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The feasibility and acceptability of a primary school-based programme targeting diet and physical activity: the PhunkyFoods Programme.

ABSTRACT: Background:This study aims to evaluate the feasibility and acceptability of the PhunkyFoods Programme, a primary school-based intervention to promote healthy nutrition and physical activity knowledge and behaviours to assess outcomes to inform a phase 3 trial. Methods:The cluster randomised feasibility trial recruited eight primary schools from the North of England. Elibility criteria included all primary schools in one town, excluding independent and special schools and schools that comprised of only key stage 2 pupils (years 3-6). Eight schools agreed to participate. Randomisation to intervention or control arms was in a 1:1 ratio. Intervention schools received PhunkyFoods over 17?months. Control schools continued with usual curriculum. Assessors were blinded to group assignment. Measures comprised of a Healthy Lifestyle Knowledge Questionnaire and Synchronised Nutrition and Activity Program to assess diet and physical activity, height, weight, and psychological wellbeing. Feasibility outcomes were recruitment, attrition rates, interviews with teaching staff, focus groups with pupils to explore the acceptability of outcome measures, implementation, intervention content, and programme fidelity. Results:Three hundred fifty-eight pupils, aged 6-9?years from eight schools were recruited at baseline (control n = 170, intervention n = 188); 337 (94.1%) at 6?months (control n = 163, intervention n = 181); and 331 (92.5%) at 18?months (control n = 152, intervention n = 179), and 6 pupils opted out. Trends in increased knowledge of healthy lifestyle behaviours, healthier eating, and liking of fruit and vegetables were reported in the intervention compared to the control group. Year 4 intervention pupils had significantly higher healthy balanced diet knowledge scores compared to control pupils, mean difference 5.1 (95% CI 0.1 to 10.1, p=0.05). At 18?months, the mean percentage of vegetables liked was higher (intervention 53.9% vs. 43.0% control). Similarly, percentage of fruits liked was also higher (intervention 76.9% vs. 67.2% control). Qualitative data showed that delivery of the intervention was feasible and acceptable to teachers and pupils. Lessons were learned to inform the phase 3 trial around the dietary assessment measure and timing of recruitment. Conclusions:Whilst the study was not powered to detect a definitive effect, results suggest a potential to increase knowledge of healthy lifestyle behaviours and dietary behaviours, suggesting that with minor changes, a phase 3 trial is likely to be deliverable. Trial registration:ISRCTN, ISRCTN15641330. Registered 8 May 2015-retrospectively registered, 10.1186/ISRCTN15641330.

SUBMITTER: Sahota P

PROVIDER: S-EPMC6925414 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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The feasibility and acceptability of a primary school-based programme targeting diet and physical activity: the PhunkyFoods Programme.

Sahota Pinki P Christian Meaghan M Day Rhiannon R Cocks Kim K

Pilot and feasibility studies 20191220

<h4>Background</h4>This study aims to evaluate the feasibility and acceptability of the PhunkyFoods Programme, a primary school-based intervention to promote healthy nutrition and physical activity knowledge and behaviours to assess outcomes to inform a phase 3 trial.<h4>Methods</h4>The cluster randomised feasibility trial recruited eight primary schools from the North of England. Elibility criteria included all primary schools in one town, excluding independent and special schools and schools t ...[more]

