Randomised controlled feasibility study of a school-based multi-level intervention to increase physical activity and decrease sedentary behaviour among vocational school students

Nelli Hankonen, Matti T. J. Heino, Sini-Tuuli Hynynen, Hanna Laine, Vera Araujo-Soares, Falko F. Sniehotta, Tommi Vasankari, Reijo Sund, Ari Haukkala

Research output: Contribution to journalArticleScientificpeer-review

Abstract

BACKGROUND: No school-based physical activity (PA) interventions among older adolescents have demonstrated long-term effectiveness, and few of them so far have addressed sedentary behaviour (SB). Based on behavioural theories and evidence, we designed a multi-level intervention to increase PA and decrease SB among vocational school students. This study investigates feasibility and acceptability of two main intervention components and research procedures. We also examine uptake of behaviour change techniques (BCTs) by the participants. METHODS: Design was an outcome assessor blinded, cluster-randomised controlled trial. Four classes of students (matched pairs) were randomised into one intervention and one control arm. The intervention consisted of (1) a 6-h group-based intervention for students, (2) two 2-h training workshops to reduce their students' sitting in class for teachers, and (3) provision of light PA equipment in classrooms. At baseline (T1), mid-intervention (T2) at 3 weeks, post-intervention (T3) and 6 months after baseline (T4) we measured hypothesised psychosocial mediators and self-reported PA and sitting. Objective assessment of PA and SB (7-day accelerometry) was conducted at T1, T3 and T4. Body composition (bioimpedance) was measured at T1 and T4. Students and teachers in the intervention arm filled in acceptability questionnaires at T3. RESULTS: Recruitment rate was 64% (students) and 88.9% (teachers), and at T3, all post-intervention measurements were completed by 33 students (retention 76.7%) and 15 teachers (retention 93.8%). Acceptability ratings of sessions were high (students M = 6.29, scale 1-7), and data collection procedures were feasible. Intervention arm students reported increased use of BCTs, but uptake of some key BCTs was suboptimal. BCT use correlated highly with objective measures of PA. Based on both self-report and student evaluation, teachers in the intervention arm increased the use of sitting reduction strategies at post-intervention and T4 follow-up (p < .05). CONCLUSIONS: We detected willingness of the target groups to participate, good response rates to questionnaires, adequate retention, as well as acceptability of the trial protocol. Investigation of BCT use among students helped further enhance intervention procedures to promote BCT use. After making necessary modifications identified, intervention effectiveness can next be tested in a definitive trial. TRIAL REGISTRATION: ISRCTN34534846 . Registered 23 May 2014. Retrospectively registered.
Original languageEnglish
Article number37
JournalInternational Journal of Behavioral Nutrition and Physical Activity
Volume14
Issue number1
Number of pages14
ISSN1479-5868
DOIs
Publication statusPublished - 21 Mar 2017
MoE publication typeA1 Journal article-refereed

Fields of Science

  • Feasibility
  • Acceptability
  • Pilot trial
  • Self-determination theory
  • Self-regulation
  • Planning
  • Behaviour change technique use
  • Vocational upper secondary school
  • OLDER ADOLESCENTS
  • HEALTH BEHAVIOR
  • PROMOTION
  • PROGRESS
  • TRIAL
  • 5144 Social psychology

