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



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.



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).



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.



ISRCTN34534846 . Registered 23 May 2014. Retrospectively registered.
Faculty of Social Sciences, University of Tampere, Kalevankatu 4, 33014, Tampere, Finland. nelli.hankonen@uta.fi.|Faculty of Social Sciences, University of Helsinki, Helsinki, Finland. nelli.hankonen@uta.fi.
Nelli
0000-0002-8464-2478
N
Hankonen
Faculty of Social Sciences, University of Helsinki, Helsinki, Finland.
Matti T J
MT
Heino
Faculty of Social Sciences, University of Helsinki, Helsinki, Finland.
Sini-Tuuli
ST
Hynynen
Faculty of Social Sciences, University of Helsinki, Helsinki, Finland.
Hanna
H
Laine
University of Newcastle Upon Tyne, Newcastle upon Tyne, UK.
Vera
V
Araújo-Soares
University of Newcastle Upon Tyne, Newcastle upon Tyne, UK.
Falko F
FF
Sniehotta
UKK Institute, Tampere, Finland.
Tommi
T
Vasankari
Faculty of Social Sciences, University of Helsinki, Helsinki, Finland.|Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
Reijo
R
Sund
Faculty of Social Sciences, University of Helsinki, Helsinki, Finland.
Ari
A
Haukkala
D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D003362:Cost-Benefit Analysis; D015444:Exercise; D005240:Feasibility Studies; D005260:Female; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D012107:Research Design; D012572:School Health Services / Q000706:statistics & numerical data*; D057185:Sedentary Behavior; D013334:Students / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014829:Vocational Education; D055815:Young Adult
Acceptability; Behaviour change technique use; Feasibility; Pilot trial; Planning; Self-determination theory; Self-regulation; Vocational upper secondary school