Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2013

Open Access 01-12-2013 | Study protocol

A cluster randomised trial of a school-based intervention to prevent decline in adolescent physical activity levels: study protocol for the ‘Physical Activity 4 Everyone’ trial

Authors: Rachel Sutherland, Elizabeth Campbell, David R Lubans, Philip J Morgan, Anthony D Okely, Nicole Nathan, Luke Wolfenden, Jannah Jones, Lynda Davies, Karen Gillham, John Wiggers

Published in: BMC Public Health | Issue 1/2013

Login to get access

Abstract

Background

Adolescence is an established period of physical activity decline. Multi-component school-based interventions have the potential to slow the decline in adolescents’ physical activity; however, few interventions have been conducted in schools located in low-income or disadvantaged communities. This study aims to assess the effectiveness of a multi-component school-based intervention in reducing the decline in physical activity among students attending secondary schools located in disadvantaged communities.

Methods/Design

The cluster randomised trial will be conducted with 10 secondary schools located in selected regions of New South Wales, Australia. The schools will be selected from areas that have a level of socio-economic status that is below the state average. Five schools will be allocated to receive an intervention based on the Health Promoting Schools framework, and will be supported by a part-time physical activity consultant placed in intervention schools who will implement a range of intervention adoption strategies. Study measures will be taken at baseline when students are in Year 7 (12–13 years) and again after 12- and 24-months. The primary outcome, minutes of moderate- to-vigorous- intensity physical activity per day and percentage of time in moderate- to vigorous-intensity physical activity (MVPA), will be objectively assessed using accelerometers (Actigraph GT3x+). Group allocation and intervention delivery will commence after baseline data collection. The intervention will continue during school terms through to 24-month follow-up.

Discussion

The study will provide evidence regarding the effectiveness of a multi-component school-based intervention that includes an in-school physical activity consultant targeting the physical activity levels of adolescents in disadvantaged Australian secondary schools.

