up an efficacious school-based physical activity intervention for ... "Cost effectiveness of a multi-component school-based physical activity intervention targeting ...
Results of a systematic and theoretical approach to scalingup an efficacious school-based physical activity intervention for adolescents: ‘Physical Activity 4 Everyone’ Matthew Mclaughlin,, Tom McKenzie, Rachel Sutherland, Libby Campbell, Karen Gillham, Nicole Nathan, Chris Rissel, Nicola Kerr, Ross Morrison, David Lubans, Philip Morgan, Luke Wolfenden, John Wiggers.
@HealthTepi
Background Efficacious school-based physical activity trials exist1 Many not scaled for implementation2 Require adaptation for implementation scale
1Kriemler et
al. 2011; 2Reis et al. 2016
Context for adaptation We are a service delivery organisation Delivering evidence based chronic disease prevention programs at scale
Physical Activity 4 Everyone (PA4E1) Efficacy trial in 10 schools
Reversed decline in physical activity1, reduction in weight gain1, cost-effective2 7 physical activity practices, supported by 6 implementation support strategies
1Sutherland
et al. 2016a; 2Sutherland et al. 2016b
6 Strategies
7 Practices
Aim To provide an overview of the adaptation process, and the adaptations made for a 24 month hybrid implementation trial in 78 schools
Method
Abbreviations: TDF – Theoretical Domains Framework BCT’s – Behaviour Change Techniques
Waltz et al. 2015
Results Main Barriers – Time – Geographic spread – Cost – Co-ordination with other agencies/providers
Results 7 Practices
Core components retained – 7 physical activity practices – Minor ammendments
Results Main Adaptations – External school change agent replaced with in-School Champion and external Support Officer – Face-to-face partially replaced with online – Addition of overnight stay workshops – Accredited education courses
– Automated immediate feedback
6 7 Strategies
Support Officer
Scaled Program Currently 12 into a 24 month cRCT Planned evaluation includes: – Implementation of school practices – Student physical activity – Cost Effectiveness – Process evaluation – quantitative and qualitative – Digital Engagement
Take Homes Adaptations – retains the original program practices found to be effective – changed delivery modes Iterative and theory informed process of scaling used Current trial investigating effectiveness
References Kriemler, S., et al. (2011). "Effect of school-based interventions on physical activity and fitness in children and adolescents: a review of reviews and systematic update." British Journal of Sports Medicine 45(11): 923-930.\ Michie, S., et al. (2005). “Making psychological theory useful for implementing evidence based practice: a consensus approach.” Qual Saf Health Care 14(1): 26–33. Michie, S., et al. (2008). "From Theory to Intervention: Mapping Theoretically Derived Behavioural Determinants to Behaviour Change Techniques." Applied Psychology 57(4): 660-680.
Milat, A. J., et al. (2015). "Narrative review of models and success factors for scaling up public health interventions.“ Implementation Science 10(1): 113. Proctor, E. K,. et al. (2013). “Implementation strategies: recommendations for specifying and reporting.” Implementation Science 8(1):139.
Reilly, K,. et al. In Review Reis, R. S., et al. (2015). "Scaling up physical activity interventions worldwide: stepping up to larger and smarter approaches to get people moving." The Lancet 388(10051): 1337-1348. Sanders, D. and Haines, A. (2006). "Implementation Research Is Needed to Achieve International Health Goals." PLOS Medicine 3(6): e186. Sutherland, R., et al. (2016a). "The Physical Activity 4 Everyone Cluster Randomized Trial: 2-Year Outcomes of a School Physical Activity Intervention Among Adolescents." Am J Prev Med 51(2): 195-205. Sutherland, R., et al. (2016b). "Cost effectiveness of a multi-component school-based physical activity intervention targeting adolescents: the 'Physical Activity 4 Everyone' cluster randomized trial." Int J Behav Nutr Phys Act 13: 94. Waltz, T. J., et al. (2015). "Use of concept mapping to characterize relationships among implementation strategies and assess their feasibility and importance: results from the Expert Recommendations for Implementing Change (ERIC) study." Implementation Science 10(1): 109.
Acknowledgments Thank you to the Priority Research Centre for Health Behaviour who awarded a travel grant to me to attend and present at this conference. Thanks to the schools involved, my co-authors and expert advisory group.
@HealthTepi Physical Activity 4 Everyone Expert Advisory Group: Prof. John Wiggers, A/Prof. Luke Wolfenden, Prof. Philip Morgan, Prof. David Lubans, Prof. Chris Rissel, Dr. Nicole Nathan, Dr. Rachel Sutherland, Dr. Libby Campbell, Dr. Christopher Oldmeadow, Mr. Ross Morrision, Ms. Mandy Williams, Ms. Karen Gilham, Mr. Andrew Bailey, Ms. Nicola Kerr.
Spare Slides
Design 24 month Cluster RCT – Secondary schools – Low SES (lowest 50% of schools in region)
Hybrid implementation design: – Primary: School level implementation of practices – Secondary: Student physical activity
Step 1
Proctor et al. 2013
Step 2
Michie et al. 2005
Michie et al. 2008
Applied to: Physical Activity 4 Everyone1,2
1Sutherland
et al. 2016; 2Michie et al. 2008
Step 3
Step 4
