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Duncombe SL, Barker AR, Price L, Walker JL, Koep JL, Woodforde J, Stylianou M. Was it a HIIT? A process evaluation of a school-based high-intensity interval training intervention. Int J Behav Nutr Phys Act 2024; 21:49. [PMID: 38684991 PMCID: PMC11059682 DOI: 10.1186/s12966-024-01599-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 04/17/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Despite a growing body of research investigating high-intensity interval training (HIIT) in schools, there are limited process evaluations investigating their implementation. This is concerning because process evaluations are important for appropriately interpreting outcome findings and augmenting intervention design. This manuscript presents a process evaluation of Making a HIIT, a school-based HIIT intervention. METHODS The Making a HIIT intervention spanned 8 weeks and was completed at three schools in Greater Brisbane, Australia. Ten classes (intervention group) completed 10-min teacher-led HIIT workouts at the beginning of health and physical education (HPE) lessons, and five classes (control group) continued with regular HPE lessons. The mixed methods evaluation was guided by the Framework for Effective Implementation by Durlak and DuPre. RESULTS Program reach: Ten schools were contacted to successfully recruit three schools, from which 79% of eligible students (n = 308, x ¯ age: 13.0 ± 0.6 years, 148 girls) provided consent. Dosage: The average number of HIIT workouts provided was 10 ± 3 and the average number attended by students was 6 ± 2. Fidelity: During HIIT workouts, the percentage of time students spent at ≥ 80% of maximum heart rate (HRmax) was 55% (interquartile range (IQR): 29%-76%). Monitoring of the control group: During lessons, the intervention and control groups spent 32% (IQR: 12%-54%) and 28% (IQR: 13%-46%) of their HPE lesson at ≥ 80% of HRmax, respectively. Responsiveness: On average, students rated their enjoyment of HIIT workouts as 3.3 ± 1.1 (neutral) on a 5-point scale. Quality: Teachers found the HIIT workouts simple to implement but provided insights into the time implications of integrating them into their lessons; elements that helped facilitate their implementation; and their use within the classroom. Differentiation: Making a HIIT involved students and teachers in the co-design of HIIT workouts. Adaption: Workouts were modified due to location and weather, the complexity of exercises, and time constraints. CONCLUSION The comprehensive evaluation of Making a HIIT provides important insights into the implementation of school-based HIIT, including encouragings findings for student enjoyment and fidelity and recommendations for improving dosage that should be considered when developing future interventions. TRIAL REGISTRATION ACTRN, ACTRN12622000534785 , Registered 5 April 2022 - Retrospectively registered.
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Affiliation(s)
- Stephanie L Duncombe
- School of Human Movement and Nutrition Sciences, The University of Queensland, Saint Lucia, QLD, 4072, Australia.
- Children's Health and Exercise Research Centre, Public Health and Sports Sciences, University of Exeter Medical School, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.
| | - Alan R Barker
- Children's Health and Exercise Research Centre, Public Health and Sports Sciences, University of Exeter Medical School, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Lisa Price
- Children's Health and Exercise Research Centre, Public Health and Sports Sciences, University of Exeter Medical School, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Jacqueline L Walker
- School of Human Movement and Nutrition Sciences, The University of Queensland, Saint Lucia, QLD, 4072, Australia
| | - Jodie L Koep
- School of Human Movement and Nutrition Sciences, The University of Queensland, Saint Lucia, QLD, 4072, Australia
- Children's Health and Exercise Research Centre, Public Health and Sports Sciences, University of Exeter Medical School, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - James Woodforde
- School of Human Movement and Nutrition Sciences, The University of Queensland, Saint Lucia, QLD, 4072, Australia
| | - Michalis Stylianou
- School of Human Movement and Nutrition Sciences, The University of Queensland, Saint Lucia, QLD, 4072, Australia
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Woodforde J, Gomersall S, Timperio A, Mavoa S, Perales F, Salmon J, Stylianou M. Before-school physical activity patterns among adolescents using accelerometer and GPS data. Health Place 2024; 86:103222. [PMID: 38458126 DOI: 10.1016/j.healthplace.2024.103222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 03/10/2024]
Abstract
Most adolescents do not meet physical activity (PA) guidelines. The before-school segment has been identified as one promising opportunity for intervention; however, there is a need for contextual understanding of PA in this segment. This study aimed to examine: a) adolescents' PA levels across various locations before school (6:00am - school start), b) contributions of before-school PA to daily PA and PA guidelines, and c) correlates of location-specific before-school PA. A cross-sectional analysis was conducted using adolescents' (n = 148, mean age 14.7) accelerometer and GPS data. Adolescents averaged 9.7 min in before-school moderate-to-vigorous PA (MVPA), representing substantial contributions to daily activity. Most MVPA occurred away from home and school. Significant correlates included segment duration, age, socio-economic status, and PA self-efficacy. Future work should consider these patterns and correlates to support adolescents' PA through targeted interventions.