Trial registration

Australian New Zealand Clinical Trials Registry ACTRN12612000382875.
Appendix
Available only for authorised users
Literature
1.
Min Lee ISE, Lobelo F, Puska P, Blair SN, Katzmarzyk PT, for the Lancet Physical Activity Series Working Group: Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet. 2012, 380 (9838): 219-229. 10.1016/S0140-6736(12)61031-9.CrossRef
2.
Strong WB, Malina RM, Blimkie CJ, Daniels SR, Dishman RK, Gutin B, Hergenroeder AC, Must A, Nixon PA, Pivarnik JM, et al: Evidence based physical activity for school-age youth. J Pediatr. 2005, 146 (6): 732-737. 10.1016/j.jpeds.2005.01.055.CrossRefPubMed
3.
Centers for Disease Control and Prevention (CDC): Youth Risk Behavior Surveillance-United States, 2009. MMWR. Volume 59. 2010, CDC, United States of America, 1-142.
4.
5.
Morley B, Scully M, Niven P, Baur LA, Crawford D, Flood V, Okely AD, Pratt IS, Salmon J, Wakefield M, for the NaSSDA Study Team: Prevalence and socio-demographic distribution of eating, physical activity and sedentary behaviours among Australian adolescents. Health Promot J Austr. 2012, In press
6.
Nader PR, Bradley RH, Houts RM, McRitchie SL, O’Brien M: Moderate-to-vigorous physical activity from ages 9 to 15 years. JAMA. 2008, 300 (3): 295-305. 10.1001/jama.300.3.295.CrossRefPubMed
7.
Dumith SC, Gigante DP, Domingues MR, Kohl HW: Physical activity change during adolescence: a systematic review and a pooled analysis. Int J Epidemiol. 2011, 40 (3): 685-698. 10.1093/ije/dyq272.CrossRefPubMed
8.
Borraccino A, Lemma P, Iannotti RJ, Zambon A, Dalmasso P, Lazzeri G, Giacchi M, Cavallo F: Socioeconomic effects on meeting physical activity guidelines: comparisons among 32 countries. Med Sci Sports Exerc. 2009, 41 (4): 749-756. 10.1249/MSS.0b013e3181917722.CrossRefPubMedPubMedCentral
9.
Drummond MDC, Dollman J, Abery L: Physical activity from early childhood to adolescence: a literature review of issues and interventions in disadvantaged populations. Journal of Student Wellbeing. 2010, 4 (2): 17-31.
10.
Telama R, Yang X, Viikari J, Valimaki I, Wanne O, Raitakari O: Physical activity from childhood to adulthood: a 21-year tracking study. Am J Prev Med. 2005, 28 (3): 267-273. 10.1016/j.amepre.2004.12.003.CrossRefPubMed
11.
Centers for Disease Control and Prevention (CDC): School health guidelines to promote healthy eating and physical activity. Morbidity and Mortality Weekly Report. 2011, 60 (5): 1-76.
12.
Ferreira I, van der Horst K, Wendel-Vos W, Kremers S, van Lenthe FJ, Brug J: Environmental correlates of physical activity in youth - a review and update. Obes Rev. 2007, 8 (2): 129-154. 10.1111/j.1467-789X.2006.00264.x.CrossRefPubMed
13.
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): 923-930. 10.1136/bjsports-2011-090186.CrossRefPubMed
14.
van Sluijs EM, McMinn AM, Griffin SJ: Effectiveness of interventions to promote physical activity in children and adolescents: systematic review of controlled trials. BMJ. 2007, 335 (7622): 703-10.1136/bmj.39320.843947.BE.CrossRefPubMedPubMedCentral
15.
Salmon J, Booth ML, Phongsavan P, Murphy N, Timperio A: Promoting physical activity participation among children and adolescents. Epidemiol Rev. 2007, 29: 144-159. 10.1093/epirev/mxm010.CrossRefPubMed
16.
De Meester F, van Lenthe FJ, Spittaels H, Lien N, De Bourdeaudhuij I: Interventions for promoting physical activity among European teenagers: a systematic review. Int J Behav Nutr Phys Act. 2009, 6: 82-10.1186/1479-5868-6-82.CrossRefPubMedPubMedCentral
17.
Dobbins M, De Corby K, Robeson P, Husson H, Tirilis D: School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6–18. Cochrane Database Syst Rev. 2009, 1: CD007651-PubMed
18.
Cleland CL, Tully MA, Kee F, Cupples ME: The effectiveness of physical activity interventions in socio-economically disadvantaged communities: a systematic review. Prev Med. 2012, 54 (6): 371-380. 10.1016/j.ypmed.2012.04.004.CrossRefPubMed
