Implementation of a school-based physical activity intervention for Brazilian adolescents: a mixed-methods evaluation

Abstract

Summary The effectiveness of physical activity interventions can be improved through examining the aspects related to their implementation. However, little such evidence has been collected, particularly in low- and middle-income countries. This study aimed to evaluate the implementation of a school-based physical activity intervention with qualitative and quantitative data from different actors (students, teachers and parents) involved in developing the program. The program was conducted in 2017 with three main components: (i) teacher training, (ii) environmental changes and (iii) educational actions. Mixed-method evaluation was performed by an independent evaluation team using a validated indicator matrix for the implementation process, including the self-reported information of students, teachers and parents, as well as interviews with teachers. In the 3 eligible schools, 350 adolescents (51% girls) answered the implementation questionnaire, as did 45 parents (84% mothers), and 47 teachers (70% female). In the qualitative analysis, 18 teachers participated. Categorical analysis found that the intervention was considered feasible by teachers. In general, teachers had a more positive perception of the implementation than did students. The lack of engagement from the school community and parents and the busy schedule of teachers were indicated to be the main difficulties. In conclusion, despite the teachers’ motivation, some barriers prevented the successful implementation of the program.

Costa et al., 2023 - Effect of a school-based multicomponent intervention on time-segmented physical activity and sedentary behavior among Brazilian adolescents: The Movimente Study

“…Our findings and previous cross-sectional analysis 26 suggest that interventions targeting psychosocial indicators and opportunities for PA in Brazil may have challenges in promoting PA and reducing SB in contexts with tight schedules (i.e. in school hours with low duration for recess and/or local school rules that make it difficult or prohibit students to access the school grounds 36 ). Despite the emerging literature 24 showing that MVPA/SB ratio is an important indicator for health markers and may suggest a better health effect, the use of this ratio is relatively new and scarce in the adolescent population.…”

“…Nonetheless, all PE teachers reported that the students became more likely to actively participate in the classes, but the same teachers reported that the more active classes did not result in positive and significant changes in students' lifestyles 36 . Another hypothesis for the lack of in-school intervention effects is that no matter how well the PE teachers were able to implement the strategies of the intervention, it is likely that the PE classes could already be active before the intervention strategies were implemented, so there would be no way to increase this further in class.…”

“…The lack of intervention effect observed in the current study for the In-School period may be because implementation of several components turned out to be challenging for some schools due to environmental context and resources (e.g., lack of time due to curricular demands and schedule interruptions; resources and administration or training workshops not age-appropriate/insufficient; teachers' autonomy decreased; space constraints; weather conditions) 37 , beliefs about consequences (e.g., takes time out of schedule; requires extra planning and set up time; no impact on PA levels; student boredom; teachers' perception of their own competence in implementing the activities; unsure of the effect of PA on academic outcomes) 37,38 , and social influences (e.g., the school system prioritizes academics activities; students do not participate and/or cannot force them to move) 37 . Previously published data on the implementation of the Movimente Study 36 showed that only 40% of teachers reported adopting active breaks during their lessons, 70% did not use the intervention education materials in the discussions in regular classes, and 63% reported that were difficulties in discussing the health-related topics.…”

“…Most schools had 2-3 PE classes per week, and most students said that they had discussions about health in the classes and that the classes were more active 36 .…”

Effectiveness and moderators of a multicomponent school-based intervention on screen time devices: the Movimente cluster-randomized controlled trial

“…This was also identified by the students who, when asked about the topics covered during the classes, recalled more topics about physical activity and diet, with ST being rarely addressed. Thus, low teacher participation and students' recall of the topics covered during the intervention may have contributed to the lack of effect [43].…”