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Scale-up of the Physical Activity 4 Everyone (PA4E1) intervention in secondary schools: 24-month implementation and cost outcomes from a cluster randomised controlled trial.
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- المؤلفون: Sutherland, Rachel1,2,3,4; Campbell, Elizabeth1,2,3,4; McLaughlin, Matthew1,2,3,4 ; Nathan, Nicole1,2,3,4; Wolfenden, Luke1,2,3,4; Lubans, David R.4; Morgan, Philip J.4; Gillham, Karen1,3; Oldmeadow, Chris3; Searles, Andrew3; Reeves, Penny2,3; Williams, Mandy5; Evans, Nicole6; Bailey, Andrew7; Boyer, James8; Lecathelinais, Christophe1,2,3; Davies, Lynda1,3; McKenzie, Tom1,3; Robertson, Katie1,3; Wiggers, John1,2,3,4
- المصدر:
International Journal of Behavioral Nutrition & Physical Activity. 10/23/2021, Vol. 18 Issue 1, p1-18. 18p.
- الموضوع:
- معلومة اضافية
- نبذة مختصرة :
Background: Physical Activity 4 Everyone (PA4E1) is an evidence-based program effective at increasing adolescent physical activity (PA) and improving weight status. This study aimed to determine a) the effectiveness of an adapted implementation intervention to scale-up PA4E1 at 24-month follow-up, b) fidelity and reach, and c) the cost and cost-effectiveness of the implementation support intervention. Methods: A cluster randomised controlled trial using a type III hybrid implementation-effectiveness design in 49 lower socio-economic secondary schools, randomised to a program (n = 24) or control group (n = 25). An adapted implementation intervention consisting of seven strategies was developed to support schools to implement PA4E1 over 24-months. The primary outcome was the proportion of schools implementing at least four of the 7 PA practices, assessed via computer assisted telephone interviews (CATI) with Head Physical Education Teachers. Secondary outcomes included the mean number of PA practices implemented, fidelity and reach, cost and cost-effectiveness. Logistic regression models assessed program effects. Results: At baseline, no schools implemented four of the 7 PA practices. At 24-months, significantly more schools in the program group (16/23, 69.6%) implemented at least four of the 7 PA practices than the control group (0/25, 0%) (p < 0.001). At 24-months, program schools were implementing an average of 3.6 more practices than control schools (4.1 (1.7) vs. 0.5 (0.8), respectively) (P < 0.001). Fidelity and reach of the implementation intervention were high (> 75%). The total cost of the program was $415,112 AUD (2018) ($17,296 per school; $117.30 per student). Conclusions: The adapted implementation intervention provides policy makers and researchers with an effective and potentially cost-effective model for scaling-up the delivery of PA4E1 in secondary schools. Further assessment of sustainability is warranted. Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12617000681358 prospectively registered 12th May 2017. [ABSTRACT FROM AUTHOR]
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