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Development of a universal approach to increase physical activity among adolescents: the GoActive intervention.



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Kesten, Joanna M 
van Sluijs, Esther MF 


OBJECTIVES: To develop a physical activity (PA) promotion intervention for adolescents using a process addressing gaps in the literature while considering participant engagement. We describe the initial development stages; (1) existing evidence, (2) large scale opinion gathering and (3) developmental qualitative work, aiming (A) to gain insight into how to increase PA among the whole of year 9 (13-14 years-old) by identifying elements for intervention inclusion (B) to improve participant engagement and (C) to develop and refine programme design. METHODS: Relevant systematic reviews and longitudinal analyses of change were examined. An intervention was developed iteratively with older adolescents (17.3 ± 0.5 years) and teachers, using the following process: (1) focus groups with (A) adolescents (n=26) and (B) teachers (n=4); (2) individual interviews (n=5) with inactive and shy adolescents focusing on engagement and programme acceptability. Qualitative data were analysed thematically. RESULTS: Limitations of the existing literature include lack of evidence on whole population approaches, limited adolescent involvement in intervention development, and poor participant engagement. Qualitative work suggested six themes which may encourage adolescents to do more PA; choice, novelty, mentorship, competition, rewards and flexibility. Teachers discussed time pressures as a barrier to encouraging adolescent PA and suggested between-class competition as a strategy. GoActive aims to increase PA through increased peer support, self-efficacy, group cohesion, self-esteem and friendship quality, and is implemented in tutor groups using a student-led tiered-leadership system. CONCLUSIONS: We have followed an evidence-based iterative approach to translate existing evidence into an adolescent PA promotion intervention. Qualitative work with adolescents and teachers supported intervention design and addressed lack of engagement with health promotion programmes within this age group. Future work will examine the feasibility and effectiveness of GoActive to increase PA among adolescents while monitoring potential negative effects. The approach developed is applicable to other population groups and health behaviours. TRIAL REGISTRATION NUMBER: ISRCTN31583496.



PUBLIC HEALTH, Physical activity, adolescent, behaviour change, intervention, Adolescent, Female, Focus Groups, Health Behavior, Health Promotion, Humans, Interviews as Topic, Male, Motor Activity, United Kingdom

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BMJ Open

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Medical Research Council (MC_UU_12015/7)
Medical Research Council (MR/K023187/1)
Medical Research Council (MC_UU_12015/6)
Economic and Social Research Council (ES/G007462/1)
Wellcome Trust (087636/Z/08/Z)
Funding for this development study and the work of all authors was supported, wholly or in part, by the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence (RES 590 28 0002). Funding from the British Heart Foundation, Department of Health, Economic and Social Research Council, Medical Research Council, and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged. The work of Kirsten Corder, Joanna Kesten and Esther M F van Sluijs was supported by the Medical Research Council (MC_UU_ 12015/7 and MC_UU_12015/6).