KIDS OUT! Protocol of a brief school-based intervention to promote physical activity and to reduce screen time in a sub-cohort of Finnish eighth graders

Anne-Mari Jussila, Tommi Vasankari, Olavi Paronen, Harri Sievänen, Kari Tokola, Henri Vähä-Ypyä, Anna Broberg, Minna Aittasalo, Anne-Mari Jussila, Tommi Vasankari, Olavi Paronen, Harri Sievänen, Kari Tokola, Henri Vähä-Ypyä, Anna Broberg, Minna Aittasalo

Abstract

Background: Adolescents' physical activity (PA) is decreasing and sedentary behavior (SB) increasing alarmingly. Insufficient PA and excessive SB are both related to various health risks indicating that interventions to promote adolescents' PA and to reduce their SB are needed. Schools have a great potential to reach most adolescents, and in Finland health education (HE) as stand-alone subject provides an excellent platform for health promotion. This paper describes the protocol and evaluation (RE-AIM) of an intervention developed for three HE lessons to increase PA and reduce SB during leisure among 8(th) graders.

Methods/design: All city-owned secondary schools in Tampere (n = 14) were invited to the study and were randomized in pairs to intervention (n = 7) and comparison group (n = 7). A specific content on PA and SB based on Health Action Process Approach model was integrated into routinely scheduled three HE lessons with the help of educational material: SoftGIS-questionnaire followed by feedback views on adolescents' current PA and SB, FeetEnergy-homework leaflet for adolescents, FeetEnergy-video in YouTube, FeetEnergy-poster for classroom and FeetEnergy-leaflet for parents. In the comparison group standard HE lessons were held. The primary indicators of Effectiveness are changes in PA and SB and in their psychosocial factors as well as in parental interference with PA and SB. The measurement points are baseline, 4 weeks after the intervention and 7 months from baseline, the last indicating also the measurement point for individual level Maintenance. The measures are accelerometers, 7-day activity diaries and questionnaires. The evaluation of Reach, Adoption and Implementation is based on the data collected during the intervention. Maintenance at organizational level is assessed two years after the intervention with a questionnaire to the HE teachers. The intervention was implemented in 2012 and the last measurements to assess organizational Maintenance were conducted in the end of 2014. A detailed description of the protocol and evaluation is provided to enable replication and better understanding of the findings, which will be reported in 2015.

Discussion: The findings will add our current knowledge about the feasibility and effectiveness of integrating simple structured elements into the HE lessons to increase PA and reduce SB in adolescents.

Trial registration: NCT01633918 (June 27th, 2012).

Figures

Fig. 1
Fig. 1
Timetable of the Kids Out! -intervention
Fig. 2
Fig. 2
FeetEnergy -homework leaflet for adolescents and a classroom poster
Fig. 3
Fig. 3
School-specific feedback views from SoftGIS responses

