A cluster randomised trial of an intervention to increase the implementation of physical activity practices in secondary schools: study protocol for scaling up the Physical Activity 4 Everyone (PA4E1) program
Abstract Background The implementation of interventions at-scale is required to maximise population health benefits. ‘Physical Activity 4 Everyone (PA4E1)’ was a multi-component school-based program targeting adolescents attending secondary schools in low socio-economic areas. An efficacy trial of t...
| Main Authors: | , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2019-07-01
|
| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12889-019-6965-0 |
| _version_ | 1818547848993570816 |
|---|---|
| author | Rachel Sutherland Elizabeth Campbell Nicole Nathan Luke Wolfenden David R. Lubans Philip J. Morgan Karen Gillham Chris Oldmeadow Andrew Searles Penny Reeves Mandy Williams Nicole Evans Andrew Bailey Ross Morrison Matthew McLaughlin John Wiggers |
| author_facet | Rachel Sutherland Elizabeth Campbell Nicole Nathan Luke Wolfenden David R. Lubans Philip J. Morgan Karen Gillham Chris Oldmeadow Andrew Searles Penny Reeves Mandy Williams Nicole Evans Andrew Bailey Ross Morrison Matthew McLaughlin John Wiggers |
| author_sort | Rachel Sutherland |
| collection | DOAJ |
| description | Abstract Background The implementation of interventions at-scale is required to maximise population health benefits. ‘Physical Activity 4 Everyone (PA4E1)’ was a multi-component school-based program targeting adolescents attending secondary schools in low socio-economic areas. An efficacy trial of the intervention demonstrated an increase in students’ mean minutes of moderate-to-vigorous physical activity (MVPA) per day and lower weight gain at low incremental cost. This study aims to assess the effectiveness and cost effectiveness of a multi-component implementation support intervention to improve implementation, at-scale, of the evidence based school physical activity (PA) practices of the PA4E1 program. Impact on student PA levels and adiposity will also be assessed, in addition to the cost of implementation. Methods A cluster randomised controlled trial, utilising an effectiveness-implementation hybrid design, will be conducted in up to 76 secondary schools located in lower socio-economic areas across four health districts in New South Wales (NSW), Australia. Schools will be randomly allocated to a usual practice control arm or a multi-component implementation support intervention to embed the seven school PA practices of the PA4E1 program. The implementation support intervention incorporates seven strategies including executive support, in-School Champion, teacher training, resources, prompts, audit and feedback and access to an external Support Officer. The primary trial outcome will be the proportion of schools meeting at least four of the seven physical activity practices of the program, assessed via surveys with Head Physical Education teachers at 12 and 24-months. Secondary outcomes will be assessed via a nested evaluation of student PA and adiposity at 12-months (Grade 8 students) and 24 months (Grade 9 students) undertaken in 30 schools (15 per group). Resource use associated with the implementation intervention will be measured prospectively. Linear mixed effects regression models will assess program effects on the primary outcome at each follow-up period. Discussion This study is one of few evidence-based multi-component PA programs scaled-up to a large number of secondary schools and evaluated via randomised controlled trial. The use of implementation science theoretical frameworks to implement the evidence-based program and the rigorous evaluation design are strengths of the study. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12617000681358 registered 12th May 2017. Protocol Version 1. |
| first_indexed | 2024-12-12T08:12:09Z |
| format | Article |
| id | doaj.art-cd94b722c9974cfc945322fde52c78d1 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-12-12T08:12:09Z |
