Skip to main content
Top
Published in: BMC Public Health 1/2019

Open Access 01-12-2019 | Research article

A process evaluation of the PLAN-A intervention (Peer-Led physical Activity iNtervention for Adolescent girls)

Authors: Simon J. Sebire, Kathryn Banfield, Russell Jago, Mark J. Edwards, Rona Campbell, Ruth Kipping, Peter S. Blair, Bryar Kadir, Kirsty Garfield, Joe Matthews, Ronan A. Lyons, William Hollingworth

Published in: BMC Public Health | Issue 1/2019

Login to get access

Abstract

Background

Few adolescent girls engage in enough physical activity (PA) to meet recommendations and there is a need for new interventions to increase girls PA. We have previously published the results of the PLAN-A cluster randomised feasibility trial which was a peer-led school-based PA intervention, showing that the intervention was feasible and held promise to increase the PA of girls aged 12–13 years. In PLAN-A, pupils nominated by their peers as influential attend training to teach them how to influence, promote and normalise physical activity amongst their peer-group. This paper reports the results of the process evaluation of the PLAN-A feasibility study, specifically focussing on acceptability to key stakeholders, intervention fidelity, receipt/experiences and perceived effect and suggested intervention refinements before proceeding to a definitive RCT.

Methods

A mixed-methods process evaluation triangulated data from qualitative focus groups and interviews with peer-supporter and non peer-supporter pupils (N = 52), parents (N = 12), teachers (N = 6) and intervention training deliverers (N = 5), quantitative questionnaires, and observations of intervention delivery. Quantitative data were analysed descriptively, and qualitative data were analysed with the Framework Method.

Results

The duration, timings, content and delivery of the peer-supporter training were acceptable. There was good fidelity to the intervention manual and its underpinning theory including high fulfilment of session objectives and use of an autonomy-supportive motivational style. Peer-supporters engaged with and enjoyed the training and retained key peer-supporter messages (what counts as PA, encouragement, empathy and subtlety). Parents and teachers were supportive of the intervention and reported perceived effects including increased PA and awareness of it, improved peer relationships, and confidence. Suggested intervention refinements included increasing participatory learning, reducing technical jargon, and providing more support to overcome challenges to giving peer support.

Conclusions

PLAN-A can be delivered as planned, is well-received, and appears to be effective in empowering adolescent girls to support their peer group to become more active. The refinements identified can be made within the original intervention structure, before proceeding to a definitive trial.

