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BMC Public Health
Published in: BMC Public Health 1/2016

Open Access 01-12-2016 | Study protocol

Improving the well-being of children and youths: a randomized multicomponent, school-based, physical activity intervention

Authors: Søren Smedegaard, Lars Breum Christiansen, Pernille Lund-Cramer, Thomas Bredahl, Thomas Skovgaard

Published in: BMC Public Health | Issue 1/2016

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Abstract

Background

The benefits of physical activity for the mental health and well-being of children and young people are well-established. Increased physical activity during school hours is associated with better physical, psychological and social health and well‐being. Unfortunately many children and young people exercise insufficiently to benefit from positive factors like well-being.
The main aim of this study is to develop, implement and evaluate a multi-component, school-based, physical activity intervention to improve psychosocial well-being among school-aged children and youths from the 4th to the 6th grade (10–13 years).

Methods

A four-phased intervention – design, pilot, RCT, evaluation - is carried out for the development, implementation and evaluation of the intervention which are guided by The Medical Research Council framework for the development of complex interventions. 24 schools have been randomized and the total study population consists of 3124 children (baseline), who are followed over a period of 9 months. Outcome measure data at the pupil level are collected using an online questionnaire at baseline and at follow-up, 9 months later with instruments for measuring primary (general physical self-worth) and secondary outcomes (self-perceived sport competences, body attractiveness, scholastic competences, social competences and global self-worth; enjoyment of PA; self-efficacy; and general well-being) that are both valid and manageable in setting-based research. The RE-AIM framework is applied as an overall instrument to guide the evaluation.

Discussion

The intervention focuses on the mental benefits of physical activity at school, which has been a rather neglected theme in health promotion research during recent decades. This is unfortunate as mental health has been proclaimed as one of the most important health concerns of the 21st century. Applying a cluster RCT study design, evaluating the real-world effectiveness of the intervention, this study is one of the largest physical activity intervention projects promoting psychosocial well-being among children and youths. Through a comprehensive effectiveness evaluation and a similar substantial process evaluation, this study is designed to gain knowledge on a broad variety of implementation issues and give detailed information on project delivery and challenges at the school level – among other things to better inform future practice.

Trial registration

Date of registration: 24 April 2015 retrospectively registered at Current Controlled Trials with study ID ISRCTN12496336
Footnotes
1
WHO: Process of translation and adaptation of instruments.
 