PMID: 31890264

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Project description:Background: Many children are not engaging in sufficient physical activity and there are substantial between-children physical activity inequalities. In addition to their primary role as educators, teachers are often regarded as being well-placed to make vital contributions to inclusive visions of physical activity promotion. With the dramatic increase in popularity of wearable technologies for physical activity promotion in recent years, there is a need to better understand teachers' perspectives about using such devices, and the data they produce, to support physical activity promotion in schools. Method: Semi-structured interviews were conducted with 26 UK-based primary school teachers, exploring their responses to children's physical activity data and their views about using wearable technologies during the school day. Interview discussions were facilitated by an elicitation technique whereby participants were presented with graphs illustrating children's in-school physical activity obtained from secondary wearable technology data. Interview transcripts were thematically analyzed. Results: Most teachers spoke positively about the use of wearable technologies specifically designed for school use, highlighting potential benefits and considerations. Many teachers were able to understand and critically interpret data showing unequal physical activity patterns both within-and between-schools. Being presented with the data prompted teachers to provide explanations about observable patterns, emotional reactions-particularly about inequalities-and express motivations to change the current situations in schools. Conclusion: These findings suggest that primary school teachers in the UK are open to integrating wearable technology for measuring children's physical activity into their practices and can interpret the data produced by such devices. Visual representations of physical activity elicited strong responses and thus could be used when working with teachers as an effective trigger to inform school practices and policies seeking to address in-school physical inactivity and inequalities.

Project description:ObjectivesTo develop a school-based obesity prevention programme and evaluate the feasibility and acceptability of the intervention and the planned definitive cluster randomised trial.DesignThis was a three stage pilot involving six schools (398 children) in South West England, including an exploratory randomised controlled trial and qualitative interviews and focus groups with teachers, parents and children.InterventionThe Healthy Lifestyle Programme uses a range of school-based activities including lessons, assemblies, parents' evenings, interactive drama workshops and goal setting to engage schools, children and their families.ResultsOf the 398 eligible children in the three pilot phases, only four opted out and a further three withdrew from the exploratory trial. In the exploratory trial, baseline measurements (anthropometric and behavioural) were obtained for 202/204 eligible children in four schools and both 18- and 24-month outcome measurements for 193/204 and 187/204 participants, respectively. Qualitative data show that delivery of the intervention is feasible within schools and acceptable to teachers, children and families. In the exploratory trial, 18/80 children (24%) in the intervention schools and 31/122 (26%) in the control schools were overweight or obese at baseline, increasing, at 18-month follow-up, to 38/119 (32%) in the control schools compared with 18/74 (24%) in the intervention schools. At 24 months the proportion of overweight and obese children in the control schools remained at 32% (36/114), whereas the proportion in the intervention schools decreased slightly to 22% (16/73).ConclusionThe Healthy Lifestyle Programme is feasible to deliver and acceptable to schools, children and their families. We recruited, retained and obtained outcome measurements from 92% of eligible children in the exploratory trial, including measurements taken after transition to secondary school, suggesting that a definitive trial is likely to be deliverable.

Project description:Background: The school gives access to children, regardless of age, ethnicity, gender and socio-economic class and can be identified as the key environment in which to promote children's physical activity (PA). The guidelines of the European Union recommend accumulating at least 10-min bouts of PA to reach the daily 60 min. Active breaks (ABs) led by teachers inside the classroom represent a good strategy to promote PA. The aim of this pilot and feasibility study was to evaluate the feasibility and effectiveness in terms of PA level of an AB programme in children aged 8-9 years attending primary school. Methods: A pre-post quasi-experimental pilot and feasibility study was performed in two primary school classes, one of which was assigned to a 14-week AB intervention (AB group) and the other to the control group (CG). At baseline and at follow-up, children were monitored for sedentary and motor activity during an entire week using ActiGraph Accelerometer (ActiLife6 wGT3X-BT). The satisfaction of children and teachers was assessed by self-administered questionnaires. Results: In the pre-post comparison, AB group (n = 16) showed a reduction in the minutes spent in weekly sedentary activity (-168.7 min, p > 0.05), an increase in the number of step counts (+14,026.9, p < 0.05) and in time spent in moderate to vigorous PA (MVPA): weekly MVPA: +64.4 min, daily MVPA: +8.05 min, percentage of MVPA: +0.70%. On the contrary, CG showed a worsening in all variables. ANCOVA analysis, after adjusting for baseline values, showed significant differences between the AB group and CG for time spent in MVPA, percentage of MVPA and step counts. The satisfaction of children and teachers was good. Teachers were able to adapt the AB protocol to the needs of the school curriculum, thus confirming the feasibility of the AB programme. Conclusions: This pilot and feasibility study showed the feasibility and effectiveness of the AB protocol and represented the basis for a future controlled trial.