Trial registration

ISCTRN, ISRCTN12543546, Registered on 28/7/2015.
Literature
1.
go back to reference Department of Health PA, Health Improvement and Protection. Start active, stay active: a report on physical activity for health from the four home countries’ chief medical officers. In: Department of Health PA, Health Improvement and Protection. London: Department of Health; 2011. Department of Health PA, Health Improvement and Protection. Start active, stay active: a report on physical activity for health from the four home countries’ chief medical officers. In: Department of Health PA, Health Improvement and Protection. London: Department of Health; 2011.
2.
go back to reference Ortega FB, Ruiz JR, Hurtig-Wennlof A, Vicente-Rodriguez G, Rizzo NS, Castillo MJ, et al. Cardiovascular fitness modifies the associations between physical activity and abdominal adiposity in children and adolescents: the European youth heart study. Br J Sports Med. 2010;44(4):256–62.PubMed Ortega FB, Ruiz JR, Hurtig-Wennlof A, Vicente-Rodriguez G, Rizzo NS, Castillo MJ, et al. Cardiovascular fitness modifies the associations between physical activity and abdominal adiposity in children and adolescents: the European youth heart study. Br J Sports Med. 2010;44(4):256–62.PubMed
3.
go back to reference Kumar B, Robinson R, Till S. Physical activity and health in adolescence. Clin Med (Lond). 2015;15(3):267–72. Kumar B, Robinson R, Till S. Physical activity and health in adolescence. Clin Med (Lond). 2015;15(3):267–72.
4.
go back to reference Strong WB, Malina RM, Blimkie CJ, Daniels SR, Dishman RK, Gutin B, et al. Evidence based physical activity for school-age youth. J Pediatr. 2005;146(6):732–7.PubMed Strong WB, Malina RM, Blimkie CJ, Daniels SR, Dishman RK, Gutin B, et al. Evidence based physical activity for school-age youth. J Pediatr. 2005;146(6):732–7.PubMed
5.
go back to reference Ekelund U, Luan J, Sherar LB, Esliger DW, Griew P, Cooper A, et al. Moderate to vigorous physical activity and sedentary time and cardiometabolic risk factors in children and adolescents. JAMA. 2012;307(7):704–12.PubMedPubMedCentral Ekelund U, Luan J, Sherar LB, Esliger DW, Griew P, Cooper A, et al. Moderate to vigorous physical activity and sedentary time and cardiometabolic risk factors in children and adolescents. JAMA. 2012;307(7):704–12.PubMedPubMedCentral
6.
go back to reference 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.PubMed 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.PubMed
7.
go back to reference Corder K, Sharp SJ, Atkin AJ, Andersen LB, Cardon G, Page A, et al. Age-related patterns of vigorous-intensity physical activity in youth: the international Children's Accelerometry database. Prev Med Rep. 2016;4:17–22.PubMedPubMedCentral Corder K, Sharp SJ, Atkin AJ, Andersen LB, Cardon G, Page A, et al. Age-related patterns of vigorous-intensity physical activity in youth: the international Children's Accelerometry database. Prev Med Rep. 2016;4:17–22.PubMedPubMedCentral
8.
go back to reference Dumith SC, Gigante DP, Domingues MR, Kohl HW 3rd. Physical activity change during adolescence: a systematic review and a pooled analysis. Int J Epidemiol. 2011;40(3):685–98.PubMed Dumith SC, Gigante DP, Domingues MR, Kohl HW 3rd. Physical activity change during adolescence: a systematic review and a pooled analysis. Int J Epidemiol. 2011;40(3):685–98.PubMed
9.
go back to reference Collings PJ, Wijndaele K, Corder K, Westgate K, Ridgway CL, Dunn V, et al. Levels and patterns of objectively-measured physical activity volume and intensity distribution in UK adolescents: the ROOTS study. Int J Behav Nutr Phys Act. 2014;11:23.PubMedPubMedCentral Collings PJ, Wijndaele K, Corder K, Westgate K, Ridgway CL, Dunn V, et al. Levels and patterns of objectively-measured physical activity volume and intensity distribution in UK adolescents: the ROOTS study. Int J Behav Nutr Phys Act. 2014;11:23.PubMedPubMedCentral
10.
go back to reference Eime RM, Harvey JT, Sawyer NA, Craike MJ, Symons CM, Payne WR. Changes in sport and physical activity participation for adolescent females: a longitudinal study. BMC Public Health. 2016;16:533.PubMedPubMedCentral Eime RM, Harvey JT, Sawyer NA, Craike MJ, Symons CM, Payne WR. Changes in sport and physical activity participation for adolescent females: a longitudinal study. BMC Public Health. 2016;16:533.PubMedPubMedCentral
11.
go back to reference Love R, Adams J, van Sluijs EMF. Are school-based physical activity interventions effective and equitable? A meta-analysis of cluster randomized controlled trials with accelerometer-assessed activity. Obes Rev. 2019;20(6):859–70.PubMedPubMedCentral Love R, Adams J, van Sluijs EMF. Are school-based physical activity interventions effective and equitable? A meta-analysis of cluster randomized controlled trials with accelerometer-assessed activity. Obes Rev. 2019;20(6):859–70.PubMedPubMedCentral
12.
