Abstract
BackgroundPhysical inactivity contributes to the global burden of non-communicable diseases. The pattern of physical activity in adulthood are often established during adolescence and sedentary behaviours in the early years could influence the development of diseases later in life. Studies on physical activity in Nigeria have focused largely on individual behaviours and the effects of school-based interventions have not been well investigated. The aim of the proposed study is to identify factors influencing; and evaluate the effects of a multi-level intervention on the physical activity behaviours of in-school adolescents in Oyo state, Nigeria.MethodsThe study will adopt a cluster randomised controlled trial design and schools will serve as the unit of randomisation. The sample size is 1000 in-school adolescents aged 10–19 years. The study will be guided by the socio-ecological model and theory of reasoned action and baseline data will be obtained through a mixed methods approach comprising a cross sectional survey to document the self-reported physical activity levels coupled with objectively measured physical activity levels using pedometers for a subset of the sample. Other measurements including weight, height, waist and hip circumferences, fitness level using the 20-m shuttle run test (20-mSRT) and blood pressure will be obtained. The schools’ built environment and policy support for physical activity will be assessed using structured questionnaires coupled with key informant interviews and focus group discussions with the school authorities. Baseline findings will guide the design and implementation of a 12-week multi-level intervention. The primary outcome measures are self–reported and 7-day objectively measured physical activity. Other secondary outcome measures are body-mass-index for age, waist-to-hip ratio, cardioresiratory fitness and blood pressure. The association between behavioural factors and physical activity levels will be assessed. Follow-up measurements will be taken immediately after the intervention and 3-months post intervention.DiscussionPhysical activity behaviours of adolescents in Nigeria are influenced by multiple factors. There is an urgent need for effective school-based interventions with a potential to improve the physical activity behaviours of adolescents in Nigeria and other low and middle income countries.Trial registrationPan African Clinical Trial Registry. Trial registration number: PACTR201706002224335, registered 26 June 2017.
Highlights
Physical inactivity contributes to the global burden of non-communicable diseases
According to the Global Status Report on Non-communicable diseases, Nigeria had an estimated 792,600 non-communicable diseases (NCDs) related deaths in 2008 and this high mortality figure is linked to four modifiable risk factors namely physical inactivity, unhealthy diets, tobacco and harmful alcohol use [2]
Research studies on the physical activity behaviours of young people in Nigeria have focused solely on individual behaviours [12, 21] without analyzing critically, the influence of social-cultural, institutional, environmental and policy level factors resulting in an unbalanced attention to individualised behaviour change strategies instead of a true public health intervention which requires systems approach [22]. These underscore the importance of this study which is designed to identify the socio-ecological factors influencing the physical activity behaviours of in-school adolescents and to evaluate the effect of a multi-level intervention on the physical activity and fitness levels of in-school adolescents in Oyo state, south western Nigeria
Summary
Study research design The proposed study will utilise a cluster randomised trial design to test the effect of a 12-week multi-level intervention on the physical activity and fitness levels of inschool adolescents aged 10–19 years in twenty two public and private-owned secondary schools in Oyo state, south western Nigeria. Prior to the experimental study, preliminary data will be collected on the physical activity behaviours of in-school adolescents and the socio-ecological factors influencing the school physical activity environment This will guide the design of a multi-level, multicomponent intervention which will run for 12 weeks with assessments conducted at baseline, post-intervention and at 3-months follow-up. P2 = 72% i.e. the proportion of the participants in the exposed (experimental) group who are expected to become physically active 12 weeks after the intervention This translates to the effect size i.e. 10% increase in the outcome measure of physical activity at follow up [24].
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