Effectiveness and cost-effectiveness of the PLAN-A intervention, a peer led physical activity program for adolescent girls: results of a cluster randomised controlled trial

Springer Science and Business Media LLC - Tập 18 - Trang 1-13 - 2021
Russell Jago1,2, Byron Tibbitts1, Kathryn Willis1, Emily Sanderson3,4, Rebecca Kandiyali3,4, Tom Reid1, Ruth R Kipping4, Rona Campbell4, Stephanie J MacNeill3,4, William Hollingworth3,4, Simon J. Sebire1
1Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
2The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol NHS Foundation Trust, Bristol, UK
3Bristol Trials Centre, Bristol Randomised Trials Collaboration, University of Bristol, Bristol, UK
4Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK

Tóm tắt

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.

Tài liệu tham khảo

Ortega FB, Ruiz JR, Hurtig-Wennlof A, Vicente-Rodriguez G, Rizzo NS, Castillo MJ, Sjostrom M. Cardiovascular fitness modifies the associations between physical activity and abdominal adiposity in children and adolescents. The European Youth Heart Study. Br J Sports Med 2008. Biddle SJH, Asare M. Physical activity and mental health in children and adolescents: a review of reviews. Br J Sports Med. 2011;45(11):886–95. Janssen I, Leblanc AG. Systematic review of the health benefits of physical activity and fitness in school-aged children and youth. Int J Behav Nutr Phys Act. 2010;7:40. Cooper AR, Goodman A, Page AS, Sherar LB, Esliger DW, van Sluijs EM, Andersen LB, Anderssen S, Cardon G, Davey R, et al. Objectively measured physical activity and sedentary time in youth: the International children’s accelerometry database (ICAD). Int J Behav Nutr Phys Act. 2015;12:113. Steene-Johannessen J, Hansen BH, Dalene KE, Kolle E, Northstone K, Moller NC, Grontved A, Wedderkopp N, Kriemler S, Page AS, et al. Variations in accelerometry measured physical activity and sedentary time across Europe - harmonized analyses of 47,497 children and adolescents. Int J Behav Nutr Phys Act. 2020;17(1):38. Jago R, Salway R, Emm-Collison L, Sebire SJ, Thompson JL, Lawlor DA. Association of BMI category with change in children’s physical activity between ages 6 and 11 years: a longitudinal study. Int J Obes (Lond). 2020;44(1):104–13. Owen MB. The effectiveness of school-based physical activity interventions for adolescent girls: A systematic review and meta-analysis. Prev Med 2017, 105. Pearson N, Braithwaite R, Biddle SJ. The effectiveness of interventions to increase physical activity among adolescent girls: a meta-analysis. Acad Pediatr 2015, 15. Campbell R, Starkey F, Holliday J, Audrey S, Bloor M, Parry-Langdon N, Hughes R, Moore L. An informal school-based peer-led intervention for smoking prevention in adolescence (ASSIST): a cluster randomised trial. Lancet. 2008;371(9624):1595–602. Sebire SJ, Jago R, Banfield K, Edwards MJ, Campbell R, Kipping R, Blair PS, Kadir B, Garfield K, Matthews J, et al. Results of a feasibility cluster randomised controlled trial of a peer-led school-based intervention to increase the physical activity of adolescent girls (PLAN-A). Int J Behav Nutr Phys Act. 2018;15(1):50. Rogers EM. Diffusion of Innovations. 1983, NY: The Free Press. In. Deci EL, Ryan RM. The “what” and “why” of goal pursuits: Human needs and the self-determination of behavior. Psychol Inq. 2000;11:227–68. Sebire SJ, Jago R, Fox KR, Edwards MJ, Thompson JL. Testing a self-determination theory model of children’s physical activity motivation: a cross-sectional study. Int J Behav Nutr Phys Act. 2013;10:111. Willis K, Tibbitts B, Sebire SJ, Reid T, MacNeill SJ, Sanderson E, Hollingworth W, Kandiyali R, Campbell R, Kipping RR, et al. Protocol for a cluster randomised controlled trial of a Peer-Led physical Activity iNtervention for Adolescent girls (PLAN-A). BMC Public Health. 2019;19(1):644. Campbell MK, Piaggio G, Elbourne DR, Altman DG, Group C. Consort 2010 statement: extension to cluster randomised trials. BMJ. 2012;345:e5661. Sebire S, Banfield K, Campbell R, Edjwards MJ, Kipping R, Kadir B, Garfield K, Matthews J, Blair PS, Lyons RA, Hollingworth W, Jago R. A peer-led physical activity intervention in schools for adolescent girls: a feasibility RCT. Public Health Research 2019, 7. Boyce W. The family affluence scale as a measure of national wealth: Validation of an adolescent self-report measure. Social Indicators Research 2006, 78. Evenson KR, Catellier DJ, Gill K, Ondrak KS, McMurray RG. Calibration of two objective measures of physical activity for children. Journal of sports sciences. 