Feasibility Study of the Secondary Level Active School Flag Programme: Study Protocol

Implementation evaluation of an Irish secondary-level whole school programme: a qualitative inquiry

Whole-of-school programmes (WSPs) are recommended to promote physical activity for adolescents. The Active School Flag (ASF) programme for secondary-level schools is one such WSP. Due to the difficulties of incorporating WSPs into the complex school system, there is a risk of poor implementation. The monitoring of unanticipated influences can help to understand key implementation processes prior to scale-up. The aims of this study were to identify perceived facilitators and barriers to implementing the ASF and recommend evidence-based implementation strategies. Focus groups and interviews (N = 50) were conducted in three schools with stakeholders involved in programme implementation, i.e. school management (n = 5), ASF coordinator (n = 4), student-leaders (aged 15–16 years) (n = 64) and staff committee (n = 25). Transcripts were analysed using codebook thematic analysis and were guided by the Consolidated Framework for Implementation Research. Implementation strategies were identified and were selected systematically to address contextual needs. Three themes surrounding the facilitators and barriers to implementation were generated: intervention design factors (e.g. capacity building and knowledge of implementers; and interest and buy-in for the programme), organizational factors (e.g. optimization of people and the busy school environment) and interpersonal factors (e.g. communication and collaboration). The examination of facilitators and barriers to implementation of the ASF has assisted with the identification of implementation strategies including (not limited to) a shared leadership programme for student leaders and a more flexible timeline for completion. These facilitative implementation strategies may assist in the effective implementation of the ASF.

Communicating Physical Activity with Adolescents: What works? A scoping review protocol

Background: Worldwide, adolescents are not meeting the minimum recommended physical activity (PA) guidelines to achieve health benefits. Awareness of the guidelines among adolescents is low, only 3.6% can report them correctly. The school is an ideal PA promotion setting, no other institute has the same reach or influence on the adolescent population. There is a need for an effective communication strategy for PA messages for adolescents. The purpose of this review is to explore how, when, who, where and what i.e. the content, context and mode of delivery of PA messages to communicate with adolescents to improve their awareness and understanding of PA that will potentially lead to an increase in PA levels. Methods: A scoping review was selected as the most appropriate methodology due to the broad nature of the research question. The PCC mnemonic (Population, concept, context), recommended by the Joanna Briggs Institute, was used to develop the search strategy and research question. This review will follow the scoping review framework developed by Arksey and O’Malley (2005) which was later updated by Levac et al (2010) to ensure the methods are systematic. It will also follow the PRISMA extension for scoping reviews checklist. Sources include databases (CINAHL, Education Source, Scopus, PubMED), grey literature from the World Health Organisation, Global Index Medicus and the reference lists of extracted articles will be checked from the year 1995 onwards. Results: A PRISMA flow diagram will demonstrate the final articles included and results will be presented and summarised as recurring themes. The results will be discussed in relation to existing literature and future implications for research, policy and practice. Conclusion: This will be the first review to explore the PA messaging context among adolescents and the findings will help inform a strategy for communicating PA to adolescents.

Ten Years of 'Flying the Flag': An Overview and Retrospective Consideration of the Active School Flag Physical Activity Initiative for Children-Design, Development & Evaluation

Whole-school physical activity (PA) promotion programmes are recommended to increase youth PA. Evaluation of programmes is essential to ensure practice is guided by evidence. This paper evaluates the Active School Flag (ASF), a whole-school PA promotion programme in Ireland, using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. ASF was evaluated across three levels-(1) administration, (2) application, (3) outcomes-using a mi✗ed-methods case study design. E✗isting data sources were reviewed, the programme coordinator was interviewed, and a pilot study was conducted to investigate impact on 3rd and 5th class students (3 schools, n = 126 students, age range 8-12 years). In-school Moderate to Vigorous Physical Activity (MVPA; by accelerometery), motivation for PA (BREQ), PA self-efficacy (PASES), school affect and peer social support (Kidscreen27) were measured pre-programme (0 months), post-programme (8 months), and at retention (12 months). Teacher perceptions of classroom behaviour (CBAST) were also measured pre- and post-programme. ASF has been successful in engaging 46% of primary schools nationally. Students' in-school moderate-vigorous PA increased in all pilot-study schools from pre-programme to retention (η2 = 0.68-0.84). ASF programme design facilitates implementation fidelity, adoption and maintenance through buy in from schools and government stakeholders. ASF presents as an effective PA promotion programme in the short-to-medium term for primary schools. This RE-AIM evaluation provides evidence of ASF effectiveness, alongside valuable findings that could support programme improvement, and inform future similar programmes.

Barriers and facilitators to changes in adolescent physical activity during COVID-19

OBJECTIVES

COVID-19 restrictions reduced adolescents' opportunities for physical activity (PA). The purpose of this study was to examine how adolescent PA changed during school closures, to identify the key barriers and facilitators for these changes during lockdown and to use this information to understand how to manage future crises' situations positively to prevent physical inactivity.

METHODS

Irish adolescents (N=1214; ages 12-18 years) participated in an online cross-sectional study during April 2020, including items on PA level, changes in PA and reasons for change in an open-ended format. Numeric analyses were through multiple binary logistic regressions, stratified by changes in PA during lockdown and inductive analysis of open coding of text responses.

RESULTS

Adolescents reported they did less PA (50%), no change (30%) or did more PA during lockdown (20%). Adolescents who did less PA were more likely to be overweight (OR=1.8, CI=1.2-2.7) or obese (OR=2.2, CI=1.2-4.0) and less likely to have strong prior PA habits (OR=0.4, CI=0.2-0.6). The most cited barriers to PA were coronavirus, club training cancelled and time. Strong associations for doing more PA included participation in strengthening exercises at least three times in the past 7 days (OR=1.7, CI=1.3-2.4); facilitators were more time, coronavirus and no school.

CONCLUSION

COVID-19 restrictions were both a barrier to and an opportunity for PA. Parents, schools, public health, communities and industries must collaborate to prevent physical inactivity at times of crisis, especially for vulnerable groups.