Scale-up of the Internet-based Professional Learning to help teachers promote Activity in Youth (iPLAY) intervention: a hybrid type 3 implementation-effectiveness trial

BACKGROUND

Whole-of-school programs have demonstrated success in improving student physical activity levels, but few have progressed beyond efficacy testing to implementation at-scale. The purpose of our study was to evaluate the scale-up of the 'Internet-based Professional Learning to help teachers promote Activity in Youth' (iPLAY) intervention in primary schools using the RE-AIM framework.

METHODS

We conducted a type 3 hybrid implementation-effectiveness study and collected data between April 2016 and June 2021, in New South Wales (NSW), Australia. RE-AIM was operationalised as: (i) Reach: Number and representativeness of students exposed to iPLAY; (ii) Effectiveness: Impact of iPLAY in a sub-sample of students (n = 5,959); (iii) Adoption: Number and representativeness of schools that received iPLAY; (iv) Implementation: Extent to which the three curricular and three non-curricular components of iPLAY were delivered as intended; (v) Maintenance: Extent to which iPLAY was sustained in schools. We conducted 43 semi-structured interviews with teachers (n = 14), leaders (n = 19), and principals (n = 10) from 18 schools (11 from urban and 7 from rural locations) to determine program maintenance.

RESULTS

Reach: iPLAY reached ~ 31,000 students from a variety of socio-economic strata (35% of students were in the bottom quartile, almost half in the middle two quartiles, and 20% in the top quartile).

EFFECTIVENESS

We observed small positive intervention effects for enjoyment of PE/sport (0.12 units, 95% CI: 0.05 to 0.20, d = 0.17), perceptions of need support from teachers (0.26 units, 95% CI: 0.16 to 0.53, d = 0.40), physical activity participation (0.28 units, 95% CI: 0.10 to 0.47, d = 0.14), and subjective well-being (0.82 units, 95% CI: 0.32 to 1.32, d = 0.12) at 24-months. Adoption: 115 schools received iPLAY.

IMPLEMENTATION

Most schools implemented the curricular (59%) and non-curricular (55%) strategies as intended. Maintenance: Based on our qualitative data, changes in teacher practices and school culture resulting from iPLAY were sustained.

CONCLUSIONS

iPLAY had extensive reach and adoption in NSW primary schools. Most of the schools implemented iPLAY as intended and effectiveness data suggest the positive effects observed in our cluster RCT were sustained when the intervention was delivered at-scale.

TRIAL REGISTRATION

ACTRN12621001132831.

Resistance training improves fatigue and quality of life in previously sedentary breast cancer survivors: a randomised controlled trial

The primary aim of this study was to evaluate the benefits of resistance training (RT) on quality of life (QOL) and fatigue in breast cancer survivors as an adjunct to usual care. We recruited 39 women who had survived breast cancer [mean age (y) 51.9 ± 8.8; time since diagnosis (m) 11.6 ± 13.2]. Primary outcomes were fatigue as assessed by the Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT) scale and QOL as assessed by the Functional Assessment of Cancer Therapy - General (FACT-G) scale. ANCOVA was used to assess the change in the primary outcomes while controlling for baseline values, with effect sizes (ES) displayed as partial Eta squared. The experimental group received supervised RT 3 days per week in a university clinic for 16 weeks. Perceptions of fatigue improved significantly in the RT group compared to controls [mean (SD) 6.7 (7.5) points vs. 1.5 (3.7) points], (P = 0.006, ES = 0.20) as did QOL [6.9 (8.5) points vs. 1.6 (4.4) points], (P = 0.015, ES = 0.16). We demonstrated both statistically and clinically important improvements in fatigue and QOL in response to RT in breast cancer survivors.

Development and evaluation of the Motivation to Limit Screen-time Questionnaire (MLSQ) for adolescents

OBJECTIVE

The aim of this study was to design and evaluate a brief scale to assess adolescents' motivation to limit their screen-time using a self-determination theory (SDT) framework.

METHODS

The development and evaluation of the Motivation to Limit Screen-time Questionnaire (MLSQ) involved three phases. In Phase 1, experts in SDT were asked to review the content validity of the MLSQ items. In Phase 2, adolescent boys (N=342, mean age=12.7 ±.5 years) completed the MLSQ and the factorial validity of the model was explored. In Phase 3, adolescent boys (N=48, mean age=14.3 ± 1.3 years) completed the MLSQ on two occasions separated by 1-week. Phases 2 and 3 were conducted in New South Wales, Australia in 2012.

RESULTS

Twenty four SDT experts reviewed the original scale items. Validity coefficients associated with six of the original eight items exceeded the threshold value (V>.68, p<.01). In Phase 2, the revised three-factor (9-items) model provided a good fit to the data (SRMR=.07, CFI=.96). The intraclass correlation (ICC) values were .67 for amotivation and .70 and .82 for controlled and autonomous motivation, respectively.

CONCLUSION

This study has provided preliminary evidence for the validity and reliability of the MLSQ in adolescent boys.