AbstractThis study assessed the efficacy of a co-designed, school-based intervention meant to promote physical activityand fitness among Dutch prevocational secondary students. In a two-year clustered randomized controlled trial,students’ physical activity and fitness was measured by indirect and direct methods. In the intervention group,we used the triple-I procedure, a participatory action research method, to co-design the intervention together withthe students and schools. This procedure involved focus group discussions by interviewing and imagingtechniques, followed by a co-design process to align the intervention content and implementation processes withstudents’ preferences. The study involved 22 Dutch schools, with a total of 2685 13-to-14-year-old prevocationalsecondary students. Schools were randomly assigned to either intervention (11 schools, 1446 students) or controlgroup (11 schools, 1239 students).There were no significant intervention differences between students’ overallphysical activity behavior on intervention versus control schools. However, with regards to various specificphysical fitness indicators, such as the long jump, handgrip strength, shuttle run test, and the sum of skinfolds,intervention school students performed significantly better than the control group students. Furthermore, whentaking into account student participation, i.e. the success of the co-design process, schools with higher levels ofstudent participation showed higher shuttle run scores. However, such graded effects were not similarly apparentwith regards to students’ physical fitness indicators. This study showed that co-designing a comprehensivephysical activity intervention on numerous Dutch high schools via the Triple-I Interactive Method was feasible.Moreover, results showed that certain aspects of physical fitness were improved after two years of intervention,although taken together with the lack of effects on physical activity, results were mixed.
Resilience to adverse events is increasingly recognized as important for human health. Socio-economic status (SES) is also frequently identified as a predictor of resilience. However, it is not well-understood how people define resilience in their everyday lives, and whether individuals have different experiences of resilience based on their SES. This study sought to fill these gaps, in the context of the COVID-19 pandemic and pandemic mitigation policies in the Netherlands.We interviewed high (n = 38) and low (n = 37) SES participants about their understanding and experiences of resilience during this period. Participants took part in individual interviews and focus groups in September 2021. Transcripts were analyzed thematically.A key theme was coping with adversity, in line with commonly-used definitions of resilience. However, we found that resilience was often defined more broadly. Resilience also encompassed aspects of self-reflection and improvement, and faith in oneself, the community and the nation. There were also key differences by SES background: elaborate and optimistic definitions and experiences of resilience were more often described by high SES individuals. For instance, high SES participants more frequently defined resilience as growing and improving. In contrast, low SES participants more commonly experienced resilience as enduring until better times arrived.Having a higher SES seemed to support resilience during the COVID-19 pandemic. This indicates that adverse events may exacerbate pre-existing financial and material difficulties among low SES individuals. This finding underscores the importance of addressing financial precarity prior to adverse events.
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Background: A consistent finding in the literature is the decline in physical activity during adolescence, resulting in activity levels below the recommended guidelines. Therefore, promotion of physical activity is recommended specifically for prevocational students.Objective: This protocol paper describes the background and design of a physical activity promotion intervention study in which prevocational students are invited to participate in the design and implementation of an intervention mix. The intervention is expected to prevent a decline in physical activity in the target group.Methods: The effectiveness of the intervention was evaluated in a two-group cluster randomized controlled trial with assessments at baseline and 2-year follow-up. A simple randomization was applied, allocating 11 schools to the intervention group and 11 schools to the control group, which followed the regular school curriculum. The research population consisted of 3003 prevocational students, aged 13-15 years. The primary outcome measures were self-reported physical activity levels (screen time, active commuting, and physical activity). As a secondary outcome, direct assessment of physical fitness (leg strength, arm strength, hip flexibility, hand speed, abdominal muscle strength, BMI, and body composition) was included. An intervention-control group comparison was presented for the baseline results. The 2-year interventions began by mapping the assets of the prevocational adolescents of each intervention school using motivational interviewing in the structured interview matrix and the photovoice method. In addition, during focus group sessions, students, school employees, and researchers cocreated and implemented an intervention plan that optimally met the students’ assets and opportunities in the school context. The degree of student participation was evaluated through interviews and questionnaires.Results: Data collection of the SALVO (stimulating an active lifestyle in prevocational students) study began in October 2015 and was completed in December 2017. Data analyses will be completed in 2021. Baseline comparisons between the intervention and control groups were not significant for age (P=.12), screen time behavior (P=.53), nonschool active commuting (P=.26), total time spent on sports activities (P=.32), total physical activities (P=.11), hip flexibility (P=.22), maximum handgrip (P=.47), BMI (P=.44), and sum of skinfolds (P=.29). Significant differences between the intervention and control groups were found in ethnicity, gender, active commuting to school (P=.03), standing broad jump (P=.02), bent arm hang (P=.01), 10× 5-m sprint (P=.01), plate tapping (P=.01), sit-ups (P=.01), and 20-m shuttle run (P=.01).Conclusions: The SALVO study assesses the effects of a participatory intervention on physical activity and fitness levels in prevocational students. The results of this study may lead to a new understanding of the effectiveness of school-based physical activity interventions when students are invited to participate and cocreate an intervention. This process would provide structured health promotion for future public health.
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