go back to reference Moore GF, Audrey S, Barker M, Bond L, Bonell C, Hardeman W, et al. Process evaluation of complex interventions: medical research council guidance. BMJ. 2015;350:h1258.PubMedPubMedCentral Moore GF, Audrey S, Barker M, Bond L, Bonell C, Hardeman W, et al. Process evaluation of complex interventions: medical research council guidance. BMJ. 2015;350:h1258.PubMedPubMedCentral
13.
go back to reference Sebire SJ, Edwards MJ, Campbell R, Jago R, Kipping R, Banfield K, et al. Protocol for a feasibility cluster randomised controlled trial of a peer-led school-based intervention to increase the physical activity of adolescent girls (PLAN-A). Pilot Feasibility Stud. 2016;2:2.PubMedPubMedCentral Sebire SJ, Edwards MJ, Campbell R, Jago R, Kipping R, Banfield K, et al. Protocol for a feasibility cluster randomised controlled trial of a peer-led school-based intervention to increase the physical activity of adolescent girls (PLAN-A). Pilot Feasibility Stud. 2016;2:2.PubMedPubMedCentral
14.
go back to reference Sebire SJ, Jago R, Banfield K, Edwards MJ, Campbell R, Kipping R, et al. Results of a feasibility cluster randomised controlled trial of a peer-led school-based intervention to increase the physical activity of adolescent girls (PLAN-A). Int J Behav Nutr Phys Act. 2018;15(1):50.PubMedPubMedCentral Sebire SJ, Jago R, Banfield K, Edwards MJ, Campbell R, Kipping R, et al. Results of a feasibility cluster randomised controlled trial of a peer-led school-based intervention to increase the physical activity of adolescent girls (PLAN-A). Int J Behav Nutr Phys Act. 2018;15(1):50.PubMedPubMedCentral
15.
go back to reference Campbell R, Starkey F, Holliday J, Audrey S, Bloor M, Parry-Langdon N, et al. An informal school-based peer-led intervention for smoking prevention in adolescence (ASSIST): a cluster randomised trial. Lancet. 2008;371(9624):1595–602.PubMedPubMedCentral Campbell R, Starkey F, Holliday J, Audrey S, Bloor M, Parry-Langdon N, et al. An informal school-based peer-led intervention for smoking prevention in adolescence (ASSIST): a cluster randomised trial. Lancet. 2008;371(9624):1595–602.PubMedPubMedCentral
16.
go back to reference Rogers EM. Diffusion of innovations. NY: The Free Press; 1983. Rogers EM. Diffusion of innovations. NY: The Free Press; 1983.
17.
go back to reference Deci EL, Ryan RM. The “what” and “why” of goal pursuits: human needs and the self-determination of behavior. Psychol Inq. 2000;11(4):227–68. Deci EL, Ryan RM. The “what” and “why” of goal pursuits: human needs and the self-determination of behavior. Psychol Inq. 2000;11(4):227–68.
18.
go back to reference Standage M, Ryan RM. Self-determination theory and exercise motivation: facilitating self-regulatory processes to support and maintain health and well-being. In: Roberts GC, Treasure DC, editors. Advances in motivation in sport and exercise. 3rd ed. Champaign: Human Kinetics; 2012. p. 233–70. Standage M, Ryan RM. Self-determination theory and exercise motivation: facilitating self-regulatory processes to support and maintain health and well-being. In: Roberts GC, Treasure DC, editors. Advances in motivation in sport and exercise. 3rd ed. Champaign: Human Kinetics; 2012. p. 233–70.
19.
go back to reference Amorose AJ, Anderson-Butcher D. Autonomy-supportive coaching and self-determined motivation in high school and college athletes: a test of self-determination theory. Psychol Sport Exerc. 2007;8:654–70. Amorose AJ, Anderson-Butcher D. Autonomy-supportive coaching and self-determined motivation in high school and college athletes: a test of self-determination theory. Psychol Sport Exerc. 2007;8:654–70.
21.
go back to reference Audrey S, Holliday J, Campbell R. It's good to talk: adolescent perspectives of an informal, peer-led intervention to reduce smoking. Soc Sci Med. 2006;63(2):320–34.PubMed Audrey S, Holliday J, Campbell R. It's good to talk: adolescent perspectives of an informal, peer-led intervention to reduce smoking. Soc Sci Med. 2006;63(2):320–34.PubMed
22.
go back to reference Smith LH. Piloting the use of teen mentors to promote a healthy diet and physical activity among children in Appalachia. J Spec Pediatr Nurs. 2011;16(1):16–26.PubMed Smith LH. Piloting the use of teen mentors to promote a healthy diet and physical activity among children in Appalachia. J Spec Pediatr Nurs. 2011;16(1):16–26.PubMed
23.
go back to reference Tymms PB, Curtis SE, Routen AC, Thomson KH, Bolden DS, Bock S, et al. Clustered randomised controlled trial of two education interventions designed to increase physical activity and well-being of secondary school students: the MOVE project. BMJ Open. 2016;6(1):e009318.PubMedPubMedCentral Tymms PB, Curtis SE, Routen AC, Thomson KH, Bolden DS, Bock S, et al. Clustered randomised controlled trial of two education interventions designed to increase physical activity and well-being of secondary school students: the MOVE project. BMJ Open. 2016;6(1):e009318.PubMedPubMedCentral
24.
