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Publication - Dr Mark Edwards

    Development and feasibility cluster randomised controlled trial of a Peer-Led physical Activity iNtervention for Adolescent girls (PLAN-A)

    Citation

    Sebire, S, Banfield, K, Campbell, R, Edwards, MJ, Kipping, R, Kadir, B, Garfield, K, Matthews, J, Blair, P, Lyons, R, Hollingworth, W & Jago, R, 2018, ‘Development and feasibility cluster randomised controlled trial of a Peer-Led physical Activity iNtervention for Adolescent girls (PLAN-A)’. National Institute for Health Research (NIHR)

    Abstract

    Background
    Girls are less active than boys and few adolescent girls meet physical activity (PA) guidelines. Peers are an important influence on the views and behaviours of adolescent girls yet many PA interventions involving peers use formal approaches which may not harness the power of peer groups. More informal peer-led PA interventions which work within proximal peer groups may hold promise for increasing girls’ PA.
    Objectives
    To examine the feasibility, evidence of promise and cost of PLAN-A, a peer-led PA intervention.
    Design
    Phase 1 comprised formative work and a pilot study conducted in one secondary school. Phase 2 was a feasibility study comprising a pilot randomised controlled trial in six secondary schools including process and economic evaluations.
    Setting
    Six secondary schools in South Gloucestershire and Wiltshire, recruited from schools above the median local Pupil Premium (i.e., more deprived).
    Participants
    Year 8 girls (aged 12-13).
    Intervention
    Year 8 girls nominated other girls in their year who are likely to be influential (e.g., who they look up to, good listeners) the 18% most nominated were invited to be peer-supporters. Peer-supporters attended two consecutive days of training (plus a top-up day five weeks later), off the school site led by pairs of peer-supporter trainers, to increase their knowledge about PA and capabilities and confidence to promote PA in their friendship group.
    Main outcome measures
    Measures focussed on establishing evidence for feasibility and promise: Recruitment and retention of Year 8 girls and peer-supporters, data provision rates (accelerometer & questionnaire collected pre-randomisation/beginning of Year 8 [T0], end of Year 8 [T1] and beginning of Year 9 [T2]), intervention acceptability, peer-supporter training attendance, intervention cost, the between-arms difference in weekday minutes of moderate-to-vigorous PA (MVPA). A process evaluation was conducted.
    Results
    Six schools were recruited, four intervention (n = 269) and two control (n = 158). 94.7% of Year 8 girls participated. 55 (17-24% of year 8 girls) peer-supporters were trained (attendance = 91-100%). Five females were trained as peer-supporter trainers. Questionnaire data provision exceeded 92% at all time points. Accelerometer return rates were >85% and wear time criteria were met by 83%, 71% and 62% of participants at T0, T1 and T2 respectively. Mean weekday MVPA did not differ between arms at T1 (1.1 mins, 95% CI = -4.3, 6.5) but did at T2 (6.1 mins, 95% CI =1.4, 10.8) favouring the intervention arm. The mean cost of intervention delivery was £2685 per school / £37 per Year 8 girl. Process evaluation identified good fidelity, engagement and enjoyment of the peer-supporter training and peer-support strategies. Peer-supporters needed more guidance on how to start conversations.
    Limitations
    Accelerometer data provision was lowest at Time 2 suggesting a need for strategies to increase compliance.
    Conclusions
    Informal peer-led intervention approaches such as PLAN-A hold promise as a means of promoting PA to adolescent girls.
    Future Work
    A definitive randomised controlled trial of PLAN-A is warranted.
    Study Registration
    ISRCTN12543546
    Funding details
    Funding was provided by the NIHR Public Health Research Programme. South Gloucestershire & Wiltshire Councils funded the intervention costs.
    500/500 words

    Full details in the University publications repository