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Affiliation(s)
- James Woodforde
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, 4072, Australia.
| | - Sjaan Gomersall
- Centre for Health and Wellbeing Research Innovation, School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, 4072, Australia; School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, 4072, Australia
| | - Anna Timperio
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, 3216, Australia
| | - Suzanne Mavoa
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, 3010, Australia
| | - Francisco Perales
- School of Social Science, The University of Queensland, St Lucia, Queensland, 4072, Australia
| | - Jo Salmon
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, 3216, Australia
| | - Michalis Stylianou
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, 4072, Australia
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Woodforde J, Kuswara K, Perales F, Salmon J, Gomersall S, Stylianou M. A qualitative exploration of multi-stakeholder perspectives of before-school physical activity. Int J Behav Nutr Phys Act 2024; 21:25. [PMID: 38424551 PMCID: PMC10905879 DOI: 10.1186/s12966-024-01572-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 02/13/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Engagement in before-school physical activity can potentially enhance health and learning-related outcomes for children and adolescents. However, influencing factors and stakeholder perceptions of before-school physical activity remain under-researched. This qualitative study aimed to examine stakeholder perceptions of: a) the suitability of the before-school segment for physical activity, b) barriers and facilitators associated with before-school physical activity, and c) strategies for schools to support before-school physical activity. METHODS Twelve focus groups and one interview were conducted with 38 participants from a range of school stakeholder groups-students, parents, teachers, school leaders, external physical activity providers, and school health and physical activity experts. Focus groups were analysed using template analysis, guided by a social-ecological model. RESULTS Stakeholders perceived before-school physical activity as valuable, for reasons including perceptions of meaningful contributions to students' cognitive functioning, classroom behaviours, and wellbeing. Factors influencing before-school physical activity were identified across multiple social-ecological levels, including the critical role of school leadership support, availability of facilities, and provision of qualified supervision. Proposed strategies highlighted the need for sustainable design, contextual relevance, and community engagement in before-school initiatives. Additionally, communication of the manifold benefits identified by stakeholders was suggested as a means to drive support and engagement in before-school physical activity. CONCLUSIONS This study provides insight for schools seeking to enhance opportunities for physical activity in the before-school hours and may inform future intervention research on the subject, taking into account its multi-faceted influences and the need for context-specific strategies.
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Affiliation(s)
- James Woodforde
- School of Human Movement and Nutrition Sciences, The University of Queensland, St. Lucia, Queensland, 4072, St Lucia, Queensland, Australia.
| | - Konsita Kuswara
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, 3216, Geelong, VIC, Australia
| | - Francisco Perales
- School of Social Science, The University of Queensland, 4072, St Lucia, Queensland, Australia
| | - Jo Salmon
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, 3216, Geelong, VIC, Australia
| | - Sjaan Gomersall
- Centre for Health and Wellbeing Research Innovation, School of Human Movement and Nutrition Sciences, The University of Queensland, 4072, St Lucia, Queensland, Australia
- School of Health and Rehabilitation Sciences, The University of Queensland, 4072, St Lucia, Queensland, Australia
| | - Michalis Stylianou
- School of Human Movement and Nutrition Sciences, The University of Queensland, St. Lucia, Queensland, 4072, St Lucia, Queensland, Australia
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Woodforde J, Perales F, Salmon J, Gomersall S, Stylianou M. Before-school physical activity levels and sociodemographic correlates among Australian adolescents: A cross-sectional study. J Sports Sci 2024; 42:237-246. [PMID: 38445635 DOI: 10.1080/02640414.2024.2326353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 02/25/2024] [Indexed: 03/07/2024]
Abstract
Understanding adolescents' physical activity levels and underpinning contextual factors is crucial for health promotion. This cross-sectional study, using 24-hour time use diaries and sociodemographic variables from the Longitudinal Study of Australian Children, addressed gaps in understanding of physical activity in the before-school segment (the time between waking up and commencing classes). The study examined a) adolescents' time spent in before-school physical activity, focusing on location and shared presence, and b) sociodemographic correlates of before-school physical activity. Completed diaries by 12-13 year-olds (n = 3,201) revealed that adolescents reported an average of 10.8 minutes of daily before-school physical activity (average segment length: 114 min), mostly classified as active transport (5.7 min). Most before-school physical activity occurred in a location other than home or school (6.1 min) and with peers (6.1 min). Notably, 51% of boys and 60% of girls did not report any before-school physical activity. Through two-part regression, we found that boys, adolescents from single-parent households, and those with longer before-school segments are more likely to report before-school physical activity compared to their counterparts. Before-school initiatives should promote active transport and diverse opportunities in other settings. Research into barriers and facilitators may inform more inclusive and effective promotion strategies, including school-based initiatives.
