KIDS OUT! Protocol of a brief school-based intervention to promote physical activity and to reduce screen time in a sub-cohort of Finnish eighth graders.

Anne-Mari Jussila,Henri Vähä-Ypyä,Anna Broberg,Tommi Vasankari,Minna Aittasalo,Kari Tokola,Harri Sievänen,Olavi Paronen

doi:10.1186/s12889-015-2007-8

Abstract

BackgroundAdolescents’ physical activity (PA) is decreasing and sedentary behavior (SB) increasing alarmingly. Insufficient PA and excessive SB are both related to various health risks indicating that interventions to promote adolescents’ PA and to reduce their SB are needed. Schools have a great potential to reach most adolescents, and in Finland health education (HE) as stand-alone subject provides an excellent platform for health promotion. This paper describes the protocol and evaluation (RE-AIM) of an intervention developed for three HE lessons to increase PA and reduce SB during leisure among 8th graders.Methods/DesignAll city-owned secondary schools in Tampere (n = 14) were invited to the study and were randomized in pairs to intervention (n = 7) and comparison group (n = 7). A specific content on PA and SB based on Health Action Process Approach model was integrated into routinely scheduled three HE lessons with the help of educational material: SoftGIS-questionnaire followed by feedback views on adolescents’ current PA and SB, FeetEnergy-homework leaflet for adolescents, FeetEnergy-video in YouTube, FeetEnergy-poster for classroom and FeetEnergy-leaflet for parents. In the comparison group standard HE lessons were held. The primary indicators of Effectiveness are changes in PA and SB and in their psychosocial factors as well as in parental interference with PA and SB. The measurement points are baseline, 4 weeks after the intervention and 7 months from baseline, the last indicating also the measurement point for individual level Maintenance. The measures are accelerometers, 7-day activity diaries and questionnaires. The evaluation of Reach, Adoption and Implementation is based on the data collected during the intervention. Maintenance at organizational level is assessed two years after the intervention with a questionnaire to the HE teachers. The intervention was implemented in 2012 and the last measurements to assess organizational Maintenance were conducted in the end of 2014. A detailed description of the protocol and evaluation is provided to enable replication and better understanding of the findings, which will be reported in 2015.DiscussionThe findings will add our current knowledge about the feasibility and effectiveness of integrating simple structured elements into the HE lessons to increase PA and reduce SB in adolescents.Trial registrationNCT01633918 (June 27th, 2012)

Highlights

Adolescents’ physical activity (PA) is decreasing and sedentary behavior (SB) increasing alarmingly
This paper describes the protocol and RE-AIM evaluation [21] of a Kids Out! –intervention, which aims to increase leisure PA and reduce SB among 8th graders by integrating multi-component approaches into three routinely scheduled health education (HE) lessons in secondary schools
It is recommended for the evaluation of health promotion interventions for more systematic balancing of internal and external validity [27, 28], which is needed for translating the study results into practice

Summary

Introduction

Adolescents’ physical activity (PA) is decreasing and sedentary behavior (SB) increasing alarmingly. Physical activity (PA) in youth is beneficial for musculoskeletal and cardiovascular health, obesity adiposity, blood pressure, metabolic syndrome, bone mineral density, anxiety, depression [1,2,3,4] and academic performance [4, 5]. To achieve these benefits children and youth should engage in moderate-to-vigorous-intensity PA at least one hour daily [2]. In 13-year-old boys the corresponding percentages were 60 %, 49 % and 44 % During these popular leisure activities adolescents are usually sitting. Excessive sedentary behavior (SB) has been found to be associated with unfavorable body composition, decreased fitness, lower self -esteem, social behavior and decreased academic performance [9, 10]

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