| publishDate | 2019-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-cd94b722c9974cfc945322fde52c78d12022-12-22T00:31:45ZengBMCBMC Public Health1471-24582019-07-0119111410.1186/s12889-019-6965-0A cluster randomised trial of an intervention to increase the implementation of physical activity practices in secondary schools: study protocol for scaling up the Physical Activity 4 Everyone (PA4E1) programRachel Sutherland0Elizabeth Campbell1Nicole Nathan2Luke Wolfenden3David R. Lubans4Philip J. Morgan5Karen Gillham6Chris Oldmeadow7Andrew Searles8Penny Reeves9Mandy Williams10Nicole Evans11Andrew Bailey12Ross Morrison13Matthew McLaughlin14John Wiggers15Hunter New England Population HealthHunter New England Population HealthHunter New England Population HealthHunter New England Population HealthPriority Research Centre in Physical Activity and Nutrition, School of Education, University of NewcastlePriority Research Centre in Physical Activity and Nutrition, School of Education, University of NewcastleHunter New England Population HealthHunter Medical Research InstituteHunter Medical Research InstituteSchool of Medicine and Public Health, University of NewcastleSouth Western Sydney Local Health DistrictCentral Coast Local Health DistrictMid North Coast Local Health DistrictNew South Waled Department of Education, Schools Sports UnitHunter New England Population HealthHunter New England Population HealthAbstract Background The implementation of interventions at-scale is required to maximise population health benefits. ‘Physical Activity 4 Everyone (PA4E1)’ was a multi-component school-based program targeting adolescents attending secondary schools in low socio-economic areas. An efficacy trial of the intervention demonstrated an increase in students’ mean minutes of moderate-to-vigorous physical activity (MVPA) per day and lower weight gain at low incremental cost. This study aims to assess the effectiveness and cost effectiveness of a multi-component implementation support intervention to improve implementation, at-scale, of the evidence based school physical activity (PA) practices of the PA4E1 program. Impact on student PA levels and adiposity will also be assessed, in addition to the cost of implementation. Methods A cluster randomised controlled trial, utilising an effectiveness-implementation hybrid design, will be conducted in up to 76 secondary schools located in lower socio-economic areas across four health districts in New South Wales (NSW), Australia. Schools will be randomly allocated to a usual practice control arm or a multi-component implementation support intervention to embed the seven school PA practices of the PA4E1 program. The implementation support intervention incorporates seven strategies including executive support, in-School Champion, teacher training, resources, prompts, audit and feedback and access to an external Support Officer. The primary trial outcome will be the proportion of schools meeting at least four of the seven physical activity practices of the program, assessed via surveys with Head Physical Education teachers at 12 and 24-months. Secondary outcomes will be assessed via a nested evaluation of student PA and adiposity at 12-months (Grade 8 students) and 24 months (Grade 9 students) undertaken in 30 schools (15 per group). Resource use associated with the implementation intervention will be measured prospectively. Linear mixed effects regression models will assess program effects on the primary outcome at each follow-up period. Discussion This study is one of few evidence-based multi-component PA programs scaled-up to a large number of secondary schools and evaluated via randomised controlled trial. The use of implementation science theoretical frameworks to implement the evidence-based program and the rigorous evaluation design are strengths of the study. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12617000681358 registered 12th May 2017. Protocol Version 1.http://link.springer.com/article/10.1186/s12889-019-6965-0Physical activityAdolescentsSchoolRandomised controlled trial, implementation, multi-component, scale-up |
