Active children through individual vouchers – evaluation (ACTIVE): protocol for a mixed method randomised control trial to increase physical activity levels in teenagers

Abstract

BackgroundMany teenagers are insufficiently active despite the health benefits of physical activity (PA). There is strong evidence to show that inactivity and low fitness levels increase the risk of non-communicable diseases such as coronary heart disease (CHD), type 2 diabetes and breast and colon cancers (Lee et al. Lancet 380:219–29, 2012). A major barrier facing adolescents is accessibility (e.g. cost and lack of local facilities). The ACTIVE project aims to tackle this barrier through a multi-faceted intervention, giving teenagers vouchers to spend on activities of their choice and empowering young people to improve their fitness and PA levels.DesignACTIVE is a mixed methods randomised control trial in 7 secondary schools in Swansea, South Wales. Quantitative and qualitative measures including PA (cooper run test (CRT), accelerometery over 7 days), cardiovascular (CV) measures (blood pressure, pulse wave analysis) and focus groups will be undertaken at 4 separate time points (baseline, 6 months,12 months and follow-up at 18 months). Intervention schools will receive a multi-component intervention involving 12 months of £20 vouchers to spend on physical activities of their choice, a peer mentor scheme and opportunities to attend advocacy meetings. Control schools are encouraged to continue usual practice. The primary aim is to examine the effect of the intervention in improving cardiovascular fitness.DiscussionThis paper describes the protocol for the ACTIVE randomised control trial, which aims to increase fitness, physical activity and socialisation of teenagers in Swansea, UK via a voucher scheme combined with peer mentoring. Results can contribute to the evidence base on teenage physical activity and, if effective, the intervention has the potential to inform future physical activity interventions and policy.Trial registration ISRCTN75594310 (Assigned 06/03/2017).

Active Children Through Individual Vouchers Evaluation: A Mixed-Method RCT

“…A detailed protocol has been published. 22 The College of Human and Health Science Ethics Committee granted ACTIVE ethical approval (reference: 090516).…”

“…The measures examined for this paper are listed below, and a more detailed explanation including power calculations can be found in the protocol paper. 22 A total of 13 schools were assessed for eligibility; 4 did not meet inclusion criteria of being located in one of Wales' most deprived areas. School-level deprivation was derived from the Welsh Index of Multiple Deprivation (WIMD), which is used to identify areas of deprivation based on income, employment, health, education, access to services, community safety, environment, and housing.…”

“…Teenagers received PA vouchers of £20 (4 vouchers in increments of £5) each month for 12 months. 22 Vouchers could be spent on existing PA provision (e.g., gym membership or sports clubs) or could be used to bring new activities into communities or schools. They could also purchase equipment.…”

“…17,18 Financial incentives have been effective in increasing PA in adults, 19−21 but it remains uncertain whether a similar approach could work with teenagers. 22 A mixed-method feasibility study of vouchers has been carried out in 1 school with high levels of deprivation. The vouchers were used to empower teenagers to be consumers and enabled access to activities they normally could not afford.…”

“…The Active Children Through Individual Vouchers Evaluation (ACTIVE) mixed-method RCT 22 was developed following the feasibility study and subsequent conversations with teenagers recommending what they felt was needed to improve PA opportunities and fitness. 4 This RCT aimed to assess whether a voucher-based, 12-month, multicomponent intervention can improve the cardiovascular fitness and cardiovascular health of participating teenagers in 4 intervention (compared with 3 control) secondary schools in South Wales.…”