19.
Marcus BH, Williams DM, Dubbert PM, Sallis JF, King AC, Yancey AK, Franklin BA, Buchner D, Daniels SR, Claytor RP: Physical activity intervention studies: what we know and what we need to know: a scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity); Council on Cardiovascular Disease in the Young; and the Interdisciplinary Working Group on Quality of Care and Outcomes Research. Circulation. 2006, 114 (24): 2739-2752. 10.1161/CIRCULATIONAHA.106.179683.CrossRefPubMed
20.
Salmon J, Ball K, Hume C, Booth M, Crawford D: Outcomes of a group-randomized trial to prevent excess weight gain, reduce screen behaviours and promote physical activity in 10-year-old children: switch-play. Int J Obes (Lond). 2008, 32 (4): 601-612. 10.1038/sj.ijo.0803805.CrossRef
21.
Ridgers ND, Stratton G, Fairclough SJ, Twisk JW: Long-term effects of a playground markings and physical structures on children’s recess physical activity levels. Prev Med. 2007, 44 (5): 393-397. 10.1016/j.ypmed.2007.01.009.CrossRefPubMed
22.
McNeil DA, Wilson BN, Siever JE, Ronca M, Mah JK: Connecting children to recreational activities: results of a cluster randomized trial. Am J Health Promot. 2009, 23 (6): 376-387. 10.4278/ajhp.071010107.CrossRefPubMed
23.
Domitrovich: Maximizing the Implementation Quality of Evidence-Based Preventive Interventions in Schools: A Conceptual Framework. Advances in School Mental Health Promotion. Special Issue: Enhancing Implementation Quality. 2011, 1 (3):
24.
Foreman RD: Evidence-based interventions in schools: developers’ views of implementation barriers and facilitators. Sch Ment Heal. 2009, 1: 26-36. 10.1007/s12310-008-9002-5.CrossRef
25.
Hazell T: MindMatters: evaluation of the professional development program and school-level implementation. 2006, Hunter Institute of Mental Health, Newcastle
26.
Bauer KW, Patel A, Prokop LA, Austin SB: Swimming upstream: faculty and staff members from urban middle schools in low-income communities describe their experience implementing nutrition and physical activity initiatives. Prev Chronic Dis. 2006, 3 (2): A37-PubMedPubMedCentral
27.
Dollman J, Lewis NR: Interactions of socioeconomic position with psychosocial and environmental correlates of children’s physical activity: an observational study of South Australian families. Int J Behav Nutr Phys Act. 2009, 6: 56-10.1186/1479-5868-6-56.CrossRefPubMedPubMedCentral
28.
Lubans DR, Morgan PJ, Dewar D, Collins CE, Plotnikoff RC, Okely AD, Batterham MJ, Finn T, Callister R: The Nutrition and Enjoyable Activity for Teen Girls (NEAT girls) randomized controlled trial for adolescent girls from disadvantaged secondary schools: rationale, study protocol, and baseline results. BMC Publ Health. 2010, 10: 652-10.1186/1471-2458-10-652.CrossRef
29.
WHO: Planning Meeting in Health Promoting Schools Project: Background, development and strategy outline of the Health Promoting Schools Project. 1991, WHO, Copenhagen
30.
Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC: Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009, 4: 50-10.1186/1748-5908-4-50.CrossRefPubMedPubMedCentral
31.
Wilson KD, Kurz RS: Bridging implementation and institutionalization within organizations: proposed employment of continuous quality improvement to further dissemination. J Public Health Manag Pract. 2008, 14 (2): 109-116.CrossRefPubMed
32.
Schulz KF, Altman DG, Moher D: CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. J Clin Epidemiol. 2010, 63 (8): 834-840. 10.1016/j.jclinepi.2010.02.005.CrossRefPubMed
33.
Moher D, Hopewell S, Schulz KF, Montori V, Gotzsche PC, Devereaux PJ, Elbourne D, Egger M, Altman DG: CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. BMJ. 2010, 340: c869-10.1136/bmj.c869.CrossRefPubMedPubMedCentral