Cite this

@article{d28c9754778b47a0a14c3bc413a2eb0c,
title = "Randomised controlled feasibility study of a school-based multi-level intervention to increase physical activity and decrease sedentary behaviour among vocational school students",
abstract = "BACKGROUND: No school-based physical activity (PA) interventions among older adolescents have demonstrated long-term effectiveness, and few of them so far have addressed sedentary behaviour (SB). Based on behavioural theories and evidence, we designed a multi-level intervention to increase PA and decrease SB among vocational school students. This study investigates feasibility and acceptability of two main intervention components and research procedures. We also examine uptake of behaviour change techniques (BCTs) by the participants. METHODS: Design was an outcome assessor blinded, cluster-randomised controlled trial. Four classes of students (matched pairs) were randomised into one intervention and one control arm. The intervention consisted of (1) a 6-h group-based intervention for students, (2) two 2-h training workshops to reduce their students' sitting in class for teachers, and (3) provision of light PA equipment in classrooms. At baseline (T1), mid-intervention (T2) at 3 weeks, post-intervention (T3) and 6 months after baseline (T4) we measured hypothesised psychosocial mediators and self-reported PA and sitting. Objective assessment of PA and SB (7-day accelerometry) was conducted at T1, T3 and T4. Body composition (bioimpedance) was measured at T1 and T4. Students and teachers in the intervention arm filled in acceptability questionnaires at T3. RESULTS: Recruitment rate was 64{\%} (students) and 88.9{\%} (teachers), and at T3, all post-intervention measurements were completed by 33 students (retention 76.7{\%}) and 15 teachers (retention 93.8{\%}). Acceptability ratings of sessions were high (students M = 6.29, scale 1-7), and data collection procedures were feasible. Intervention arm students reported increased use of BCTs, but uptake of some key BCTs was suboptimal. BCT use correlated highly with objective measures of PA. Based on both self-report and student evaluation, teachers in the intervention arm increased the use of sitting reduction strategies at post-intervention and T4 follow-up (p < .05). CONCLUSIONS: We detected willingness of the target groups to participate, good response rates to questionnaires, adequate retention, as well as acceptability of the trial protocol. Investigation of BCT use among students helped further enhance intervention procedures to promote BCT use. After making necessary modifications identified, intervention effectiveness can next be tested in a definitive trial. TRIAL REGISTRATION: ISRCTN34534846 . Registered 23 May 2014. Retrospectively registered.",
keywords = "Feasibility, Acceptability, Pilot trial, Self-determination theory, Self-regulation, Planning, Behaviour change technique use, Vocational upper secondary school, OLDER ADOLESCENTS, HEALTH BEHAVIOR, PROMOTION, PROGRESS, TRIAL, 5144 Social psychology",
author = "Nelli Hankonen and Heino, {Matti T. J.} and Sini-Tuuli Hynynen and Hanna Laine and Vera Araujo-Soares and Sniehotta, {Falko F.} and Tommi Vasankari and Reijo Sund and Ari Haukkala",
year = "2017",
month = "3",
day = "21",
doi = "10.1186/s12966-017-0484-0",
language = "English",
volume = "14",
journal = "International Journal of Behavioral Nutrition and Physical Activity",
issn = "1479-5868",
publisher = "BMC",
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Randomised controlled feasibility study of a school-based multi-level intervention to increase physical activity and decrease sedentary behaviour among vocational school students. / Hankonen, Nelli; Heino, Matti T. J.; Hynynen, Sini-Tuuli; Laine, Hanna; Araujo-Soares, Vera; Sniehotta, Falko F.; Vasankari, Tommi; Sund, Reijo; Haukkala, Ari.

In: International Journal of Behavioral Nutrition and Physical Activity, Vol. 14, No. 1, 37, 21.03.2017.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Randomised controlled feasibility study of a school-based multi-level intervention to increase physical activity and decrease sedentary behaviour among vocational school students

AU - Hankonen, Nelli

AU - Heino, Matti T. J.

AU - Hynynen, Sini-Tuuli

AU - Laine, Hanna

AU - Araujo-Soares, Vera

AU - Sniehotta, Falko F.

