title: International inter-school competition to encourage children to walk to school: a mixed methods feasibility study.
abstract: BACKGROUND
  Active travel to school can be an important contributor to the total physical activity of children but levels have declined and more novel approaches are required to stimulate this as an habitual behaviour. The aim of this mixed methods study was to investigate the feasibility of an international walk to school competition supported by novel swipecard technology to increase children's walking to/from school.
  
  
  METHODS
  Children aged 9-13 years old participated in an international walk to school competition to win points for themselves, their school and their country over a 4-week period. Walks to and from school were recorded using swipecard technology and a bespoke website. For each point earned by participants, 1 pence (£ 0.01) was donated to the charity of the school's choice. The primary outcome was number of walks to/from school objectively recorded using the swipecard tracking system over the intervention period. Other measures included attitudes towards walking collected at baseline and week 4 (post-intervention). A qualitative sub-study involving focus groups with children, parents and teachers provided further insight.
  
  
  RESULTS
  A total of 3817 children (mean age 11.5 ± SD 0.7) from 12 schools in three cities (London and Reading, England and Vancouver, Canada) took part in the intervention, representing a 95% intervention participation rate. Results show a gradual decline in the average number of children walking to and from school over the 4-week period (week 1 mean 29% ± SD2.5; week 2 mean 18% ± SD3.6; week 3 mean 14% ± SD4.0; week 4 mean 12% ± SD1.1). Post intervention, 97% of children felt that walking to school helped them stay healthy, feel happy (81%) and stay alert in class (76%). These results are supported by qualitative findings from children, parents and teachers. Key areas for improvement include the need to incorporate strategies for maintenance of behaviour change into the intervention and also to adopt novel methods of data collection to increase follow-up rates.
  
  
  CONCLUSIONS
  This mixed methods study suggests that an international walk to school competition using innovative technology can be feasibly implemented and offers a novel way of engaging schools and motivating children to walk to school.
authors.affiliation: Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland, UK. ruth.hunter@qub.ac.uk.|UKCRC Centre of Excellence for Public Health (NI), Queen's University Belfast, Belfast, Northern Ireland, UK. ruth.hunter@qub.ac.uk.
authors.forename: Ruth F
authors.initials: RF
authors.lastname: Hunter
authors.affiliation: The Evidence Centre, London, England, UK. debra@evidencecentre.com.
authors.forename: Debra
authors.initials: D
authors.lastname: de Silva
authors.affiliation: Intelligent Health Ltd, Reading, England, UK. veronica.reynolds@intelligenthealth.co.uk.
authors.forename: Veronica
authors.initials: V
authors.lastname: Reynolds
authors.affiliation: Intelligent Health Ltd, Reading, England, UK. william.bird@intelligenthealth.co.uk.
authors.forename: William
authors.initials: W
authors.lastname: Bird
authors.affiliation: Centre for Exercise, Nutrition and Health Sciences, University of Bristol, Bristol, England, UK. k.r.fox@bristol.ac.uk.
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: Fox
mesh_terms: D000293:Adolescent; D002170:Canada; D002648:Child; D003163:Competitive Behavior; D004739:England; D005240:Feasibility Studies; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D009042:Motivation; D012574:Schools; D013334:Students / Q000523:psychology*; D016138:Walking / Q000523:psychology* / Q000706:statistics & numerical data