34.
Australian Bureau of Statistics(ABS): Statistical Geography Volume 1- Australian Standard Geogrphical Classification (ASGC). 2006, Commonwealth of Australia, Canberra
35.
Australian Bureau of Statistics(ABS): Population Estimates (HOIST). Edited by Evidence. 2012, NSW Ministry of Health, Sydney
36.
37.
NSW Department of Education and Training: Memorandum to all Principals. Student Fitness and Physical Activity Action Plan. 1998, NSW Department of Education and Training, NSW Australia
38.
Okely AD, Cotton WG, Lubans DR, Morgan PJ, Puglisi L, Miller J, Wright J, Batterham MJ, Peralta LR, Perry J: A school-based intervention to promote physical activity among adolescent girls: rationale, design, and baseline data from the Girls in Sport group randomised controlled trial. BMC Publ Health. 2011, 11: 658-10.1186/1471-2458-11-658.CrossRef
39.
Australian Bureau of Statistics (ABS): Technical Paper:Census of Population and Housing: Socio-Economic Indexes For Australia (SEIFA). Cat. no 2039.0.55.001. 2001, Commonwealth of Australia, Canberra
40.
Hardy L: SPANS: School Nutrition and Physical Activity Survey. Executive Summary. 2011, The University of Sydney, Sydney
41.
Wolfenden L, Neve M, Farrell L, Lecathelinais C, Bell C, Milat A, Wiggers J, Sutherland R: Physical activity policies and practices of childcare centres in Australia. J Paediatr Child Health. 2011, 47 (3): 73-76. 10.1111/j.1440-1754.2010.01738.x.CrossRefPubMed
42.
Bandura A: Social foundations of thought and action: A social cognitive theory. 1986, Prentice-Hall, Inc, Englewood Cliffs
43.
Green LW, Richard L, Potvin L: Ecological foundations of health promotion. Am J Health Promot. 1996, 10 (4): 270-281. 10.4278/0890-1171-10.4.270.CrossRefPubMed
44.
Bandura A: Health promotion by social cognitive means. Health Educ Behav. 2004, 31 (2): 143-164. 10.1177/1090198104263660.CrossRefPubMed
45.
Lubans D, Morgan P: Evaluation of an extra-curricular school sport programme promoting lifestyle and lifetime activity for adolescents. J Sports Sci. 2008, 26 (5): 519-529. 10.1080/02640410701624549.CrossRefPubMed
46.
Baranowski T, Anderson C, Carmack C: Mediating variable framework in physical activity interventions. How are we doing? How might we do better?. Am J Prev Med. 1998, 15 (4): 266-297. 10.1016/S0749-3797(98)00080-4.CrossRefPubMed
47.
48.
Lubans DR, Morgan PJ, Callister R, Collins CE: Effects of integrating pedometers, parental materials, and E-mail support within an extracurricular school sport intervention. J Adolesc Health. 2009, 44 (2): 176-183. 10.1016/j.jadohealth.2008.06.020.CrossRefPubMed
49.
Pate RR, Ward DS, Saunders RP, Felton G, Dishman RK, Dowda M: Promotion of physical activity among high-school girls: a randomized controlled trial. Am J Public Health. 2005, 95 (9): 1582-1587. 10.2105/AJPH.2004.045807.CrossRefPubMedPubMedCentral
50.
Scruggs PW: Middle school physical education physical activity quantification: a pedometer steps/min guideline. Res Q Exerc Sport. 2007, 78 (4): 284-292. 10.5641/193250307X13082490461309.PubMed
51.
Centers for Disease Control and Prevention(CDC): School Health Index: A Self-Assessment and Planning Guide. Middle school/ High school version. 2005, Centres for Disease Control and Prevention, Atlanta, Georgia
52.
Lubans DR, Morgan PJ, Callister R, Collins CE, Plotnikoff RC: Exploring the mechanisms of physical activity and dietary behavior change in the program x intervention for adolescents. J Adolesc Health. 2010, 47 (1): 83-91. 10.1016/j.jadohealth.2009.12.015.CrossRefPubMed
53.
Morgan PJ, Saunders KL, Lubans DR: Improving physical self-perception in adolescent boys from disadvantaged schools: psychological outcomes from the Physical Activity Leaders randomized controlled trial. Pediatr Obes. 2012, 7 (3): e27-e32. 10.1111/j.2047-6310.2012.00050.x.CrossRefPubMed