References

    1. Strong WB, Malina RM, Blimkie CJR, Daniels SR, Dishman RK, Gutin B, Hergenroeder AC, Must A, Nixon PA, Pivarnik JM, Rowland T, Trost S, Trudeau F. Evidence based physical activity for school-age youth. J Pediatr. 2005;146:732–7. doi: 10.1016/j.jpeds.2005.01.055.
    1. Physical Activity Guidelines Advisory Committee. Physical Activity Guidelines Advisory Committee Report, 2008. Washington, DC: U.S. Department of Health and Human Services; 2008.
    1. Janssen I, LeBlanc AG. Systematic review of the health benefits of physical activity and fitness in school-aged children and youth. Int J Behav Nutr Phys Act. 2010;7:40. doi: 10.1186/1479-5868-7-40.
    1. Landry BW, Driscoll SW. Physical activity in children and adolescents. PM&R. 2012;4:826–32. doi: 10.1016/j.pmrj.2012.09.585.
    1. Singh A, Uijtdewilligen L, Twisk J, van Mechelen W, Chinapaw M. Physical activity and performance at school. A systematic review of the literature including a methodological quality assessment. Arch Pediatr Adolesc Med. 2012;166:49–55. doi: 10.1001/archpediatrics.2011.716.
    1. Currie C, Zanotti C, Morgan A, Currie D, de Looze M, Roberts C, Samdal O, Smith ORF, Barnekow V. 2012. Social determinants of health and well-being among young people. HBSC international report from the 2009/2010 survey. Health Policy for Children and Adolescents, No. 6. WHO Regional Office for Europe: Copenhagen; 2012.
    1. Tammelin T, Laine K, Turpeinen T (eds.). Oppilaiden fyysinen aktiivisuus. Jyväskylä: Liikunnan ja kansanterveyden julkaisuja 272;. Jyväskylä 2013. (In Finnish)
    1. Pate RR, Mitchell JA, Byun W, Dowda M. Sedentary behaviour in youth. Br J Sports Med. 2011;45:906–13. doi: 10.1136/bjsports-2011-090192.
    1. Booth FW, Hargreaves M. Understanding multi-organ pathology from insufficient exercise. J Appl Physiol. 2011;111:1199–200. doi: 10.1152/japplphysiol.01034.2011.
    1. Tremblay M, LeBlanc A, Kho M, Saunders T, Larouche R, Colley R, Goldfield G, Connor Gorber S. Systematic review of sedentary behavior and health indicators in school-aged children and youth. Int J Behav Nutr Phys Act. 2011;8:98. doi: 10.1186/1479-5868-8-98.
    1. Fogelholm M, Paronen O, Miettinen M. Physical activity – a possibility for welfare policy. The state and development of health-enhancing physical activity in Finland. Helsinki, Finland: Reports of the Ministry of Social Affairs and Health; 2007. p. 1.
    1. Buliung RN, Mitra R, Faulkner G. Active school transportation in the Greater Toronto Area, Canada: an exploration of trends in space and time (1986–2006) Prev Med. 2009;48:507–12. doi: 10.1016/j.ypmed.2009.03.001.
    1. Davison KK, Werder JL, Lawson CT. Children’s active commuting to school: current knowledge and future directions. Prev Chronic Dis. 2008;5:1–11.
    1. The National Travel Survey 2011-2012. Ministry of Transport and Communications Finland, the Finnish National Road Administration and the Finnish Rail Administration; 2012.
    1. Cooper AR, Page AS, Wheeler BW, Griew P, Davis L, Hillsdon M, Jago R. Mapping the walk to school using accelerometry combined with a global positioning system. Am J Prev Med. 2010;38:178–83. doi: 10.1016/j.amepre.2009.10.036.
    1. Faulkner GEJ, Buliung RN, Flora PK, Fusco C. Active school transport, physical activity levels and body weight of children and youth: aA systematic review. Prev Med. 2009;48:3–8. doi: 10.1016/j.ypmed.2008.10.017.
    1. Larouche R, Saunders TJ, Faulkner G, Colley R, Tremblay M. Associations between active school transport and physical activity, bodycomposition, and cardiovascular fitness: a systematic review of 68 studies. J Phys Act Health. 2014;11:206–27. doi: 10.1123/jpah.2011-034.
    1. Dobbins M, DeCorby K, Robeson P, Husson H, Tirilis D. School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6-18. Cochrane Database Syst Rev. 2013;2:CD007651.
    1. Kriemler S, Meyer U, Martin E, van Sluijs EM, Andersen LB, Martin BW. Effect of school-based interventions on physical activity and fitness in children and adolescents: a review of reviews and systematic update. Br J Sports Med. 2011;45:923–30. doi: 10.1136/bjsports-2011-090186.
    1. Murillo Pardo B, García Bengoechea E, Generelo Lanaspa E, Bush PL, Zaragoza Casterad J, Julián Clemente JA, García GL. Promising school-based strategies and intervention guidelines to increase physical activity of adolescents. Health Educ Res. 2013;28(3):523–38. doi: 10.1093/her/cyt040.
    1. Glasgow RE, Vogt TM, Boles SM. Evaluating the public health impact of health promotion interventions: tThe RE-AIM framework. Am J Public Health. 1999;89:1322–7. doi: 10.2105/AJPH.89.9.1322.
    1. Paronen O, Aittasalo M, Jussila A. Kasit liikkeelle! Koulumatka ja liikuntakysely Tampereella 2011. . (In Finnish)
