The Physical Activity 4 Everyone Cluster Randomized Trial

2-Year Outcomes of a School Physical Activity Intervention Among Adolescents

Rachel L. Sutherland, Elizabeth M. Campbell, David R. Lubans, Philip J. Morgan, Nicole K. Nathan, Luke Wolfenden, Anthony D. Okely, Karen E. Gillham, Jenna L. Hollis, Chris J. Oldmeadow, Amanda J. Williams, Lynda J. Davies, Jarrod S. Wiese, Alessandra Bisquera, John H. Wiggers

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Abstract

IntroductionFew interventions have been successful in reducing the physical activity decline typically observed among adolescents. The aim of this paper is to report the 24-month effectiveness of a multicomponent school-based intervention (Physical Activity 4 Everyone) in reducing the decline in moderate to vigorous physical activity (MVPA) among secondary school students in disadvantaged areas of New South Wales, Australia.Study designA cluster RCT was conducted in five intervention and five control schools with follow-up measures taken at 24 months post-randomization.
Setting/participantsThe trial was undertaken within secondary schools located in disadvantaged communities in New South Wales, Australia.
InterventionA multicomponent school-based intervention based on the Health Promoting Schools Framework was implemented. The intervention consisted of seven physical activity promotion strategies that targeted the curriculum (teaching strategies to increase physical activity in physical education lessons, student physical activity plans, and modification of school sport program); school environment (recess/lunchtime activities, school physical activity policy); parents (parent newsletters); and community (community physical activity provider promotion). Six additional strategies supported school implementation of the physical activity intervention strategies.
Main outcome measureMinutes per day spent in MVPA, objectively measured by accelerometer.
ResultsParticipants (N=1,150, 49% male) were a cohort of students aged 12 years (Grade 7) at baseline (March–June 2012) and 14 years (Grade 9) at follow-up (March–July 2014). At 24-month follow-up, there were significant effects in favor of the intervention group for daily minutes of MVPA. The adjusted mean difference in change in daily MVPA between groups was 7.0 minutes (95% CI=2.7, 11.4, p<0.002) (analysis conducted December 2014–February 2015). Sensitivity analyses based on multiple imputation were consistent with the main analysis (6.0 minutes, 95% CI=0.6, 11.3, p<0.031).
ConclusionsThe intervention was effective in increasing adolescents’ minutes of MVPA, suggesting that implementation of the intervention by disadvantaged schools has the potential to slow the decline in physical activity. 
Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12612000382875.
Original languageEnglish
Pages (from-to)195-205
Number of pages11
JournalAmerican Journal of Preventive Medicine
Volume51
Issue number2
Early online date18 Apr 2016
DOIs
Publication statusPublished - Aug 2016

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Exercise
Vulnerable Populations
South Australia
New South Wales
Students
Lunch
Physical Education and Training
School Health Services
Random Allocation
New Zealand
Curriculum
Sports
Registries
Teaching
Parents
Clinical Trials

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The Physical Activity 4 Everyone Cluster Randomized Trial : 2-Year Outcomes of a School Physical Activity Intervention Among Adolescents. / Sutherland, Rachel L.; Campbell, Elizabeth M.; Lubans, David R.; Morgan, Philip J.; Nathan, Nicole K.; Wolfenden, Luke; Okely, Anthony D.; Gillham, Karen E.; Hollis, Jenna L.; Oldmeadow, Chris J.; Williams, Amanda J.; Davies, Lynda J.; Wiese, Jarrod S.; Bisquera, Alessandra; Wiggers, John H.

In: American Journal of Preventive Medicine, Vol. 51, No. 2, 08.2016, p. 195-205.