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Affiliation(s)
- James Woodforde
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Francisco Perales
- School of Social Science, The University of Queensland, St Lucia, Queensland, Australia
| | - Jo Salmon
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Sjaan Gomersall
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia
- Centre for Health and Wellbeing Research Innovation, School of Human Movement and Nutrition Sciences, The University of Queensland, Queensland, Australia
| | - Michalis Stylianou
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia
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Alsop T, Woodforde J, Rosbergen I, Mahendran N, Brauer S, Gomersall S. Perspectives of health professionals on physical activity and sedentary behaviour in hospitalised adults: A systematic review and thematic synthesis. Clin Rehabil 2023; 37:1386-1405. [PMID: 37070142 PMCID: PMC10426259 DOI: 10.1177/02692155231170451] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 04/02/2023] [Indexed: 04/19/2023]
Abstract
OBJECTIVE To explore health professionals' perspectives on physical activity and sedentary behaviour of hospitalised adults to understand factors that contribute to these behaviours in this environment. DATA SOURCES Five databases (PubMed, MEDLINE, Embase, PsycINFO and CINAHL) were searched in March 2023. REVIEW METHODS Thematic synthesis. Included studies explored perspectives of health professionals on the physical activity and/or sedentary behaviour of hospitalised adults using qualitative methods. Study eligibility was assessed independently by two reviewers and results thematically analysed. Quality was assessed using the McMaster Critical Review Form and confidence in findings assessed using GRADE-CERQual. RESULTS Findings from 40 studies explored perspectives of over 1408 health professionals from 12 health disciplines. The central theme identified was that physical activity is not a priority in this setting due to the complex interplay of multilevel influences present in the interdisciplinary inpatient landscape. Subthemes, the hospital is a place for rest, there are not enough resources to make movement a priority, everyone's job is no one's job and policy and leadership drives priorities, supported the central theme. Quality of included studies was variable; critical appraisal scores ranged from 36% to 95% on a modified scoring system. Confidence in findings was moderate to high. CONCLUSION Physical activity in the inpatient setting is not a priority, even in rehabilitation units where optimising function is the key. A shift in focus towards functional recovery and returning home may promote a positive movement culture that is supported by appropriate resources, leadership, policy, and the interdisciplinary team.
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Affiliation(s)
- Tahlia Alsop
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - James Woodforde
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Ingrid Rosbergen
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Department of Physiotherapy & Faculty of Health, University of Applied Sciences Leiden, Leiden, The Netherlands
| | - Niruthikha Mahendran
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Sandra Brauer
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Sjaan Gomersall
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
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Stylianou M, Woodforde J, Duncombe S, Kolbe-Alexander T, Gomersall S. School physical activity policies and associations with physical activity practices and behaviours: A systematic review of the literature. Health Place 2021; 73:102705. [PMID: 34844131 DOI: 10.1016/j.healthplace.2021.102705] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 09/08/2021] [Accepted: 10/24/2021] [Indexed: 01/02/2023]
Abstract
The development and implementation of school policies is considered a key strategy for the promotion of physical activity (PA) in children and adolescents. This study aimed to systematically review and synthesise existing literature focusing on the associations between formal written school-based PA policies and (a) school PA practices and (b) PA behaviours of school-aged children and adolescents. Fifty-one papers reporting on 52 studies met the eligibility criteria. All but two studies were from high income countries, most used cross-sectional designs and demonstrated fair methodological quality, and just over a third examined language aspects of policies. Findings predominantly indicated a lack of or inconclusive associations between the various characteristics examined and PA outcomes. Inconclusive associations were identified between both PA practice and behaviour outcomes and state level policies, policies focusing on PE and school-day PA, and in studies examining language aspects of policies. Inconclusive associations with both types of outcomes were more likely to be identified compared to a lack of associations in studies using self-report measures and in studies not providing information about the quality of exposure and outcome measures used. Overall, findings highlight the need for further research that acknowledges the complex relationship between school policies and PA outcomes and employs robust methodological approaches to enhance our understanding of this area.
