Effectiveness and cost-effectiveness of the GoActive intervention to increase physical activity among UK adolescents: A cluster randomised controlled trial

Abstract

Background Less than 20% of adolescents globally meet recommended levels of physical activity, and not meeting these recommended levels is associated with social disadvantage and rising disease risk. The determinants of physical activity in adolescents are multilevel and poorly understood, but the school's social environment likely plays an important role. We conducted a cluster randomised controlled trial to assess the effectiveness of a school-based programme (GoActive) to increase moderate-to-vigorous physical activity (MVPA) among adolescents. Methods and findings Non-fee-paying, coeducational schools including Year 9 students in the UK counties of Cambridgeshire and Essex were eligible for inclusion. Within participating schools (n = 16), all Year 9 students were eligible and invited to participate. Participants were 2,862 13-to 14year-olds (84% of eligible students). After baseline assessment, schools were computerrandomised, stratified by school-level pupil premium funding (below/above county-specific median) and county (control: 8 schools, 1,319 participants, mean [SD] participants per school n = 165 [62]; intervention: 8 schools, 1,543 participants, n = 193 [43]). Measurement staff were blinded to allocation. The iteratively developed, feasibility-tested 12-week intervention, aligned with self-determination theory, trained older adolescent mentors and inclass peer-leaders to encourage classes to conduct 2 new weekly activities. Students and classes gained points and rewards for engaging in any activity in or out of school. The

A School-Based Randomized Controlled Trial to Promote Cycling to School in Adolescents: The PACO Study

“…To summarize, doing research in schools is important to prevent unhealthy behaviours and related beliefs common in our society. Achieving a balance between the scientific requirements of randomized designs and the constraints imposed by real world circumstances is necessary to improve the quality of research conducted in educational settings [ 83 ]. It is also consistent with recent calls to achieve a balance between the established evidence-based pathway and a practice-based evidence pathway, and for a more nuanced approach to appraising the utility of diverse types of evidence [ 84 ].…”

“…However, there is evidence about the difficulty of changing behaviours though school-based interventions. For example, the rigorously developed school-based Go Active intervention was no more effective than standard school practice at increasing adolescent PA [ 83 ]. Therefore, mediators must be measured to identify the pathways for achieving future behaviour changes.…”

The reimagination of school-based physical activity research in the COVID-19 era

“…Corder and colleagues highlight issues with teacher burden ('time pressures') and future sustainability of the GoActive delivery model. The team trained peer mentors and had local authority-funded health trainers facilitate half of the delivery that ultimately negatively affected fidelity [6].…”

“…The Corder and colleagues paper in this PLOS Medicine special issue [6] is the latest example of such a trial. The authors report on the effectiveness and cost-effectiveness of a theorydriven, feasibility-tested physical activity promotion programme for 12 to 14 year olds in 16 UK secondary schools.…”

Reach, Recruitment, Dose, and Intervention Fidelity of the GoActive School-Based Physical Activity Intervention in the UK: A Mixed-Methods Process Evaluation

“…Underpinned by elements of Self-Determination Theory [ 13 ], GoActive was developed to improve physical activity through strengthened peer and mentor support, self-efficacy, group cohesion, self-esteem and friendship quality using a tiered-leadership system within schools. The effectiveness evaluation showed no effect on minutes of MVPA at 10-month follow-up [ 14 ].…”