Literature
1.
Biddle SJ, Asare M. Physical activity and mental health in children and adolescents: a review of reviews. Br J Sports Med. 2011;45(11):886–95.CrossRefPubMed
2.
Ekeland E, Heian F, Hagen KB. Can exercise improve self esteem in children and young people? A systematic review of randomised controlled trials. Br J Sports Med. 2005;39(11):792–8. discussion 792–798.CrossRefPubMedPubMedCentral
3.
4.
Biddle SJ, Mutrie N, Gorely T. Psychology of Physical Activity: Determinants, Well-Being and Interventions. 3rd ed. Abingdon: Routledge; 2015.
5.
Eime RM, Young JA, Harvey JT, Charity MJ, Payne WR. A systematic review of the psychological and social benefits of participation in sport for children and adolescents: informing development of a conceptual model of health through sport. Int J Behav Nutr Phys Act. 2013;10:98.CrossRefPubMedPubMedCentral
6.
Hills AP, Dengel DR, Lubans DR. Supporting public health priorities: recommendations for physical education and physical activity promotion in schools. Prog Cardiovasc Dis. 2015;57(4):368–74.CrossRefPubMed
7.
Dobbins M, Husson H, DeCorby K, LaRocca RL. School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18. Cochrane database sys rev. 2013;2:Cd007651.
8.
Sollerhed AC, Ejlertsson G. Physical benefits of expanded physical education in primary school: findings from a 3-year intervention study in Sweden. Scand J Med Sci Sports. 2008;18(1):102–7.CrossRefPubMed
9.
Graf C, Koch B, Falkowski G, Jouck S, Christ H, Staudenmaier K, Tokarski W, Gerber A, Predel H-G, Dordel S. School-based prevention: Effects on obesity and physical performance after 4 years. J Sports Sci. 2008;26(10):987–94.CrossRefPubMed
10.
Donnelly JE, Greene JL, Gibson CA, Smith BK, Washburn RA, Sullivan DK, DuBose K, Mayo MS, Schmelzle KH, Ryan JJ, et al. Physical Activity Across the Curriculum (PAAC): a randomized controlled trial to promote physical activity and diminish overweight and obesity in elementary school children. Prev Med. 2009;49(4):336–41.CrossRefPubMedPubMedCentral
11.
Kriemler S, Zahner L, Schindler C, Meyer U, Hartmann T, Hebestreit H, Brunner-La Rocca HP, van Mechelen W, Puder JJ. Effect of school based physical activity programme (KISS) on fitness and adiposity in primary schoolchildren: cluster randomised controlled trial. BMJ. 2010;340:c785.CrossRefPubMedPubMedCentral
12.
Kriemler S, Meyer U, Martin E, van Sluijs EM, Andersen LB, Martin BW. Effect of school-based interventions on physical activity and fitness in children and adolescents: a review of reviews and systematic update. Br J Sports Med. 2011;45(11):923–30.CrossRefPubMed
13.
Lai SK, Costigan SA, Morgan PJ, Lubans DR, Stodden DF, Salmon J, Barnett LM. Do school-based interventions focusing on physical activity, fitness, or fundamental movement skill competency produce a sustained impact in these outcomes in children and adolescents? A systematic review of follow-up studies. Sports Med. 2014;44(1):67–79.CrossRefPubMed
14.
Jago R, Rawlins E, Kipping RR, Wells S, Chittleborough C, Peters TJ, Mytton J, Lawlor DA, Campbell R. Lessons learned from the AFLY5 RCT process evaluation: implications for the design of physical activity and nutrition interventions in schools. BMC Public Health. 2015;15:946.CrossRefPubMedPubMedCentral
15.
Babic MJ, Morgan PJ, Plotnikoff RC, Lonsdale C, White RL, Lubans DR. Physical activity and physical self-concept in youth: systematic review and meta-analysis. Sports Med. 2014;44(11):1589–601.CrossRefPubMed
16.
Kohl III HW, Cook HD. Educating the student body: Taking physical activity and physical education to school. Washington, DC: National Academies Press; 2013.
17.
Demetriou Y, Höner O. Physical activity interventions in the school setting: A systematic review. Psychol Sport Exerc. 2012;13(2):186–96.CrossRef
18.
Bailey R, Hillman C, Arent S, Petitpas A. Physical activity: an underestimated investment in human capital? J Phys Act Health. 2013;10(3):289–308.CrossRefPubMed
19.