2008;26(14):1557–65. Wille N: Development of the EQ-5D-Y: a child-friendly version of the EQ-5D. Quality of life research: an international journal of quality of life aspects of treatment, care and rehabilitation 2010, 19. Europe TKG. The KIDSCREEN Questionnaires: Quality of life questionnaires for children and adolescents. Pabst Science Publishers; 2006. Chen G, Stevens K, Rowen D, Ratcliffe J. From KIDSCREEN-10 to CHU9D: creating a unique mapping algorithm for application in economic evaluation. Health Qual Life Outcomes. 2014;12(1):134. Marsh HW. Self Description Questionnaire (SDQ) II: A theoretical and empirical basis for the measurement of multiple dimensions of adolescent self-concept. A test manual and research monograph. New South Wales: University of Western Sydney, Faculty of Education; 1992. Markland D, Tobin V. A modification of the Behavioral Regulation in Exercise Questionnaire to include an assessment of amotivation. Journal of Sport Exercise Psychology. 2004;26:191–6. Standage M, Duda JL, Ntoumanis N. A test of self-determination theory in school physical education. Br J Educ Psychol. 2005;75(Pt 3):411–33. McAuley E, Duncan T, Tammen VV. Psychometric properties of the Intrinsic Motivation Inventory in a competitive sport setting: a confirmatory factor analysis. Res Q Exerc Sport. 1989;60(1):48–58. Bartholomew JBLA, Jowers EM, Allua S. Validation of the Physical Activity Self-Efficacy Scale: Testing measurement invariance between Hispanic and Caucasian children. J Phys Act Health. 2006;3(1):70–8. Mendonça G, Júnior JC. Physical activity and social support in adolescents: analysis of different types and sources of social support. Journal of sports sciences. 2015;33(18):1942–51. Macneill SJ, Jago R. Statistical Analysis plan for PLAN A: A cluster randomised trial of a Peer-Led physical Activity iNtervention for Adolescent girls. Unpublished University of Bristol; 2020. Hicks RT. D: Casual Mediation Analysis. The Stata Journal. 2011;11(4):1–15. Department of Health and Social Care. UK Chief Medical Officers’ Physical Activity Guidelines. In. Edited by Department of Health and Social Care. London; 2019. Ng ESW, Grieve R, Carpenter JR. Two-stage nonparametric bootstrap sampling with shrinkage correction for clustered data. Stata J. 2013;13(1):141–64. Gomes M, Ng ESW, Grieve R, Nixon R, Carpenter J, Thompson SG. Developing Appropriate Methods for Cost-Effectiveness Analysis of Cluster Randomized Trials. Med Decis Making. 2012;32(2):350–61. Fenwick E, O’Brien BJ, Briggs A. Cost-effectiveness acceptability curves - facts, fallacies and frequently asked questions. Health Econ. 2004;13(5):405–15. Sutherland RL, Campbell EM, Lubans DR, Morgan PJ, Nathan NK, Wolfenden L, Okely AD, Gillham KE, Hollis JL, Oldmeadow CJ, et al. The Physical Activity 4 Everyone Cluster Randomized Trial: 2-Year Outcomes of a School Physical Activity Intervention Among Adolescents. Am J Prev Med. 2016;51(2):195–205. Beets MW, Weaver RG, Turner-McGrievy G, Huberty J, Ward DS, Pate RR, Freedman D, Hutto B, Moore JB, Bottai M, et al. Physical activity outcomes in afterschool programs: A group randomized controlled trial. Prev Med. 2016;90:207–15. Harrington DM, Davies MJ, Bodicoat DH, Charles JM, Chudasama YV, Gorely T, Khunti K, Plekhanova T, Rowlands AV, Sherar LB, et al: Effectiveness of the ‘Girls Active’ school-based physical activity programme: A cluster randomised controlled trial. Int J Behav Nutr Phys Activity 2018, 15. Corder K, Sharp SJ, Jong ST, Foubister C, Brown HE, Wells EK, Armitage SM, Croxson CHD, Vignoles A, Wilkinson PO, et al: Effectiveness and cost-effectiveness of the GoActive intervention to increase physical activity among UK adolescents: A cluster randomised controlled trial. PLoS Med 2020, 17(7). Harrington DM, O’Reilly M. The reimagination of school-based physical activity research in the COVID-19 era. PLoS Med 2020, 17(8). Beets MW, Weaver RG, Ioannidis JPA, Geraci M, Brazendale K, Decker L, Okely AD, Lubans D, van Sluijs E, Jago R, et al: Identification and evaluation of risk of generalizability biases in pilot versus efficacy/effectiveness trials: a systematic review and meta-analysis. Int J Behav Nutr Phys Activity 2020, 17(1). Chatzisarantis NLD, Hagger MS. Effects of an intervention based on self-determination theory on self-reported leisure-time physical activity participation. Psychology health. 2009;24(1):29–48. Shannon S, Brennan D, Hanna D, Younger Z, Hassan J, Breslin G. The Effect of a School-Based Intervention on Physical Activity and Well-Being: a Non-Randomised Controlled Trial with Children of Low Socio-Economic Status. Sports Med-Open 2018, 4. Demetriou Y, Reimers AK, Alesi M, Scifo L, Borrego CC, Monteiro D, Kelso A. Effects of school-based interventions on motivation towards physical activity in children and adolescents: protocol for a systematic review. Syst Rev-London 2019, 8.