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The Physical Activity 4 Everyone cluster randomized trial: 2-year outcomes of a school physical activity intervention among adolescents
Sutherland RL, Campbell EM, Lubans DR, Morgan PJ, Nathan NK, Wolfenden L, Okely AD, Gillham KE, Hollis JL, Oldmeadow CJ, Williams AJ, Davies LJ, Wiese JS, Bisquera A, Wiggers JH
American Journal of Preventive Medicine 2016 Aug;51(2):195-205
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

INTRODUCTION: Few interventions have been successful in reducing the physical activity decline typically observed among adolescents. The aim of this paper is to report the 24-month effectiveness of a multicomponent school-based intervention (Physical Activity 4 Everyone) in reducing the decline in moderate to vigorous physical activity (MVPA) among secondary school students in disadvantaged areas of New South Wales, Australia. STUDY DESIGN: A cluster RCT was conducted in five intervention and five control schools with follow-up measures taken at 24 months post-randomization. SETTING/PARTICIPANTS: The trial was undertaken within secondary schools located in disadvantaged communities in New South Wales, Australia. INTERVENTION: A multicomponent school-based intervention based on the Health Promoting Schools Framework was implemented. The intervention consisted of seven physical activity promotion strategies that targeted the curriculum (teaching strategies to increase physical activity in physical education lessons, student physical activity plans, and modification of school sport program); school environment (recess/lunchtime activities, school physical activity policy); parents (parent newsletters); and community (community physical activity provider promotion). Six additional strategies supported school implementation of the physical activity intervention strategies. MAIN OUTCOME MEASURE: Minutes per day spent in MVPA, objectively measured by accelerometer. RESULTS: Participants (n = 1,150, 49% male) were a cohort of students aged 12 years (grade 7) at baseline (March to June 2012) and 14 years (grade 9) at follow-up (March to July 2014). At 24-month follow-up, there were significant effects in favor of the intervention group for daily minutes of MVPA. The adjusted mean difference in change in daily MVPA between groups was 7.0 minutes (95% CI 2.7 to 11.4, p < 0.002) (analysis conducted December 2014 to February 2015). Sensitivity analyses based on multiple imputation were consistent with the main analysis (6.0 minutes, 95% CI 0.6 to 11.3, p < 0.031). CONCLUSIONS: The intervention was effective in increasing adolescents' minutes of MVPA, suggesting that implementation of the intervention by disadvantaged schools has the potential to slow the decline in physical activity. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12612000382875.

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