Jago Russell, Tibbitts Byron, Willis Kathryn, Sanderson Emily, Kandiyali Rebecca, Reid Tom, Kipping Ruth R, Campbell Rona, MacNeill Stephanie J, Hollingworth William, Sebire Simon J
Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Road, BS8 1TZ, Bristol, UK.
The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol NHS Foundation Trust, Bristol, UK.
Int J Behav Nutr Phys Act. 2021 May 13;18(1):63. doi: 10.1186/s12966-021-01133-8.
Physical activity is associated with improved health. Girls are less active than boys. Pilot work showed that a peer-led physical activity intervention called PLAN-A was a promising method of increasing physical activity in secondary school age girls. This study examined the effectiveness and cost-effectiveness of the PLAN-A intervention.
We conducted a cluster randomised controlled trial with Year 9 (13-14 year old) girls recruited from 20 secondary schools. Schools were randomly assigned to the PLAN-A intervention or a non-intervention control group after baseline data collection. Girls nominated students to be peer leaders. The top 18 % of girls nominated by their peers in intervention schools received three days of training designed to prepare them to support physical activity. Data were collected at two time points, baseline (T0) and 5-6 months post-intervention (T1). Participants wore an accelerometer for seven days to assess the primary outcome of mean weekday minutes of moderate-to-vigorous physical activity (MVPA). Multivariable mixed effects linear regression was used to estimate differences in the primary outcome between the two arms on an Intention-to-Treat (ITT) basis. Resource use and quality of life were measured and a within trial economic evaluation from a public sector perspective was conducted.
A total of 1558 girls were recruited to the study. At T0, girls in both arms engaged in an average of 51 min of MVPA per weekday. The adjusted mean difference in weekday MVPA at T1 was - 2.84 min per day (95 % CI = -5.94 to 0.25) indicating a slightly larger decline in weekday MVPA in the intervention group. Results were broadly consistent when repeated using a multiple imputation approach and for pre-specified secondary outcomes and sub-groups. The mean cost of the PLAN-A intervention was £2817 per school, equivalent to £31 per girl. Economic analyses indicated that PLAN-A did not lead to demonstrable cost-effectiveness in terms of cost per unit change in QALY.
This study has shown that the PLAN-A intervention did not result in higher levels of weekday MVPA or associated secondary outcomes among Year 9 girls. The PLAN-A intervention should not be disseminated as a public health strategy.
ISRCTN14539759 -31 May, 2018.
体育活动与健康状况改善相关。女孩的运动量比男孩少。前期试验表明，一种名为PLAN - A的同伴主导的体育活动干预措施是增加中学年龄段女孩体育活动量的一种有前景的方法。本研究考察了PLAN - A干预措施的有效性和成本效益。
我们对从20所中学招募的9年级（13 - 14岁）女孩进行了一项整群随机对照试验。在收集基线数据后，学校被随机分配到PLAN - A干预组或非干预对照组。女孩们提名学生担任同伴领袖。在干预学校中，被同伴提名的前18%的女孩接受了为期三天的培训，以使她们有能力支持体育活动。在两个时间点收集数据，基线期（T0）和干预后5 - 6个月（T1）。参与者佩戴加速度计七天，以评估中度至剧烈体育活动（MVPA）的工作日平均分钟数这一主要结局指标。使用多变量混合效应线性回归，在意向性分析（ITT）基础上估计两组在主要结局指标上的差异。测量了资源使用情况和生活质量，并从公共部门角度进行了试验期内的经济评估。
共有1558名女孩参与了本研究。在T0时，两组女孩平均每个工作日进行MVPA的时间为51分钟。T1时工作日MVPA的调整后平均差异为每天 - 2.84分钟（95%CI = - 5.94至0.25），表明干预组工作日MVPA的下降幅度略大。在使用多重填补法重复分析以及针对预先设定的次要结局指标和亚组进行分析时，结果大致一致。PLAN - A干预措施的平均成本为每所学校2817英镑，相当于每个女孩31英镑。经济分析表明，就每质量调整生命年（QALY）变化的单位成本而言，PLAN - A并未显示出明显的成本效益。
本研究表明，PLAN - A干预措施并未使9年级女孩的工作日MVPA水平或相关次要结局指标更高。PLAN - A干预措施不应作为一项公共卫生策略进行推广。
ISRCTN14539759 - 2018年5月31日。
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