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Pathways to Increasing Adolescent Physical Activity and Wellbeing: A Mediation Analysis of Intervention Components Designed Using a Participatory Approach.

Published version
Peer-reviewed

Type

Article

Change log

Authors

Werneck, André O 
Jong, Stephanie T 
Hoare, Erin 
Brown, Helen Elizabeth 

Abstract

We assessed which intervention components were associated with change in moderate-to-vigorous physical activity (MVPA) and wellbeing through proposed psychosocial mediators. Eight schools (n = 1319; 13-14 years) ran GoActive, where older mentors and in-class-peer-leaders encouraged classes to conduct two new activities/week; students gained points and rewards for activity. We assessed exposures: participant-perceived engagement with components (post-intervention): older mentorship, peer leadership, class sessions, competition, rewards, points entered online; potential mediators (change from baseline): social support, self-efficacy, group cohesion, friendship quality, self-esteem; and outcomes (change from baseline): accelerometer-assessed MVPA (min/day), wellbeing (Warwick-Edinburgh). Mediation was assessed using linear regression models stratified by gender (adjusted for age, ethnicity, language, school, BMI z-score, baseline values), assessing associations between (1) exposures and mediators, (2) exposures and outcomes (without mediators) and (3) exposure and mediator with outcome using bootstrap resampling. No evidence was found to support the use of these components to increase physical activity. Among boys, higher perceived teacher and mentor support were associated with improved wellbeing via various mediators. Among girls, higher perceived mentor support and perception of competition and rewards were positively associated with wellbeing via self-efficacy, self-esteem and social support. If implemented well, mentorship could increase wellbeing among adolescents. Teacher support and class-based activity sessions may be important for boys' wellbeing, whereas rewards and competition warrant consideration among girls.

Description

Keywords

adolescent, health promotion, intervention, mental health, physical activity, school, Adolescent, Adolescent Behavior, Behavior Therapy, Exercise, Female, Health Promotion, Humans, Male, Motivation, Patient Participation, Social Support, Students, United Kingdom

Journal Title

Int J Environ Res Public Health

Conference Name

Journal ISSN

1661-7827
1660-4601

Volume Title

17

Publisher

MDPI AG
Sponsorship
Wellcome Trust (087636/Z/08/Z)
Economic and Social Research Council (ES/G007462/1)
Medical Research Council (MC_UU_12015/7)
Medical Research Council (MR/K023187/1)
Department of Health (via National Institute for Health Research (NIHR)) (114687)
MRC (MC_UU_00006/5)