    1. Schwarzer R. Modeling health behavior change: how to predict and modify the adoption and maintenance of health behaviors. Appl Psychol. 2008;57:1–29.
    1. Kyttä M, Kahila M. PehmoGIS elinympäristön koetun laadun kartoittajana (SoftGIS methodology in revealing the localized experiences of living environment) Finland: Helsinki University of Technology. Centre for Urban and Regional Studies; 2006.
    1. Kyttä M, Kahila M, Broberg A, Tynnilä J. Laatu kokemuksina (Quality as an experience). In Staffans, A, & Väyrynen, E,. (eds.) Oppiva kaupunkisuunnittelu (Urban Plannign as a Learning Process). Helsinki University of Technology, Department of Architecture. Publication 98;79-120;, 2009b. (In Finnish)
    1. European Schoolnet and University of Liege. (2013). Survey of schools: ICT in education. Benchmarking access, use and attitudes to technology in Europe’s schools. Final Report (ESSIE).Brussels: European Union. Retrieved November 26 2013. .
    1. Eakin EG, Smith BJ, Bauman A. Evaluating the population health impact of physical activity interventions in primary health care – are we asking the right questions? J Phys Act Health. 2005;2:197–215.
    1. Owen N, Glanz K, Sallis JF, Kelder SH. Evidence-based approaches to dissemination and diffusion of physical activity interventions. Am J Prev Med. 2006;31(S4):S35–S44. doi: 10.1016/j.amepre.2006.06.008.
    1. Aittasalo M, Miilunpalo S, Ståhl T, Kukkonen-Harjula K. From innovation to practice: initiation, implementation and evaluation of a national physician-based physical activity promotion programme. Health Promot Int. 2007;22:19–27. doi: 10.1093/heapro/dal040.
    1. Ridley K, Olds TS, Hill A. The Multimedia activity recall for children and adolescents (MARCA): development and evaluation. Int J Behav Nutr Phys Act. 2006;3:10. doi: 10.1186/1479-5868-3-10.
    1. Bandura A. Health promotion by social cognitive means. Health Educ Behav. 2004;31:143–64. doi: 10.1177/1090198104263660.
    1. Dishman RK, Mot RW, Saunders R, Felton G, Ward DS, Dowda M, et al. Self-efficacy partially mediates the effect of a school-based physical-activity intervention among adolescent girls. Prev Med. 2004;38:628–36. doi: 10.1016/j.ypmed.2003.12.007.
    1. Dishman RK, Saunders RP, Motl RW, Dowda M, Pate RR. Self-efficacy moderates the relation between declines in physical activity and perceived social support in high school girls. J Pediatr Psych. 2009;34:441–51. doi: 10.1093/jpepsy/jsn100.
    1. De Bourdeaudhuij I, Lefevre J, Deforche B, Wijndaele K, Matton L, Philippaerts R. Physical activity and psychosocial correlates in normal weight and overweight 11 to 19 year olds. Obes Res. 2005;13:1097–105. doi: 10.1038/oby.2005.128.
    1. Haerens L, Cerin E, Maes L, Cardon G, Deforche B, De Bourdeaudhuij I. Explaining the effect of a 1-year intervention promoting physical activity in middle schools: a mediation analysis. Public Health Nutr. 2008;11(5):501–512. doi: 10.1017/S136898000700078X.
    1. Spence JC, Blanchard CM, Clark M, Plotnikoff RC, Storey KE, McCargar LJ. The role of self-efficacy in explaining gender differences in physical activity among adolescents: A multilevel analysis. J Phys Act Health. 2010;7:176–183.
    1. Van Der Horst K, Paw MJCA, Twisk JWR, Van Mechelen W. A brief review on correlates of physical activity and sedentariness in youth. Med Sci Sports Exerc. 2007;39(8):1241–50. doi: 10.1249/mss.0b013e318059bf35.
    1. Deforche B, De Bourdeaudhuij I, Tanghe A, Hills AP, De Bode P. Changes in physical activity and psychosocial determinants of physical activity in children and adolescents treated for obesity. Patient Educ Couns. 2004;55:407–15. doi: 10.1016/j.pec.2003.07.012.
    1. Dishman RK, Hales DP, Sallis JF, Saunders R, Dunn AL, Bedimo-Rung AL, Ring KB. Validity of social-cognitive measures for physical activity in middle-school girls. J Pediatr Psych. 2010;35:72–88. doi: 10.1093/jpepsy/jsp031.
    1. Jago R, Baranowski T, Watson K, Bachman C, Baranowski JC, Thompson D, Hernández AE, Venditti E, Blackshear T, Moe E. Development of new physical activity and sedentary behavior change self-efficacy questionnaires using item response modeling. Int J Behav Nutr Phys Act. 2009;6:20. doi: 10.1186/1479-5868-6-20.
    1. Lee RE, Nigg CR, DiClemente CC, Courneya KS. Validating motivational readiness for exercise behaviour with adolescents. Res Q Exerc Sport. 2001;72:401–10. doi: 10.1080/02701367.2001.10608976.
    1. Motl RW, Dishman RK, Trost SG, Saunders RP, Dowda M, Felton G, Ward DS, Pate RR. Factorial validity and invariance of questionnaires measuring social-cognitive determinants of physical activity among adolescent girls. Prev Med. 2000;31:584–94. doi: 10.1006/pmed.2000.0735.

Source: PubMed

3
Abonnere