Brunelle J, Danish SJ, Forneris T. The impact of a sport-based life skill program on adolescent prosocial values. Appl Dev Sci. 2007;11(1):43–55.CrossRef
20.
Holland MJG. The role and development of life skills in young sports participants. Birmingham: University of Birmingham; 2012.
21.
Naylor PJ, McKay HA. Prevention in the first place: schools a setting for action on physical inactivity. Br J Sports Med. 2009;43(1):10–3.CrossRefPubMed
22.
Nilsen P. Making sense of implementation theories, models and frameworks. Implement Sci. 2015;10(1):1–13.CrossRef
23.
Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M, Medical Research Council G. Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ. 2008;337:a1655.CrossRefPubMedPubMedCentral
24.
Straus S, Tetroe J, Graham ID. Knowledge translation in health care: moving from evidence to practice: Wiley; 2013.
25.
Glasgow RE, Emmons KM. How can we increase translation of research into practice? Types of evidence needed. Annu Rev Public Health. 2007;28:413–33.CrossRefPubMed
26.
Kessler R, Glasgow RE. A proposal to speed translation of healthcare research into practice: dramatic change is needed. Am J Prev Med. 2011;40(6):637–44.CrossRefPubMed
27.
Lavis J, Davies H, Oxman A, Denis JL, Golden-Biddle K, Ferlie E. Towards systematic reviews that inform health care management and policy-making. J Health Serv Res Policy. 2005;10 Suppl 1:35–48.CrossRefPubMed
28.
Pope C, Mays N, Popay J. Informing policy making and management in healthcare: the place for synthesis. Healthcare policy. 2006;1(2):43–8.PubMedPubMedCentral
29.
Ryan RM, Deci EL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol. 2000;55(1):68–78.CrossRefPubMed
30.
Deci EL, Ryan RM. Intrinsic motivation and self-determination in human behavior. New York: Plenum. 1985
31.
Collins D. Pretesting survey instruments: an overview of cognitive methods. Qual Life Res. 2003;12(3):229–38.CrossRefPubMed
32.
Raudenbush SW, Martinez A, Spybrook J. Strategies for improving precision in group-randomized experiments. Educ Evaluation Policy Analysis. 2007;29(1):5–29.CrossRef
33.
Glasgow RE, Vogt TM, Boles SM. Evaluating the public health impact of health promotion interventions: the RE-AIM framework. Am J Public Health. 1999;89(9):1322–7.CrossRefPubMedPubMedCentral
34.
Sperber AD. Translation and validation of study instruments for cross-cultural research. Gastroenterology. 2004;126(Supplement 1):S124–8.CrossRefPubMed
35.
Fox KR, Corbin CB. THE PHYSICAL SELF-PERCEPTION PROFILE - DEVELOPMENT AND PRELIMINARY VALIDATION. J Sport Exerc Psychol. 1989;11(4):408–30.CrossRef
36.
Whitehead J. A Study of Children’s Physical Self-Perceptions Using an Adapted Physical Self-Perception Profile Questionnaire. Pediatr Exerc Sci. 1995;7:132–51.CrossRef
37.
Muris P, Meesters C, Fijen P. The self-perception profile for children: Further evidence for its factor structure, reliability, and validity. Pers Individ Dif. 2003;35(8):1791–802.CrossRef
38.
Harter S. The Self-Perception Profile for Children: Revision of the Perceived Competence Scale for Children. Denver, CO: University of Denver; 1985.
39.
Harter S. Self-Perception Profile for Children: Manuals and Questionnaires (Grades 3–8)..University of Denver Arts, Humanities and Social Sciences Department of Psychology. 2012
40.
Christensen U, Krolner R, Nilsson CJ, Lyngbye PW, Hougaard CO, Nygaard E, Thielen K, Holstein BE, Avlund K, Lund R. Addressing social inequality in aging by the Danish occupational social class measurement. J Aging Health. 2014;26(1):106–27.CrossRefPubMed
41.
Grimby G, Borjesson M, Jonsdottir IH, Schnohr P, Thelle DS, Saltin B. The “Saltin-Grimby Physical Activity Level Scale” and its application to health research. Scand J Med Sci Sports. 2015;25 Suppl 4:119–25.CrossRefPubMed
42.
Dishman RK, Motl RW, Saunders RP, Dowda M, Felton G, Ward DS, Pate RR. Factorial invariance and latent mean structure of questionnaires measuring social-cognitive determinants of physical activity among black and white adolescent girls. Prev Med. 2002;34(1):100–8.CrossRefPubMed
