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|Title:||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||Authors:||Evans, Nicole ;Sutherland, R.;Campbell, E.;McLaughlin, M.;Nathan, N.;Wolfenden, L.;Lubans, D.R.;Morgan, P.J.;Gillham, K.;Oldmeadow, C.;Searles, A.;Reeves, P.;Williams, M.;Bailey, A.;Boyer, J.;Lecathelinais, C.;Davies, L.;McKenzie, T.;Robertson, K.;Wiggers, J.||Affliation:||Central Coast Local Health District
The University of Newcastle
|Issue Date:||Oct-2021||Source:||18(1):137||Journal title:||International Journal of Behavioral Nutrition and Physical Activity||Department:||Public Health||Abstract:||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.||URI:||https://elibrary.cclhd.health.nsw.gov.au/cclhdjspui/handle/1/2121||DOI:||10.1186/s12966-021-01206-8||Pubmed:||https://pubmed.ncbi.nlm.nih.gov/34688281/||ISSN:||1479-5868||Publicaton type:||Journal Article||Keywords:||Public Health||Study or Trial:||Randomized Controlled Clinical Trial/Controlled Clinical Trial|
|Appears in Collections:||Public Health / Health Promotion|
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