Project description:There is an urgent need for children in China to increase their physical activity levels. We first developed a 16-week school-based behavior change intervention based on the Behavior Change Wheel and Theoretical Domains Framework. We then conducted a cluster feasibility non-randomized controlled trial (RCT) among children in Yangzhou, China. This qualitative process evaluation was embedded within the cluster feasibility non-RCT and aimed to: (1) explore the experiences and perceptions of participants and providers in the intervention and trial; and (2) generate recommendations to inform a future intervention and full-scale cluster RCT. A qualitative study, using semi-structured interviews with trial participants (n = 20 children: 10 intervention, 10 control), parents (n = 20), and health education providers (n = 2), was conducted in two public schools in Yangzhou, China. Interviews were audio-recorded, transcribed, and translated verbatim from Mandarin to English. Data were analyzed using thematic analysis. Findings believed to reflect experiences and perceptions of participants in the intervention and the trial are presented as eight major themes: (1) perceived high efficacy of the intervention components to help children become more active, (2) appreciation of the intervention features, (3) factors that facilitated or impeded intervention attendance and delivery, (4) positive experiences and feelings gained through the data collection process, (5) satisfaction regarding the organization and implementation of the trial, (6) influences of personal beliefs and emotional responses to the trial, (7) social influences on participatory decision-making, and (8) key barriers to consider regarding the recruitment of participants. The intervention and trial methods were acceptable to children, parents, and health education providers. School-based behavior change intervention was perceived to be a useful approach to increase physical activity in children aged 10-12 years in China. However, there were barriers to intervention delivery and engagement that should be considered when designing a future cluster RCT to assess the intervention efficacy.

Project description:Although fitness may benefit cognition in youth, most attention has been given to cardiorespiratory fitness despite the health benefits of muscular fitness. Few studies have examined interventions that incorporate both cardiorespiratory and muscular fitness or have been offered during school recess. Furthermore, most fitness intervention studies examining cognitive outcomes have not reported on implementation information. The purpose of this pilot study was to examine the feasibility, acceptability, and preliminary efficacy on fitness and cognition of a recess intervention in elementary school children. Two schools were randomized to either a 3-month cardiorespiratory and muscular fitness intervention (15 minutes/weekday during recess) or control condition (standard recess activities). Process evaluation (feasibility and acceptability) measures were recorded daily (research staff questionnaire), weekly (accelerometer and heart rate monitors), and post-intervention (participant and school-staff questionnaires). Preliminary efficacy measures included pre- and post-intervention inhibition/attention, working memory, and cardiorespiratory and muscular fitness scores. Some feasibility and acceptability measures were favorable (88% of the lessons were implemented, 78% of the lessons were implemented as planned, and the majority of students and school staff were satisfied with most aspects of the intervention). However, intensity adherence during the intervention sessions based on accelerometry (% of time spent in moderate-to-vigorous activity: 41.7 ± 14.5) and participation (19.4% attendance rate) were lower than expected. Preliminary efficacy of the intervention on cognitive and fitness outcomes was not demonstrated. This study provided evidence that some aspects of the fitness intervention were acceptable during school recess. However, important implementation factors (i.e., intervention exposure) should be targeted to improve youth fitness programs offered during this school setting.

Project description:BackgroundNo 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.MethodsDesign 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.ResultsRecruitment 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).ConclusionsWe 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.Trial registrationISRCTN34534846 . Registered 23 May 2014. Retrospectively registered.

Dataset Information

The feasibility and acceptability of a primary school-based programme targeting diet and physical activity: the PhunkyFoods Programme.

Publications

The feasibility and acceptability of a primary school-based programme targeting diet and physical activity: the PhunkyFoods Programme.

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