54.
Sallis JF, McKenzie TL, Conway TL, Elder JP, Prochaska JJ, Brown M, Zive MM, Marshall SJ, Alcaraz JE: Environmental interventions for eating and physical activity: a randomized controlled trial in middle schools. Am J Prev Med. 2003, 24 (3): 209-217. 10.1016/S0749-3797(02)00646-3.CrossRefPubMed
55.
56.
Connolly P, McKenzie TL: Effects of a games intervention on the physical activity levels of children at recess. Res Q Exerc Sport. 1995, 66 (suppl): A60-
57.
McKenzie TL, Sallis JF, Prochaska JJ, Conway TL, Marshall SJ, Rosengard P: Evaluation of a two-year middle-school physical education intervention: M-SPAN. Med Sci Sports Exerc. 2004, 36 (8): 1382-1388. 10.1249/01.MSS.0000135792.20358.4D.CrossRefPubMed
58.
Lubans DR, Morgan PJ, Weaver K, Callister R, Dewar DL, Costigan SA, Finn T, Smith J, Upton L, Plotnikoff RC: Rationale and study protocol for the supporting children’s outcomes using rewards, exercise and skills (SCORES) group randomized controlled trial:A physical activity and fundamental movement skills intervention for primary schools in low-income communities. BMC Publ Health. 2012, 12 (1): 427-10.1186/1471-2458-12-427.CrossRef
59.
Bravata DM, Smith-Spangler C, Sundaram V, Gienger AL, Lin N, Lewis R, Stave CD, Olkin I, Sirard JR: Using pedometers to increase physical activity and improve health: a systematic review. JAMA. 2007, 298 (19): 2296-2304. 10.1001/jama.298.19.2296.CrossRefPubMed
60.
O’Connor TM, Jago R, Baranowski T: Engaging parents to increase youth physical activity a systematic review. Am J Prev Med. 2009, 37 (2): 141-149. 10.1016/j.amepre.2009.04.020.CrossRefPubMed
61.
Moulding NT, Silagy CA, Weller DP: A framework for effective management of change in clinical practice: dissemination and implementation of clinical practice guidelines. Qual Health Care. 1999, 8 (3): 177-183. 10.1136/qshc.8.3.177.CrossRefPubMedPubMedCentral
62.
Gottfredson DCGG: Quality of school-based prevention programs: results from a national survey. Journal of Research in Crime and Delinquency. 2002, 39: 3-36. 10.1177/002242780203900101.CrossRef
63.
Nathan N, Wolfenden L, Bell AC, Wyse R, Morgan PJ, Butler M, Sutherland R, Milat AJ, Hector D, Wiggers J: Effectiveness of a multi-strategy intervention in increasing the implementation of vegetable and fruit breaks by Australian primary schools: a non-randomized controlled trial. BMC Publ Health. 2012, 12 (1): 651-10.1186/1471-2458-12-651.CrossRef
64.
Finch M, Wolfenden L, Morgan PJ, Freund M, Wyse R, Wiggers J: A cluster randomised trial to evaluate a physical activity intervention among 3–5 year old children attending long day care services: study protocol. BMC Publ Health. 2010, 10: 534-10.1186/1471-2458-10-534.CrossRef
65.
Trost SG: State of the art reviews: measurement of physical activity in children and adolescents. American Journal of Lifestyle Medicine. 2007, 1 (4): 299-314. 10.1177/1559827607301686.CrossRef
66.
Dollman J, Okely AD, Hardy L, Timperio A, Salmon J, Hills AP: A hitchhiker’s guide to assessing young people’s physical activity: deciding what method to use. J Sci Med Sport. 2009, 12 (5): 518-525. 10.1016/j.jsams.2008.09.007.CrossRefPubMed
67.
McClain JJ, Tudor-Locke C: Objective monitoring of physical activity in children: considerations for instrument selection. J Sci Med Sport. 2009, 12 (5): 526-533. 10.1016/j.jsams.2008.09.012.CrossRefPubMed
68.
Troiano RP, Berrigan D, Dodd KW, Masse LC, Tilert T, McDowell M: Physical activity in the United States measured by accelerometer. Med Sci Sports Exerc. 2008, 40 (1): 181-188.CrossRefPubMed
69.
Evenson KR, Catellier DJ, Gill K, Ondrak KS, McMurray RG: Calibration of two objective measures of physical activity for children. J Sports Sci. 2008, 26 (14): 1557-1565. 10.1080/02640410802334196.CrossRefPubMed
70.