go back to reference Corder K, Brown HE, Schiff A, van Sluijs EM. Feasibility study and pilot cluster-randomised controlled trial of the GoActive intervention aiming to promote physical activity among adolescents: outcomes and lessons learnt. BMJ Open. 2016;6(11):e012335.PubMedPubMedCentral Corder K, Brown HE, Schiff A, van Sluijs EM. Feasibility study and pilot cluster-randomised controlled trial of the GoActive intervention aiming to promote physical activity among adolescents: outcomes and lessons learnt. BMJ Open. 2016;6(11):e012335.PubMedPubMedCentral
25.
go back to reference Santos RG, Durksen A, Rabbanni R, Chanoine JP, Lamboo Miln A, Mayer T, et al. Effectiveness of peer-based healthy living lesson plans on anthropometric measures and physical activity in elementary school students: a cluster randomized trial. JAMA Pediatr. 2014;168(4):330–7.PubMed Santos RG, Durksen A, Rabbanni R, Chanoine JP, Lamboo Miln A, Mayer T, et al. Effectiveness of peer-based healthy living lesson plans on anthropometric measures and physical activity in elementary school students: a cluster randomized trial. JAMA Pediatr. 2014;168(4):330–7.PubMed
26.
go back to reference Fortier MS, Duda JL, Guerin E, Teixeira PJ. Promoting physical activity: development and testing of self-determination theory-based interventions. Int J Behav Nutr Phys Act. 2012;9:20.PubMedPubMedCentral Fortier MS, Duda JL, Guerin E, Teixeira PJ. Promoting physical activity: development and testing of self-determination theory-based interventions. Int J Behav Nutr Phys Act. 2012;9:20.PubMedPubMedCentral
27.
go back to reference Sparks C, Dimmock J, Whipp P, Lonsdale C, Jackson B. “Getting connected”: high school physical education teacher behaviors that facilitate students’ relatedness support perceptions. Sport Exerc Perform Psychol. 2015;4(3):219–36. Sparks C, Dimmock J, Whipp P, Lonsdale C, Jackson B. “Getting connected”: high school physical education teacher behaviors that facilitate students’ relatedness support perceptions. Sport Exerc Perform Psychol. 2015;4(3):219–36.
28.
go back to reference Sebire SJ, Kesten JM, Edwards MJ, May T, Banfield K, Tomkinson K, et al. Using self-determination theory to promote adolescent girls' physical activity: exploring the theoretical fidelity of the Bristol girls dance project. Psychol Sport Exerc. 2016;24:100–10.PubMedPubMedCentral Sebire SJ, Kesten JM, Edwards MJ, May T, Banfield K, Tomkinson K, et al. Using self-determination theory to promote adolescent girls' physical activity: exploring the theoretical fidelity of the Bristol girls dance project. Psychol Sport Exerc. 2016;24:100–10.PubMedPubMedCentral
29.
go back to reference Sebire SJ, Edwards MJ, Fox KR, Davies B, Banfield K, Wood L, et al. Delivery and receipt of a self-determination theory-based extra-curricular physical activity intervention: exploring theoretical fidelity in action 3:30. J Sport Exerc Psychol. 2016;38(4):1–36.PubMed Sebire SJ, Edwards MJ, Fox KR, Davies B, Banfield K, Wood L, et al. Delivery and receipt of a self-determination theory-based extra-curricular physical activity intervention: exploring theoretical fidelity in action 3:30. J Sport Exerc Psychol. 2016;38(4):1–36.PubMed
30.
go back to reference Su Y, Reeve J. A meta-analysis of the effectiveness of inervention programs designed to support autonomy. Educ Psychol Rev. 2011;23(1):159–88. Su Y, Reeve J. A meta-analysis of the effectiveness of inervention programs designed to support autonomy. Educ Psychol Rev. 2011;23(1):159–88.
31.
go back to reference Dobbie F, Purves R, McKell J, Dougall N, White J, Campbell R, et al. A process evaluation of the implementation of ASSIST in Scotland: final report. Stirling: University of Stirling; 2017. Dobbie F, Purves R, McKell J, Dougall N, White J, Campbell R, et al. A process evaluation of the implementation of ASSIST in Scotland: final report. Stirling: University of Stirling; 2017.
32.
go back to reference Sebire SJ, Edwards MJ, Fox KR, Davies B, Banfield K, Wood L, et al. Delivery and receipt of a self-determination-theory-based extracurricular physical activity intervention: exploring theoretical Fidelity in action 3:30. J Sport Exerc Psychol. 2016;38(4):381–95.PubMed Sebire SJ, Edwards MJ, Fox KR, Davies B, Banfield K, Wood L, et al. Delivery and receipt of a self-determination-theory-based extracurricular physical activity intervention: exploring theoretical Fidelity in action 3:30. J Sport Exerc Psychol. 2016;38(4):381–95.PubMed
Metadata
Title
A process evaluation of the PLAN-A intervention (Peer-Led physical Activity iNtervention for Adolescent girls)
Authors
Simon J. Sebire
Kathryn Banfield
Russell Jago
Mark J. Edwards
Rona Campbell
Ruth Kipping
Peter S. Blair
Bryar Kadir
Kirsty Garfield
Joe Matthews
Ronan A. Lyons
William Hollingworth
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2019
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-019-7545-z

Other articles of this Issue 1/2019

BMC Public Health 1/2019 Go to the issue