43.
Motl RW, Dishman RK, Trost SG, Saunders RP, Dowda M, Felton G, Ward DS, Pate RR. Factorial validity and invariance of questionnaires measuring social-cognitive determinants of physical activity among adolescent girls. Prev Med. 2000;31(5):584–94.CrossRefPubMed
44.
Saunders RP, Pate RR, Felton G, Dowda M, Weinrich MC, Ward DS, Parsons MA, Baranowski T. Development of questionnaires to measure psychosocial influences on children’s physical activity. Prev Med. 1997;26(2):241–7.CrossRefPubMed
45.
Bartholomew JB, Loukas A, Jowers EM, Allua S. Validation of the physical activity self-efficacy scale: Testing measurement invariance between Hispanic and Caucasian children. J Phys Act Health. 2006;3(1):70.CrossRef
46.
Motl RW, Dishman RK, Saunders R, Dowda M, Felton G, Pate RR. Measuring enjoyment of physical activity in adolescent girls. Am J Prev Med. 2001;21(2):110–7.CrossRefPubMed
47.
Moore JB ZY, Hanes J, Joan D, Berard G, Barbeau P. Measuring Enjoyment of Physical Activity in Children: Validation of the Physical Activity Enjoyment Scale. J Appl Sport Psychol. 2009;21(S1):S116–s129
48.
Dishman RK, Motl RW, Saunders R, Felton G, Ward DS, Dowda M, Pate RR. Enjoyment mediates effects of a school-based physical-activity intervention. Med Sci Sports Exerc. 2005;37(3):478–87.CrossRefPubMed
49.
Dishman RK, Hales DP, Sallis JF, Saunders R, Dunn AL, Bedimo-Rung AL, Ring KB. Validity of social-cognitive measures for physical activity in middle-school girls. J Pediatr Psychol. 2010;35(1):72–88.CrossRefPubMed
50.
Paxton RJ, Nigg C, Motl RW, Yamashita M, Chung R, Battista J, Chang J. Physical Activity Enjoyment Scale short form--does it fit for children? Res Q Exerc Sport. 2008;79(3):423–7.CrossRefPubMed
51.
Carraro A, Young MC, Robazza C. A contribution to the validation of the physical activity enjoyment scale in an Italian sample. Soc Behav Personal Int J. 2008;36(7):911–8.CrossRef
52.
Ravens-Sieberer U, Herdman M, Devine J, Otto C, Bullinger M, Rose M, Klasen F. The European KIDSCREEN approach to measure quality of life and well-being in children: development, current application, and future advances. Qual Life Res. 2014;23(3):791–803.CrossRefPubMed
53.
Hemming K, Marsh J. A menu-driven facility for sample-size calculations in cluster randomized controlled trials. Stata J. 2013;13(1):114–35.
54.
Schwartz MB, Henderson KE. Does Obesity Prevention Cause Eating Disorders? J Am Acad Child Adolesc Psychiatry. 2009;48(8):784–6.CrossRefPubMed
55.
Santelli JS, Smith Rogers A, Rosenfeld WD, DuRant RH, Dubler N, Morreale M, English A, Lyss S, Wimberly Y, Schissel A. Guidelines for adolescent health research. A position paper of the Society for Adolescent Medicine. J Adolesc Health. 2003;33(5):396–409.PubMed
56.
Lubans DR, Plotnikoff RC, Lubans NJ. Review: A systematic review of the impact of physical activity programmes on social and emotional well-being in at-risk youth. Child Adolesc Mental Health. 2012;17(1):2–13.CrossRef
57.
Spence S, White M, Adamson AJ, Matthews JNS. Does the use of passive or active consent affect consent or completion rates, or dietary data quality? Repeat cross-sectional survey among school children aged 11–12 years. BMJ Open. 2015;5(1).
58.
Cully JA, Armento ME, Mott J, Nadorff MR, Naik AD, Stanley MA, Sorocco KH, Kunik ME, Petersen NJ, Kauth MR. Brief cognitive behavioral therapy in primary care: a hybrid type 2 patient-randomized effectiveness-implementation design. Implement Sci. 2012;7:64.CrossRefPubMedPubMedCentral
Metadata
Title
Improving the well-being of children and youths: a randomized multicomponent, school-based, physical activity intervention
Authors
Søren Smedegaard
Lars Breum Christiansen
Pernille Lund-Cramer
Thomas Bredahl
Thomas Skovgaard
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2016
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-016-3794-2

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