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Affiliation(s)
- Michalis Stylianou
- School of Human Movement and Nutrition Sciences, The University of Queensland, St. Lucia, Queensland, 4072, Australia.
| | - James Woodforde
- School of Human Movement and Nutrition Sciences, The University of Queensland, St. Lucia, Queensland, 4072, Australia
| | - Stephanie Duncombe
- School of Human Movement and Nutrition Sciences, The University of Queensland, St. Lucia, Queensland, 4072, Australia
| | - Tracy Kolbe-Alexander
- School of Health & Wellbeing, University of Southern Queensland, lpswich, Queensland, 4305, Australia
| | - Sjaan Gomersall
- School of Human Movement and Nutrition Sciences, The University of Queensland, St. Lucia, Queensland, 4072, Australia; School of Health and Rehabilitation Sciences, The University of Queensland, St. Lucia, Queensland, 4072, Australia
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Woodforde J, Alsop T, Salmon J, Gomersall S, Stylianou M. Effects of school-based before-school physical activity programmes on children's physical activity levels, health and learning-related outcomes: a systematic review. Br J Sports Med 2021; 56:740-754. [PMID: 34815223 DOI: 10.1136/bjsports-2021-104470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2021] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To review and evaluate the impact of school-based, before-school physical activity (PA) programmes on children's PA levels, health and learning-related outcomes. DESIGN Systematic review. DATA SOURCES PubMed, PsycINFO, Scopus, Embase and ERIC were searched in January 2021. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: (1) Original research published in English, (2) sample included typically developing school-age children and/or adolescents, (3) examined school-based PA programmes delivered before school, (4) included a comparator and (5) reported associations with PA, physical health, learning-related and/or psychosocial outcomes. Studies examining before-school active transport or sport were excluded. RESULTS Thirteen articles representing 10 studies were included (published 2012-2020); seven conducted in primary schools. Programmes ranged between 3 weeks and 6 months, primarily operating daily and for 25-40 min. One study examined a programme informed by theory; six incorporated fidelity measures. Data synthesis, considering consistency of findings, showed indeterminate associations for the domains of physical health, learning-related and psychosocial outcomes. Among subdomains, synthesis showed positive associations with before-school and daily PA, cardiorespiratory and muscular fitness, readiness to learn and an inverse association with adiposity. Risk of bias was high/serious or insufficiently detailed across studies and outcome domains, except PA, which included moderate-risk studies. CONCLUSION There is limited available evidence on school-based, before-school PA programmes, with some positive associations at domain and subdomain levels. Continued research is justified to understand the role of before-school programmes for facilitating PA. Future research should follow recommended practice for intervention design and process evaluation, and address under-represented contexts, including secondary schools. PROSPERO REGISTRATION NUMBER CRD42020181108.
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Affiliation(s)
- James Woodforde
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Tahlia Alsop
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Jo Salmon
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Sjaan Gomersall
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia.,School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Michalis Stylianou
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia
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Woodforde J, Alspo T, Salmon J, Gomersall S, Stylianou M. Before-school physical activity programs and youth physical activity, health and learning-related outcomes: a systematic review. J Sci Med Sport 2021. [DOI: 10.1016/j.jsams.2021.09.187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Woodforde J. Letter: Management of facial pain. Med J Aust 1975; 2:917. [PMID: 1221265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Woodforde J. Dr. Woodforde, on the Influenza. Med Phys J 1803; 9:505-509. [PMID: 30491549 PMCID: PMC5672488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Woodforde J. To the Editors of the Medical and Physical Journal. Med Phys J 1801; 5:151-152. [PMID: 30489773 PMCID: PMC5598621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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