| spellingShingle | Rachel Sutherland Elizabeth Campbell Nicole Nathan Luke Wolfenden David R. Lubans Philip J. Morgan Karen Gillham Chris Oldmeadow Andrew Searles Penny Reeves Mandy Williams Nicole Evans Andrew Bailey Ross Morrison Matthew McLaughlin John Wiggers A cluster randomised trial of an intervention to increase the implementation of physical activity practices in secondary schools: study protocol for scaling up the Physical Activity 4 Everyone (PA4E1) program BMC Public Health Physical activity Adolescents School Randomised controlled trial, implementation, multi-component, scale-up |
| title | A cluster randomised trial of an intervention to increase the implementation of physical activity practices in secondary schools: study protocol for scaling up the Physical Activity 4 Everyone (PA4E1) program |
| title_full | A cluster randomised trial of an intervention to increase the implementation of physical activity practices in secondary schools: study protocol for scaling up the Physical Activity 4 Everyone (PA4E1) program |
| title_fullStr | A cluster randomised trial of an intervention to increase the implementation of physical activity practices in secondary schools: study protocol for scaling up the Physical Activity 4 Everyone (PA4E1) program |
| title_full_unstemmed | A cluster randomised trial of an intervention to increase the implementation of physical activity practices in secondary schools: study protocol for scaling up the Physical Activity 4 Everyone (PA4E1) program |
| title_short | A cluster randomised trial of an intervention to increase the implementation of physical activity practices in secondary schools: study protocol for scaling up the Physical Activity 4 Everyone (PA4E1) program |
| title_sort | cluster randomised trial of an intervention to increase the implementation of physical activity practices in secondary schools study protocol for scaling up the physical activity 4 everyone pa4e1 program |
| topic | Physical activity Adolescents School Randomised controlled trial, implementation, multi-component, scale-up |
| url | http://link.springer.com/article/10.1186/s12889-019-6965-0 |
| work_keys_str_mv | AT rachelsutherland aclusterrandomisedtrialofaninterventiontoincreasetheimplementationofphysicalactivitypracticesinsecondaryschoolsstudyprotocolforscalingupthephysicalactivity4everyonepa4e1program AT elizabethcampbell aclusterrandomisedtrialofaninterventiontoincreasetheimplementationofphysicalactivitypracticesinsecondaryschoolsstudyprotocolforscalingupthephysicalactivity4everyonepa4e1program AT nicolenathan aclusterrandomisedtrialofaninterventiontoincreasetheimplementationofphysicalactivitypracticesinsecondaryschoolsstudyprotocolforscalingupthephysicalactivity4everyonepa4e1program AT lukewolfenden aclusterrandomisedtrialofaninterventiontoincreasetheimplementationofphysicalactivitypracticesinsecondaryschoolsstudyprotocolforscalingupthephysicalactivity4everyonepa4e1program AT davidrlubans aclusterrandomisedtrialofaninterventiontoincreasetheimplementationofphysicalactivitypracticesinsecondaryschoolsstudyprotocolforscalingupthephysicalactivity4everyonepa4e1program AT philipjmorgan aclusterrandomisedtrialofaninterventiontoincreasetheimplementationofphysicalactivitypracticesinsecondaryschoolsstudyprotocolforscalingupthephysicalactivity4everyonepa4e1program AT karengillham aclusterrandomisedtrialofaninterventiontoincreasetheimplementationofphysicalactivitypracticesinsecondaryschoolsstudyprotocolforscalingupthephysicalactivity4everyonepa4e1program AT chrisoldmeadow aclusterrandomisedtrialofaninterventiontoincreasetheimplementationofphysicalactivitypracticesinsecondaryschoolsstudyprotocolforscalingupthephysicalactivity4everyonepa4e1program AT andrewsearles aclusterrandomisedtrialofaninterventiontoincreasetheimplementationofphysicalactivitypracticesinsecondaryschoolsstudyprotocolforscalingupthephysicalactivity4everyonepa4e1program AT pennyreeves aclusterrandomisedtrialofaninterventiontoincreasetheimplementationofphysicalactivitypracticesinsecondaryschoolsstudyprotocolforscalingupthephysicalactivity4everyonepa4e1program AT mandywilliams aclusterrandomisedtrialofaninterventiontoincreasetheimplementationofphysicalactivitypracticesinsecondaryschoolsstudyprotocolforscalingupthephysicalactivity4everyonepa4e1program