Research output: Contribution to journalArticle

Sutherland, RL, Campbell, EM, Lubans, DR, Morgan, PJ, Nathan, NK, Wolfenden, L, Okely, AD, Gillham, KE, Hollis, JL, Oldmeadow, CJ, Williams, AJ, Davies, LJ, Wiese, JS, Bisquera, A & Wiggers, JH 2016, 'The Physical Activity 4 Everyone Cluster Randomized Trial: 2-Year Outcomes of a School Physical Activity Intervention Among Adolescents', American Journal of Preventive Medicine, vol. 51, no. 2, pp. 195-205. https://doi.org/10.1016/j.amepre.2016.02.020
Sutherland, Rachel L. ; Campbell, Elizabeth M. ; Lubans, David R. ; Morgan, Philip J. ; Nathan, Nicole K. ; Wolfenden, Luke ; Okely, Anthony D. ; Gillham, Karen E. ; Hollis, Jenna L. ; Oldmeadow, Chris J. ; Williams, Amanda J. ; Davies, Lynda J. ; Wiese, Jarrod S. ; Bisquera, Alessandra ; Wiggers, John H. / The Physical Activity 4 Everyone Cluster Randomized Trial : 2-Year Outcomes of a School Physical Activity Intervention Among Adolescents. In: American Journal of Preventive Medicine. 2016 ; Vol. 51, No. 2. pp. 195-205.
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title = "The Physical Activity 4 Everyone Cluster Randomized Trial: 2-Year Outcomes of a School Physical Activity Intervention Among Adolescents",
abstract = "IntroductionFew interventions have been successful in reducing the physical activity decline typically observed among adolescents. The aim of this paper is to report the 24-month effectiveness of a multicomponent school-based intervention (Physical Activity 4 Everyone) in reducing the decline in moderate to vigorous physical activity (MVPA) among secondary school students in disadvantaged areas of New South Wales, Australia.Study designA cluster RCT was conducted in five intervention and five control schools with follow-up measures taken at 24 months post-randomization.Setting/participantsThe trial was undertaken within secondary schools located in disadvantaged communities in New South Wales, Australia.InterventionA multicomponent school-based intervention based on the Health Promoting Schools Framework was implemented. The intervention consisted of seven physical activity promotion strategies that targeted the curriculum (teaching strategies to increase physical activity in physical education lessons, student physical activity plans, and modification of school sport program); school environment (recess/lunchtime activities, school physical activity policy); parents (parent newsletters); and community (community physical activity provider promotion). Six additional strategies supported school implementation of the physical activity intervention strategies.Main outcome measureMinutes per day spent in MVPA, objectively measured by accelerometer.ResultsParticipants (N=1,150, 49{\%} male) were a cohort of students aged 12 years (Grade 7) at baseline (March–June 2012) and 14 years (Grade 9) at follow-up (March–July 2014). At 24-month follow-up, there were significant effects in favor of the intervention group for daily minutes of MVPA. The adjusted mean difference in change in daily MVPA between groups was 7.0 minutes (95{\%} CI=2.7, 11.4, p<0.002) (analysis conducted December 2014–February 2015). Sensitivity analyses based on multiple imputation were consistent with the main analysis (6.0 minutes, 95{\%} CI=0.6, 11.3, p<0.031).ConclusionsThe intervention was effective in increasing adolescents’ minutes of MVPA, suggesting that implementation of the intervention by disadvantaged schools has the potential to slow the decline in physical activity. Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12612000382875.",
author = "Sutherland, {Rachel L.} and Campbell, {Elizabeth M.} and Lubans, {David R.} and Morgan, {Philip J.} and Nathan, {Nicole K.} and Luke Wolfenden and Okely, {Anthony D.} and Gillham, {Karen E.} and Hollis, {Jenna L.} and Oldmeadow, {Chris J.} and Williams, {Amanda J.} and Davies, {Lynda J.} and Wiese, {Jarrod S.} and Alessandra Bisquera and Wiggers, {John H.}",
note = "Acknowledgments The Physical Activity 4 Everyone intervention trial was funded by the New South Wales Ministry of Health through the New South Wales Health Promotion Demonstration Research Grants Scheme and conducted by Hunter New England Population Health (a unit of the Hunter New England Local Health District), in collaboration with the University of Newcastle and University of Wollongong. Infrastructure support was provided by Hunter Medical Research Institute. The research team acknowledges the importance of making research data publically available. Access to the accelerometer data from this study may be made available to external collaborators following the development of data transfer agreements. Further results arising from the study can be found at www.goodforkids.nsw.gov.au/high-schools/. No financial disclosures were reported by the authors of this paper.",
year = "2016",
month = "8",
doi = "10.1016/j.amepre.2016.02.020",
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TY - JOUR

T1 - The Physical Activity 4 Everyone Cluster Randomized Trial

T2 - 2-Year Outcomes of a School Physical Activity Intervention Among Adolescents

AU - Sutherland, Rachel L.

AU - Campbell, Elizabeth M.

AU - Lubans, David R.

AU - Morgan, Philip J.

AU - Nathan, Nicole K.

AU - Wolfenden, Luke

AU - Okely, Anthony D.

AU - Gillham, Karen E.

AU - Hollis, Jenna L.

AU - Oldmeadow, Chris J.

AU - Williams, Amanda J.

AU - Davies, Lynda J.

AU - Wiese, Jarrod S.

AU - Bisquera, Alessandra

AU - Wiggers, John H.

