A school-based intervention incorporating smartphone technology to improve health-related fitness among adolescents: rationale and study protocol for the NEAT and ATLAS 2.0 cluster randomised controlled trial and dissemination study

David R Lubans, Jordan J Smith, Louisa R Peralta, Ronald C Plotnikoff, Anthony D Okely, Jo Salmon, Narelle Eather, Deborah L Dewar, Sarah Kennedy, Chris Lonsdale, Toni A Hilland, Paul Estabrooks, Tara L Finn, Emma Pollock, Philip J Morgan, David R Lubans, Jordan J Smith, Louisa R Peralta, Ronald C Plotnikoff, Anthony D Okely, Jo Salmon, Narelle Eather, Deborah L Dewar, Sarah Kennedy, Chris Lonsdale, Toni A Hilland, Paul Estabrooks, Tara L Finn, Emma Pollock, Philip J Morgan

Abstract

Introduction: Physical inactivity has been described as a global pandemic. Interventions aimed at developing skills in lifelong physical activities may provide the foundation for an active lifestyle into adulthood. In general, school-based physical activity interventions targeting adolescents have produced modest results and few have been designed to be 'scaled-up' and disseminated. This study aims to: (1) assess the effectiveness of two physical activity promotion programmes (ie, NEAT and ATLAS) that have been modified for scalability; and (2) evaluate the dissemination of these programmes throughout government funded secondary schools.

Methods and analysis: The study will be conducted in two phases. In the first phase (cluster randomised controlled trial), 16 schools will be randomly allocated to the intervention or a usual care control condition. In the second phase, the Reach, Effectiveness, Adoption, Implementation and Maintenance (Re-AIM) framework will be used to guide the design and evaluation of programme dissemination throughout New South Wales (NSW), Australia. In both phases, teachers will be trained to deliver the NEAT and ATLAS programmes, which will include: (1) interactive student seminars; (2) structured physical activity programmes; (3) lunch-time fitness sessions; and (4) web-based smartphone apps. In the cluster RCT, study outcomes will be assessed at baseline, 6 months (primary end point) and 12-months. Muscular fitness will be the primary outcome and secondary outcomes will include: objectively measured body composition, cardiorespiratory fitness, flexibility, resistance training skill competency, physical activity, self-reported recreational screen-time, sleep, sugar-sweetened beverage and junk food snack consumption, self-esteem and well-being.

Ethics and dissemination: This study has received approval from the University of Newcastle (H-2014-0312) and the NSW Department of Education (SERAP: 2012121) human research ethics committees. This study is funded by the Australian Research Council (FT140100399) and the NSW Department of Education.

Trial registration number: ACTRN12615000360516; Pre-results.

Keywords: Adolescents; Behaviour change; Physical activity; Physical fitness; Resistance Training.

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Figures

Figure 1
Figure 1
Implementation strategies, intervention components, hypothesised mediators and study outcomes. ATLAS, Active Teen Leaders Avoiding Screen-time; NEAT, Nutrition and Enjoyable Activity for Teens; PA, physical activity.

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