing data. Future trials are encouraged to use implementation frameworks in the design phase to guide implementation and scale-up of PA trials [51].…”

Process Evaluation of Project FFAB (Fun Fast Activity Blasts): A Multi-Activity School-Based High-Intensity Interval Training Intervention

“…To date, only three detailed qualitative evaluations of real-world HIIT programmes exist, but these involved adult participants as part of a workplace intervention (Kinnafick et al, 2018 ; Metcalfe et al, 2020 ; Burn et al, 2021 ). Five school-based HIIT studies included aspects of process evaluation within their outcome trials (Buchan et al, 2013 ; Leahy et al, 2019 ; Kennedy et al, 2020 ; Lubans et al, 2020 ; Costigan et al, 2015b ). However, these evaluations were either conducted quantitatively, predominantly focusing on those delivering the intervention (i.e., the schoolteachers) as opposed to those receiving the intervention (i.e., the school pupils) (Costigan et al, 2015b ; Leahy et al, 2019 ; Kennedy et al, 2020 ; Lubans et al, 2020 ), or provided inadequate detail about the qualitative methods and analysis techniques utilised (Buchan et al, 2013 ).…”