Effect and cost of an after-school dance programme on the physical activity of 11–12 year old girls: The Bristol Girls Dance Project, a school-based cluster randomised controlled trial

Abstract

BackgroundThe aim of this study was to examine the effectiveness and cost of an after-school dance intervention at increasing the physical activity levels of Year 7 girls (age 11–12).MethodsA cluster randomised controlled trial was conducted in 18 secondary schools. Participants were Year 7 girls attending a study school. The Bristol Girls Dance Project (BGDP) intervention consisted of up to forty, 75-minute dance sessions delivered in the period immediately after school by experienced dance instructors over 20-weeks. The pre-specified primary outcome was accelerometer assessed mean minutes of weekday moderate to vigorous physical activity (MVPA) at time 2 (52 weeks are T0 baseline assessments). Secondary outcomes included accelerometer assessed mean minutes of weekday MVPA at time 1 (while the intervention was still running) and psychosocial outcomes. Intervention costs were assessed.Results571 girls participated. Valid accelerometer data were collected from 549 girls at baseline with 508 girls providing valid accelerometer data at baseline and time 2. There were no differences between the intervention and control group for accelerometer assessed physical activity at either time 1 or time 2. Only one third of the girls in the intervention arm met the pre-set adherence criteria of attending two thirds of the dance sessions that were available to them. Instrumental variable regression analyses using complier average causal effects provided no evidence of a difference between girls who attended the sessions and the control group. The average cost of the intervention was £73 per girl, which was reduced to £63 when dance instructor travel expenses were excluded.ConclusionThis trial showed no evidence that an after-school dance programme can increase the physical activity of Year 7 girls. The trial highlighted the difficulty encountered in maintaining attendance in physical activity programmes delivered in secondary schools. There is a need to find new ways to help adolescent girls to be physically active via identifying ways to support and encourage sustained engagement in physical activity over the life course.Trial registrationISRCTN52882523Electronic supplementary materialThe online version of this article (doi:10.1186/s12966-015-0289-y) contains supplementary material, which is available to authorized users.

The theory of expanded, extended, and enhanced opportunities for youth physical activity promotion

“…These two studies focused on the introduction of a new physical activity opportunity two to three days per week in the hours immediately after the end of the school day [26, 27]. The interventions were grounded in the Self Determination Theory and/or the Social Cognitive Theory and were designed to promote behavioral skills for engaging in physical activity outside of the program, as well as to promote physical activity during the program by offering different choices for physical activity within an autonomy-supported environment.…”

“…Hence, we believe these efforts are largely misplaced in assuming children and adolescents are autonomous agents in their physical activity decision making. The literature, however, would suggest that youth are largely active when provided either compulsory activity opportunities or opt to participate in voluntary activity opportunities [26, 27, 56, 62, 67, 72, 77, 88–91]. Because of this, when interventions incorporate one or more of the three approaches, effort should be directed at those involved in making decisions surrounding expansion, extension, or enhancement.…”

“…Studies that developed new physical activity opportunities in the hours after the school day consistently report attendance is less than optimal [26, 27, 95–97]. However, when youth do attend these voluntary opportunities they exhibit higher levels of physical activity compared to days they do not attend or the program does not operate [26, 27]. Given this, expanding voluntary physical activity opportunities is highly effective at increasing PA for those youth who attend.…”

“…The question is then, “How do we get more youth to attend (and/or keep attending) such programs?” Extensive formative work went into the development of these voluntary physical activity opportunities to ensure the program provided activities that were either culturally tailored or had other programmatic components that appealed to the target population [26, 95]. Moreover, these studies delivered activities founded in complex behavioral theory designed to maximize motivation for involvement both within and outside of program operating hours [26, 27]. For example, one study [26] conducted extensive formative work to design an after-school program that appealed to girls [98, 99].…”

“…These mechanisms also lack a common taxonomy by which the scientific literature refers to them when applied across various settings and contexts within an intervention. Interventions that do include one or more of these are mostly devoid of explanations about how and why such approaches should lead to changes in youth physical activity [26, 27]. This renders their perceived contribution to the overall effectiveness of an intervention as subsidiary to the classical theoretical constructs or models guiding an intervention’s development.…”