PLAN-A: Assessment of whether a peer-led program increases the physical activity of year 9 girls
Prospectively registered
Being physically active is good for children’s health. Few adolescent girls are active enough to get these health benefits and teenage girls face lots of barriers to being physically active. Research shows that most school-based programs to increase adolescents' physical activity do not work, but few high quality studies have been tried in the UK. A peer-led program called PLAN-A has been developed in which adolescent girls inspire their peers to take part in more physical activity. Preliminary work has shown that PLAN-A has the potential to help adolescent girls to be more physically active.
This study aims to examine whether girls who take part in the PLAN-A program in 10 intervention schools obtain more moderate to vigorous intensity physical activity (MVPA) a year after the baseline assessment has been made than girls in 10 comparison schools. It also assesses how much the program costs and conducts qualitative research to understand how the program was received by schools and pupils and if it could be improved or adapted before using widely.
Year 9 girls in participating schools.
The study is based on a feasibility trial in which a peer-led physical activity intervention for 13-14 year old girls was developed. The study is conducted in 20 schools, ten of which receive the intervention. In these schools, peer supporters are trained by experts in physical activity and youth work. Ten schools are “comparison schools” and do not do the peer-training. Schools are allocated to intervention or comparison at random.
Year 9 girls in all twenty schools are asked to provide information at two times: before the schools are chosen to be project or comparison schools, and 1 year after the first measurements. Participants’ physical activity levels are measured using activity monitors and their motivation for being active using questionnaires. The cost of delivering the intervention is also assessed. Interviews and group discussions with peer-supporters, pupils, school staff, trainers and public health commissioners are used to find out what was successful and what could be changed in future.
The benefits of participation for peer-supporters include an increased awareness of physical activity and the health benefits of being more active, improved teamwork, communication, empathy and problem solving skills, and a potential increase in physical activity levels due to the ideas and knowledge gained during the training and intervention period. The benefits of participation for Year 9 girls who are not peer-supporters include being encouraged to be more active from their peers, greater exposure to new ideas about how to incorporate physical activity into their day-to-day life, and the potential health benefits this holds. Schools benefit by having a number of their pupils attending a training course which may increase their skills, confidence and leadership abilities. Additionally, physical activity levels throughout the Year 9 female cohort may be increased.
The potential risks to participants are minimal. Peer-supporters may face instances of bullying/teasing, but we ensure reporting procedures are in place to minimise such instances and effectively deal with any that do arise. Non-peer-supporters may feel pressured to be active, but the training that peer-supporters receive covers empathy and effective communication.
Peer-supporters attend a two-day course to develop the skills, knowledge and confidence to promote physical activity amongst their peers. Training is held off-site and led by external peer-supporter educators who themselves have attended a training programme. The peer-supporter training is informed by our developmental work with Year 9 girls, is interactive and address issues central to girls’ PA, including: PA benefits, active choices, developing an active identity, being active with friends, sedentary behaviour, communicating with confidence, empathy and supporting motivation. The content is grounded in self-determination theory to build the girls’ perceived autonomy, competence and sense of social support, both for being a peer-supporter and to promote physical activity. Peer-supporters are encouraged to keep these concepts in mind when having conversations with their peers.
3. 10-week informal health message peer-diffusion component:
Peer-supporters informally promote messages about increasing physical activity amongst their peers for 10 weeks. At the mid-point of the intervention peer-supporters attend a 1 day off-site top-up session to revisit core messages, share successes and collaboratively resolve problems.
Year 9 girls in all twenty schools are asked to provide information at two times: before the schools are chosen to be project or comparison schools and 1 year after the first measurements.
Accelerometer determined mean minutes of Weekday MVPA at T1 (baseline + 1 year)
1. Accelerometer determined mean minutes of Weekend MVPA at T1 (baseline + 1 year)
2. Accelerometer determined mean minutes of Weekday sedentary time at T1 (baseline + 1 year)
3. Accelerometer determined mean minutes of Weekend sedentary time at T1 (baseline + 1 year)
4. Cost-effectiveness of the PLAN-A intervention from a public-sector perspective
Year 9 girls in participating schools
No participant exclusion criteria