title: Development of a universal approach to increase physical activity among adolescents: the GoActive intervention.
abstract: OBJECTIVE
  To develop a physical activity (PA) promotion intervention for adolescents using a process addressing gaps in the literature while considering participant engagement. We describe the initial development stages; (1) existing evidence, (2) large scale opinion gathering and (3) developmental qualitative work, aiming (A) to gain insight into how to increase PA among the whole of year 9 (13-14 years-old) by identifying elements for intervention inclusion (B) to improve participant engagement and (C) to develop and refine programme design.
  
  
  METHODS
  Relevant systematic reviews and longitudinal analyses of change were examined. An intervention was developed iteratively with older adolescents (17.3 ± 0.5 years) and teachers, using the following process: (1) focus groups with (A) adolescents (n=26) and (B) teachers (n=4); (2) individual interviews (n=5) with inactive and shy adolescents focusing on engagement and programme acceptability. Qualitative data were analysed thematically.
  
  
  RESULTS
  Limitations of the existing literature include lack of evidence on whole population approaches, limited adolescent involvement in intervention development, and poor participant engagement. Qualitative work suggested six themes which may encourage adolescents to do more PA; choice, novelty, mentorship, competition, rewards and flexibility. Teachers discussed time pressures as a barrier to encouraging adolescent PA and suggested between-class competition as a strategy. GoActive aims to increase PA through increased peer support, self-efficacy, group cohesion, self-esteem and friendship quality, and is implemented in tutor groups using a student-led tiered-leadership system.
  
  
  CONCLUSIONS
  We have followed an evidence-based iterative approach to translate existing evidence into an adolescent PA promotion intervention. Qualitative work with adolescents and teachers supported intervention design and addressed lack of engagement with health promotion programmes within this age group. Future work will examine the feasibility and effectiveness of GoActive to increase PA among adolescents while monitoring potential negative effects. The approach developed is applicable to other population groups and health behaviours.
  
  
  BACKGROUND
  ISRCTN31583496.
authors: MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK MRC Epidemiology Unit, UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge School of Clinical Medicine, Cambridge, UK.
authors: Kirsten
authors: K
authors: Corder
authors: MRC Epidemiology Unit, UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge School of Clinical Medicine, Cambridge, UK.
authors: Annie
authors: A
authors: Schiff
authors: MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK.
authors: Joanna M
authors: JM
authors: Kesten
authors: MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK MRC Epidemiology Unit, UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge School of Clinical Medicine, Cambridge, UK.
authors: Esther M F
authors: EM
authors: van Sluijs
mesh_terms: D000293:Adolescent; D005260:Female; D017144:Focus Groups; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009043:Motor Activity; D006113:United Kingdom
keywords: PUBLIC HEALTH; Physical activity; adolescent; behaviour change; intervention