N1 - Acknowledgments The Physical Activity 4 Everyone intervention trial was funded by the New South Wales Ministry of Health through the New South Wales Health Promotion Demonstration Research Grants Scheme and conducted by Hunter New England Population Health (a unit of the Hunter New England Local Health District), in collaboration with the University of Newcastle and University of Wollongong. Infrastructure support was provided by Hunter Medical Research Institute. The research team acknowledges the importance of making research data publically available. Access to the accelerometer data from this study may be made available to external collaborators following the development of data transfer agreements. Further results arising from the study can be found at www.goodforkids.nsw.gov.au/high-schools/. No financial disclosures were reported by the authors of this paper.

PY - 2016/8

Y1 - 2016/8

N2 - IntroductionFew interventions have been successful in reducing the physical activity decline typically observed among adolescents. The aim of this paper is to report the 24-month effectiveness of a multicomponent school-based intervention (Physical Activity 4 Everyone) in reducing the decline in moderate to vigorous physical activity (MVPA) among secondary school students in disadvantaged areas of New South Wales, Australia.Study designA cluster RCT was conducted in five intervention and five control schools with follow-up measures taken at 24 months post-randomization.Setting/participantsThe trial was undertaken within secondary schools located in disadvantaged communities in New South Wales, Australia.InterventionA multicomponent school-based intervention based on the Health Promoting Schools Framework was implemented. The intervention consisted of seven physical activity promotion strategies that targeted the curriculum (teaching strategies to increase physical activity in physical education lessons, student physical activity plans, and modification of school sport program); school environment (recess/lunchtime activities, school physical activity policy); parents (parent newsletters); and community (community physical activity provider promotion). Six additional strategies supported school implementation of the physical activity intervention strategies.Main outcome measureMinutes per day spent in MVPA, objectively measured by accelerometer.ResultsParticipants (N=1,150, 49% male) were a cohort of students aged 12 years (Grade 7) at baseline (March–June 2012) and 14 years (Grade 9) at follow-up (March–July 2014). At 24-month follow-up, there were significant effects in favor of the intervention group for daily minutes of MVPA. The adjusted mean difference in change in daily MVPA between groups was 7.0 minutes (95% CI=2.7, 11.4, p<0.002) (analysis conducted December 2014–February 2015). Sensitivity analyses based on multiple imputation were consistent with the main analysis (6.0 minutes, 95% CI=0.6, 11.3, p<0.031).ConclusionsThe intervention was effective in increasing adolescents’ minutes of MVPA, suggesting that implementation of the intervention by disadvantaged schools has the potential to slow the decline in physical activity. Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12612000382875.

AB - IntroductionFew interventions have been successful in reducing the physical activity decline typically observed among adolescents. The aim of this paper is to report the 24-month effectiveness of a multicomponent school-based intervention (Physical Activity 4 Everyone) in reducing the decline in moderate to vigorous physical activity (MVPA) among secondary school students in disadvantaged areas of New South Wales, Australia.Study designA cluster RCT was conducted in five intervention and five control schools with follow-up measures taken at 24 months post-randomization.Setting/participantsThe trial was undertaken within secondary schools located in disadvantaged communities in New South Wales, Australia.InterventionA multicomponent school-based intervention based on the Health Promoting Schools Framework was implemented. The intervention consisted of seven physical activity promotion strategies that targeted the curriculum (teaching strategies to increase physical activity in physical education lessons, student physical activity plans, and modification of school sport program); school environment (recess/lunchtime activities, school physical activity policy); parents (parent newsletters); and community (community physical activity provider promotion). Six additional strategies supported school implementation of the physical activity intervention strategies.Main outcome measureMinutes per day spent in MVPA, objectively measured by accelerometer.ResultsParticipants (N=1,150, 49% male) were a cohort of students aged 12 years (Grade 7) at baseline (March–June 2012) and 14 years (Grade 9) at follow-up (March–July 2014). At 24-month follow-up, there were significant effects in favor of the intervention group for daily minutes of MVPA. The adjusted mean difference in change in daily MVPA between groups was 7.0 minutes (95% CI=2.7, 11.4, p<0.002) (analysis conducted December 2014–February 2015). Sensitivity analyses based on multiple imputation were consistent with the main analysis (6.0 minutes, 95% CI=0.6, 11.3, p<0.031).ConclusionsThe intervention was effective in increasing adolescents’ minutes of MVPA, suggesting that implementation of the intervention by disadvantaged schools has the potential to slow the decline in physical activity. Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12612000382875.

U2 - 10.1016/j.amepre.2016.02.020

DO - 10.1016/j.amepre.2016.02.020

M3 - Article

VL - 51

SP - 195

EP - 205

JO - American Journal of Preventive Medicine

JF - American Journal of Preventive Medicine

SN - 0749-3797

IS - 2

ER -