Booth ML, Okely AD, Chey TN, Bauman A: The reliability and validity of the adolescent physical activity recall questionnaire. Med Sci Sports Exerc. 2002, 34 (12): 1986-1995. 10.1097/00005768-200212000-00019.CrossRefPubMed
71.
Dewar D, Lubans DR, Morgan PJ, Plotnikoff R: Development and evaluation of social-cognitive measures related to adolescent physical activity. J Phys Act Health. In Press
72.
Marfell-Jones MOT, Stew A, Carter L: International standards for anthropometric assessment. International standards for anthropometric assessment. 2006, The International Society for the Advancement of Kinanthropometry, Australia
73.
Cole TJ, Bellizzi MC, Flegal KM, Dietz WH: Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000, 320 (7244): 1240-1243. 10.1136/bmj.320.7244.1240.CrossRefPubMedPubMedCentral
74.
75.
McKenzie TL: Observational measures of children’s physical activity. J Sch Health. 1991, 61 (5): 224-227. 10.1111/j.1746-1561.1991.tb06019.x.CrossRefPubMed
76.
Murray DM, Stevens J, Hannan PJ, Catellier DJ, Schmitz KH, Dowda M, Conway TL, Rice JC, Yang S: School-level intraclass correlation for physical activity in sixth grade girls. Med Sci Sports Exerc. 2006, 38 (5): 926-936. 10.1249/01.mss.0000218188.57274.91.CrossRefPubMedPubMedCentral
77.
Hayes RJ, Moulton LH: Cluster Randomised Trials. 2009, Chapman and Hall/CRC, Boca RatonCrossRef
78.
White IR, Horton NJ, Carpenter J, Pocock SJ: Strategy for intention to treat analysis in randomised trials with missing outcome data. BMJ. 2011, 342: d40-10.1136/bmj.d40.CrossRefPubMedPubMedCentral
79.
Lubans DR, Morgan PJ, Okely AD, Dewar D, Collins CE, Batterham M, Callister R, Plotnikoff RC: Preventing obesity among adolescent girls: one-year outcomes of the nutrition and enjoyable activity for teen girls (NEAT Girls) cluster randomized controlled trial. Arch Pediatr Adolesc Med. 2012, 166 (9): 821-827. 10.1001/archpediatrics.2012.41.CrossRefPubMed
80.
Greenberg MT, Domitrovich CE, Graczyk PA, Zins JE: The Study of Implementation in School-Based Preventive Interventions: Theory, Research, and Practice. Volume 3. 2005, Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, Rockville, MD
81.
Jenkinson KA, Naughton G, Benson AC: The GLAMA (Girls! Lead! Achieve! Mentor! Activate!) physical activity and peer leadership intervention pilot project: a process evaluation using the RE-AIM framework. BMC Publ Health. 2012, 12: 55-10.1186/1471-2458-12-55.CrossRef
Metadata
Title
A cluster randomised trial of a school-based intervention to prevent decline in adolescent physical activity levels: study protocol for the ‘Physical Activity 4 Everyone’ trial
Authors
Rachel Sutherland
Elizabeth Campbell
David R Lubans
Philip J Morgan
Anthony D Okely
Nicole Nathan
Luke Wolfenden
Jannah Jones
Lynda Davies
Karen Gillham
John Wiggers
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2013
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-13-57

Other articles of this Issue 1/2013

BMC Public Health 1/2013 Go to the issue

Research article

Gender difference in the characteristics of and high-risk behaviours among non-injecting heterosexual methamphetamine users in Qingdao, Shandong Province, China

Research article

Fit in 50 years: participation in high school sports best predicts one’s physical activity after Age 70

Research article

Childhood adversity as a risk for cancer: findings from the 1958 British birth cohort study

Research article

Parental food-related behaviors and family meal frequencies: associations in Norwegian dyads of parents and preadolescent children

Research article

The grounded psychometric development and initial validation of the Health Literacy Questionnaire (HLQ)

Research article

Traumatic experiences and mental health consequences among child survivors of the 2008 Sichuan earthquake: a community-based follow-up study