Results of a feasibility cluster randomised controlled trial of a peer-led school-based intervention to increase the physical activity of adolescent girls (PLAN-A)

Abstract

BackgroundMost adolescent girls in the UK do not meet government physical activity recommendations and effective interventions are needed. This study reports the results of a feasibility trial of PLAN-A, a novel school-based peer-led physical activity intervention for adolescent girls.MethodsA two-arm cluster randomised controlled feasibility study was conducted in six English secondary schools (4 intervention & 2 control). Year 8 (age 12-13) girls were eligible and randomisation was at school-level. The intervention involved training Year 8 girls (out of school for two consecutive days, plus one top-up day 5 weeks later), who were identified by their peers as influential, to provide informal support to their friends to increase their physical activity. Feasibility of the intervention and the research was examined, including: recruitment, training attendance and data provision rates, evidence of promise of the intervention to affect weekday moderate-to-vigorous physical activity (MVPA), intervention cost and estimation of the sample size for a definitive trial. Accelerometer and questionnaire data were collected at the beginning of Year 8 (Time 0), the end of Year 8 (10-weeks after peer-supporter training) and the beginning of Year 9 (Time 2).ResultsFour hundred twenty-seven girls were recruited (95% recruitment rate). 55 girls consented to be a peer-supporter and 53 peer-supporters were trained (97% of those invited). Accelerometer return rates exceeded 85% at each time point and wear time criteria was met by 83%, 71% and 62% participants at Time 0, 1 and 2 respectively. Questionnaire data were provided by >91% of participants at each time point. Complete-case adjusted linear regression analysis showed evidence of a 6.09 minute (95% CI = 1.43, 10.76) between-arms difference in weekday MVPA at Time 2 in favour of the intervention arm. On average PLAN-A cost £2685 per school to deliver (£37 per Year 8 girl). There were no adverse events. A trial involving 20 schools would be adequately powered to detect a between-arms difference in weekday MVPA of at least six minutes.ConclusionsThe PLAN-A intervention adopts a novel peer-led approach, is feasible, and shows evidence of promise to positively affect girls’ physical activity levels. A definitive trial is warranted.Trial registrationISCTRN, ISRCTN12543546, Registered on 28/7/2015, URL of registry record: http://www.isrctn.com/ISRCTN12543546Electronic supplementary materialThe online version of this article (10.1186/s12966-018-0682-4) contains supplementary material, which is available to authorized users.

A revised teaching assistant-led extracurricular physical activity programme for 8- to 10-year-olds: the Action 3:30R feasibility cluster RCT

“…Self-reported responses to HRQoL measures by participants in the intervention arm and the control arm were similar at baseline and follow-up. This finding is consistent with previous studies 57,62 in which HRQoL measures were found to be unresponsive among school children with 'healthy' profiles and supports the case for considering alternative HRQoL measures that are appropriate for use with this population.…”

“…Unfortunately, the funding landscape makes securing funds specifically to create and test these measures with children very difficultyet without them our ability to measure the effects of our interventions on potential mediators is limited. 57,61,62 The majority of extracurricular physical activity provision provided by schools in this study was funded by the school or parents and this finding is comparable with the results of an audit of after-school club provision for children in Years 5 and 6 from primary schools in England. 19 Notably, estimated Action 3:30 costs were found to compare favourably with the costs associated with existing extra-curricular physical activity delivered in study schools.…”

“…18 Few other studies report the costs of children's physical activity, but these estimates are comparable with those that have been reported in recent years. 57,61,62 Cost-effectiveness As this was a feasibility trial and not powered to detect significant differences in MVPA, there was no firm basis for creating a cost-effectiveness ratio to compare the change in costs with the change in outcomes (MVPA) through a full economic evaluation. However, a partial economic evaluation was viable and this was conducted on cost changes alone (see Table 28).…”

A process evaluation of the PLAN-A intervention (Peer-Led physical Activity iNtervention for Adolescent girls)

“…We have recently reported the protocol [13] and findings [14] of a feasibility study of PLAN-A, a Peer-Led physical Activity iNtervention for Adolescent girls. The PLAN-A intervention is based on a previously effective stop-smoking intervention, A Stop Smoking in Schools Trial (ASSIST) [15], which used informal peer-diffusion to spread positive messages and develop new norms for health behaviour (for ASSIST, not smoking; for PLAN-A, being physically active).…”

“…We conducted a feasibility cluster randomised controlled trial of the PLAN-A intervention in six secondary schools (four intervention, two control) involving 427 Year 8 girls. Measures of intervention feasibility and objective assessments of girls' MVPA at baseline, 10 weeks and 5 months follow up were collected [14]. We found that school, participant, trainer and peer-supporter recruitment and retention were feasible, that data required to evaluate the intervention could be collected and that 94% of peer-supporters attended all of the training.…”