AU - Vasankari, Tommi

AU - Sund, Reijo

AU - Haukkala, Ari

PY - 2017/3/21

Y1 - 2017/3/21

N2 - BACKGROUND: No school-based physical activity (PA) interventions among older adolescents have demonstrated long-term effectiveness, and few of them so far have addressed sedentary behaviour (SB). Based on behavioural theories and evidence, we designed a multi-level intervention to increase PA and decrease SB among vocational school students. This study investigates feasibility and acceptability of two main intervention components and research procedures. We also examine uptake of behaviour change techniques (BCTs) by the participants. METHODS: Design was an outcome assessor blinded, cluster-randomised controlled trial. Four classes of students (matched pairs) were randomised into one intervention and one control arm. The intervention consisted of (1) a 6-h group-based intervention for students, (2) two 2-h training workshops to reduce their students' sitting in class for teachers, and (3) provision of light PA equipment in classrooms. At baseline (T1), mid-intervention (T2) at 3 weeks, post-intervention (T3) and 6 months after baseline (T4) we measured hypothesised psychosocial mediators and self-reported PA and sitting. Objective assessment of PA and SB (7-day accelerometry) was conducted at T1, T3 and T4. Body composition (bioimpedance) was measured at T1 and T4. Students and teachers in the intervention arm filled in acceptability questionnaires at T3. RESULTS: Recruitment rate was 64% (students) and 88.9% (teachers), and at T3, all post-intervention measurements were completed by 33 students (retention 76.7%) and 15 teachers (retention 93.8%). Acceptability ratings of sessions were high (students M = 6.29, scale 1-7), and data collection procedures were feasible. Intervention arm students reported increased use of BCTs, but uptake of some key BCTs was suboptimal. BCT use correlated highly with objective measures of PA. Based on both self-report and student evaluation, teachers in the intervention arm increased the use of sitting reduction strategies at post-intervention and T4 follow-up (p < .05). CONCLUSIONS: We detected willingness of the target groups to participate, good response rates to questionnaires, adequate retention, as well as acceptability of the trial protocol. Investigation of BCT use among students helped further enhance intervention procedures to promote BCT use. After making necessary modifications identified, intervention effectiveness can next be tested in a definitive trial. TRIAL REGISTRATION: ISRCTN34534846 . Registered 23 May 2014. Retrospectively registered.

AB - BACKGROUND: No school-based physical activity (PA) interventions among older adolescents have demonstrated long-term effectiveness, and few of them so far have addressed sedentary behaviour (SB). Based on behavioural theories and evidence, we designed a multi-level intervention to increase PA and decrease SB among vocational school students. This study investigates feasibility and acceptability of two main intervention components and research procedures. We also examine uptake of behaviour change techniques (BCTs) by the participants. METHODS: Design was an outcome assessor blinded, cluster-randomised controlled trial. Four classes of students (matched pairs) were randomised into one intervention and one control arm. The intervention consisted of (1) a 6-h group-based intervention for students, (2) two 2-h training workshops to reduce their students' sitting in class for teachers, and (3) provision of light PA equipment in classrooms. At baseline (T1), mid-intervention (T2) at 3 weeks, post-intervention (T3) and 6 months after baseline (T4) we measured hypothesised psychosocial mediators and self-reported PA and sitting. Objective assessment of PA and SB (7-day accelerometry) was conducted at T1, T3 and T4. Body composition (bioimpedance) was measured at T1 and T4. Students and teachers in the intervention arm filled in acceptability questionnaires at T3. RESULTS: Recruitment rate was 64% (students) and 88.9% (teachers), and at T3, all post-intervention measurements were completed by 33 students (retention 76.7%) and 15 teachers (retention 93.8%). Acceptability ratings of sessions were high (students M = 6.29, scale 1-7), and data collection procedures were feasible. Intervention arm students reported increased use of BCTs, but uptake of some key BCTs was suboptimal. BCT use correlated highly with objective measures of PA. Based on both self-report and student evaluation, teachers in the intervention arm increased the use of sitting reduction strategies at post-intervention and T4 follow-up (p < .05). CONCLUSIONS: We detected willingness of the target groups to participate, good response rates to questionnaires, adequate retention, as well as acceptability of the trial protocol. Investigation of BCT use among students helped further enhance intervention procedures to promote BCT use. After making necessary modifications identified, intervention effectiveness can next be tested in a definitive trial. TRIAL REGISTRATION: ISRCTN34534846 . Registered 23 May 2014. Retrospectively registered.

KW - Feasibility

KW - Acceptability

KW - Pilot trial

KW - Self-determination theory

KW - Self-regulation

KW - Planning

KW - Behaviour change technique use

KW - Vocational upper secondary school

KW - OLDER ADOLESCENTS

KW - HEALTH BEHAVIOR

KW - PROMOTION

KW - PROGRESS

KW - TRIAL

KW - 5144 Social psychology

U2 - 10.1186/s12966-017-0484-0

DO - 10.1186/s12966-017-0484-0

M3 - Article

VL - 14

JO - International Journal of Behavioral Nutrition and Physical Activity

JF - International Journal of Behavioral Nutrition and Physical Activity

SN - 1479-5868

IS - 1

M1 - 37

ER -