AT nicoleevans aclusterrandomisedtrialofaninterventiontoincreasetheimplementationofphysicalactivitypracticesinsecondaryschoolsstudyprotocolforscalingupthephysicalactivity4everyonepa4e1program AT andrewbailey aclusterrandomisedtrialofaninterventiontoincreasetheimplementationofphysicalactivitypracticesinsecondaryschoolsstudyprotocolforscalingupthephysicalactivity4everyonepa4e1program AT rossmorrison aclusterrandomisedtrialofaninterventiontoincreasetheimplementationofphysicalactivitypracticesinsecondaryschoolsstudyprotocolforscalingupthephysicalactivity4everyonepa4e1program AT matthewmclaughlin aclusterrandomisedtrialofaninterventiontoincreasetheimplementationofphysicalactivitypracticesinsecondaryschoolsstudyprotocolforscalingupthephysicalactivity4everyonepa4e1program AT johnwiggers aclusterrandomisedtrialofaninterventiontoincreasetheimplementationofphysicalactivitypracticesinsecondaryschoolsstudyprotocolforscalingupthephysicalactivity4everyonepa4e1program AT rachelsutherland clusterrandomisedtrialofaninterventiontoincreasetheimplementationofphysicalactivitypracticesinsecondaryschoolsstudyprotocolforscalingupthephysicalactivity4everyonepa4e1program AT elizabethcampbell clusterrandomisedtrialofaninterventiontoincreasetheimplementationofphysicalactivitypracticesinsecondaryschoolsstudyprotocolforscalingupthephysicalactivity4everyonepa4e1program AT nicolenathan clusterrandomisedtrialofaninterventiontoincreasetheimplementationofphysicalactivitypracticesinsecondaryschoolsstudyprotocolforscalingupthephysicalactivity4everyonepa4e1program AT lukewolfenden clusterrandomisedtrialofaninterventiontoincreasetheimplementationofphysicalactivitypracticesinsecondaryschoolsstudyprotocolforscalingupthephysicalactivity4everyonepa4e1program AT davidrlubans clusterrandomisedtrialofaninterventiontoincreasetheimplementationofphysicalactivitypracticesinsecondaryschoolsstudyprotocolforscalingupthephysicalactivity4everyonepa4e1program AT philipjmorgan clusterrandomisedtrialofaninterventiontoincreasetheimplementationofphysicalactivitypracticesinsecondaryschoolsstudyprotocolforscalingupthephysicalactivity4everyonepa4e1program AT karengillham clusterrandomisedtrialofaninterventiontoincreasetheimplementationofphysicalactivitypracticesinsecondaryschoolsstudyprotocolforscalingupthephysicalactivity4everyonepa4e1program AT chrisoldmeadow clusterrandomisedtrialofaninterventiontoincreasetheimplementationofphysicalactivitypracticesinsecondaryschoolsstudyprotocolforscalingupthephysicalactivity4everyonepa4e1program AT andrewsearles clusterrandomisedtrialofaninterventiontoincreasetheimplementationofphysicalactivitypracticesinsecondaryschoolsstudyprotocolforscalingupthephysicalactivity4everyonepa4e1program AT pennyreeves clusterrandomisedtrialofaninterventiontoincreasetheimplementationofphysicalactivitypracticesinsecondaryschoolsstudyprotocolforscalingupthephysicalactivity4everyonepa4e1program AT mandywilliams clusterrandomisedtrialofaninterventiontoincreasetheimplementationofphysicalactivitypracticesinsecondaryschoolsstudyprotocolforscalingupthephysicalactivity4everyonepa4e1program AT nicoleevans clusterrandomisedtrialofaninterventiontoincreasetheimplementationofphysicalactivitypracticesinsecondaryschoolsstudyprotocolforscalingupthephysicalactivity4everyonepa4e1program AT andrewbailey clusterrandomisedtrialofaninterventiontoincreasetheimplementationofphysicalactivitypracticesinsecondaryschoolsstudyprotocolforscalingupthephysicalactivity4everyonepa4e1program AT rossmorrison clusterrandomisedtrialofaninterventiontoincreasetheimplementationofphysicalactivitypracticesinsecondaryschoolsstudyprotocolforscalingupthephysicalactivity4everyonepa4e1program AT matthewmclaughlin clusterrandomisedtrialofaninterventiontoincreasetheimplementationofphysicalactivitypracticesinsecondaryschoolsstudyprotocolforscalingupthephysicalactivity4everyonepa4e1program AT johnwiggers clusterrandomisedtrialofaninterventiontoincreasetheimplementationofphysicalactivitypracticesinsecondaryschoolsstudyprotocolforscalingupthephysicalactivity4everyonepa4e1program |