Using facilitator–receiver peer dyads matched according to socioeconomic status to promote behaviour change in overweight adolescents: a feasibility study

Abstract

ObjectiveTo evaluate the feasibility of an innovative peer intervention promoting healthy eating and physical activity, which purposefully selected peer facilitators according to socioeconomic status to target less-advantaged overweight receivers.SettingNine high schools, two middle schools.ParticipantsOne hundred and fifty-six adolescents were approached to become facilitators, of whom 18 were trained. Thirty-two of 56 potential receivers agreed to participate.InterventionThe peer intervention was carried out in 2013–2014 and embedded in a larger trial: PRALIMAP-INÈS (Promotion de l’ALIMentation et l’Activité Physique-INEgalité de Santé). Facilitanoators were selected and trained to organise weight-control activities with specific peer receivers participating in the programme.Primary and secondary outcome measuresDifferent types of data were collected to assess demand, acceptability, implementation and practicality of the intervention. For the facilitators, this included 6 training sessions, 11 mid-programme interviews, 4 end-of-programme sessions, telephone notes and text message exchanges. All six potential receivers in one school were also interviewed. Sociodemographic and health characteristics were also analysed.ResultsAgreeing to participate was more likely when asked by a peer compared with a professional (51.2% discordant pairs; p<0.02). Twelve activities, mostly based on physical activity and implemented during weekends or holidays, were carried out. The mean age of active receivers was 16 and their body mass index was higher than other participants. For both facilitators and active receivers, there were more participating girls. Qualitative analysis reveals key implementation challenges for facilitators. Interviews with the receivers highlight social difficulties, with most feeling bad about their appearance and wanting to lose weight. Those who participated in peer activities were very positive about the experience especially social support.ConclusionsThe present study suggests the peer intervention is feasible provided organisational difficulties are addressed. Good practice recommendations are formulated, including a longer training session, organising a joint meeting with the facilitators and receivers, matching dyads on place of residence and multiplying modes of contact.Trial registration numberNCT01688453.

Changes in Physical Activity Behaviour and Psychosocial Correlates Unique to the Transition from Primary to Secondary Schooling in Adolescent Females: A Longitudinal Cohort Study

“…An American study found that a physical activity decline over a three year period, which encompassed a move from elementary to middle school (akin to the move from primary to secondary school in this study), was least pronounced in those students who perceived more parent and friend support compared to those who reported the largest decrease in friend support [13]. The few physical activity interventions that have specifically targeted the peer environment had little or no success in influencing daily physical activity levels [27][28][29]. Arguably, cross-sectional associations reported in much of the literature may be bi-directional, in that active adolescents may associate socially with like-minded and, therefore, supportive peers.…”

Themes in Train-the-Trainer Nutrition Education Interventions Targeting Middle School Students: A Systematic Review

“…The screening process identified 48 papers meeting the criteria for inclusion in the review, representing 39 unique interventions. An additional five papers were identified during the full text review that pertained to included interventions, for a total of 53 papers used in the data extraction process [ 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , …”

“…The framework shown in Table 1 above was applied to each of the 39 interventions to divide them into categories. Eight of the interventions [ 21 , 40 , 45 , 52 , 53 , 59 , 65 , 70 , 72 , 73 ] included two different groups that were trained as facilitators, so they were included in both applicable categories. Two interventions [ 33 , 46 , 47 ] had both an in-class curriculum component and an out-of-school component where students interacted with professional athletes; these are included in both groups A and D. Five interventions trained the target population themselves to deliver the intervention to others.…”

“…Four of the interventions took place either during the school lunch period or after school. Same-age peers promoted healthy eating and conducted taste tests in the cafeteria [ 24 , 25 , 26 ], planned their own events with peers [ 65 ], or taught lessons and promoted nutrition messages through club activities [ 68 ]. The remaining three interventions involved a small group of the target population who participated in afterschool programs where nutrition was incorporated into another activity.…”

“…Our first dimension for synthesis of themes centered on train-the trainer approaches, and we found that engaging sessions that provide opportunities for role play and talking through scenarios that may arise with the target youth were well-received [ 49 , 50 , 51 , 56 , 57 , 70 , 72 , 73 ], especially when those being trained were cross-age or same-age peers [ 24 , 25 , 38 , 65 ]. For example, the Foley et al paper describes trainers interactively teaching the curriculum to cross-age peers and then giving the youth the opportunity to practice teaching the lessons during the training [ 38 ].…”