Hankonen Nelli, Heino Matti T J, Hynynen Sini-Tuuli, Laine Hanna, Araújo-Soares Vera, Sniehotta Falko F, Vasankari Tommi, Sund Reijo, Haukkala Ari
Faculty of Social Sciences, University of Tampere, Kalevankatu 4, 33014, Tampere, Finland.
Faculty of Social Sciences, University of Helsinki, Helsinki, Finland.
Int J Behav Nutr Phys Act. 2017 Mar 21;14(1):37. doi: 10.1186/s12966-017-0484-0.
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.
针对大龄青少年的校内体育活动（PA）干预措施均未显示出长期有效性，而且迄今为止几乎没有措施涉及久坐行为（SB）。基于行为理论和证据，我们设计了一项多层次干预措施，以增加职业学校学生的体育活动并减少久坐行为。本研究调查了两项主要干预组成部分和研究程序的可行性与可接受性。我们还考察了参与者对行为改变技术（BCTs）的采用情况。
采用结果评估者盲法、整群随机对照试验设计。将四组学生（配对）随机分为一个干预组和一个对照组。干预措施包括：（1）为学生开展一次为期6小时的小组干预；（2）为教师举办两次为期2小时的培训工作坊，以减少学生在课堂上的久坐时间；（3）在教室提供轻度体育活动设备。在基线期（T1）、干预中期（3周后的T2）、干预后（T3）以及基线期后6个月（T4），我们测量了假设的心理社会调节因素以及自我报告的体育活动和久坐情况。在T1、T3和T4对体育活动和久坐行为进行客观评估（7天加速度计测量）。在T1和T4测量身体成分（生物电阻抗）。干预组的学生和教师在T3填写可接受性问卷。
招募率为64%（学生）和88.9%（教师），在T3时，33名学生（保留率76.7%）和15名教师（保留率93.8%）完成了所有干预后测量。各环节的可接受性评分较高（学生M = 6.29，1 - 7分制），数据收集程序可行。干预组学生报告使用行为改变技术的情况有所增加，但一些关键行为改变技术未得到充分采用。行为改变技术的使用与体育活动的客观测量高度相关。基于自我报告和学生评价，干预组教师在干预后和T4随访时增加了减少久坐策略的使用（p < .05）。
我们发现目标群体有参与意愿，问卷回复率良好，保留率充足，且试验方案具有可接受性。对学生使用行为改变技术的调查有助于进一步完善干预程序，以促进行为改变技术的使用。在进行必要修改后，接下来可以在确定性试验中测试干预效果。
ISRCTN34534846。2014年5月23日注册。回顾性注册。
