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.
Objective: To investigate the effects of a school-based once-a-week sports program on physical fitness, physical activity, and cardiometabolic health in children and adolescents with a physical disability. Methods: This controlled clinical trial included 71 children and adolescents from four schools for special education [mean age 13.7 (2.9) years, range 8–19, 55% boys]. Participants had various chronic health conditions including cerebral palsy (37%), other neuromuscular (44%), metabolic (8%), musculoskeletal (7%), and cardiovascular (4%) disorders. Before recruitment and based on the presence of school-based sports, schools were assigned as sport or control group. School-based sports were initiated and provided by motivated experienced physical educators. The sport group (n = 31) participated in a once-a-week school-based sports program for 6 months, which included team sports. The control group (n = 40) followed the regular curriculum. Anaerobic performance was assessed by the Muscle Power Sprint Test. Secondary outcome measures included aerobic performance, VO2 peak, strength, physical activity, blood pressure, arterial stiffness, body composition, and the metabolic profile. Results: A significant improvement of 16% in favor of the sport group was found for anaerobic performance (p = 0.003). In addition, the sport group lost 2.8% more fat mass compared to the control group (p = 0.007). No changes were found for aerobic performance, VO2 peak, physical activity, blood pressure, arterial stiffness, and the metabolic profile. Conclusion: Anaerobic performance and fat mass improved following a school-based sports program. These effects are promising for long-term fitness and health promotion, because sports sessions at school eliminate certain barriers for sports participation and adding a once-a-week sports session showed already positive effects for 6 months.
PurposeThe majority of older patients, scheduled for a cardiac procedure, do not adhere to international dietary intake and physical activity guidelines. The purpose of this study was to explore barriers and facilitators regarding dietary intake and physical activity behaviour change in older patients undergoing transcatheter aortic valve implantation (TAVI).MethodsWe conducted a qualitative study using semi-structured interviews with patients undergoing TAVI. Interviews were analysed by two independent researchers using thematic analysis, the capability, opportunity and motivation behaviour model was used as a framework.ResultsThe study included 13 patients (82 ± 6 years old, 6 females) until data saturation was reached. Six themes were identified, which were all applicable to both dietary intake and physical activity. Three following themes were identified as barriers: (1) low physical capability, (2) healthy dietary intake and physical activity are not a priority at an older age and (3) ingrained habits and preferences. Three following themes were identified as facilitators: (1) knowledge that dietary intake and physical activity are important for maintaining health, (2) norms set by family, friends and caregivers and (3) support from the social environment.ConclusionOur study found that older patients had mixed feelings about changing their behaviour. The majority initially stated that dietary intake and physical activity were not a priority at older age. However, with knowledge that behaviour could improve health, patients also stated willingness to change, leading to a state of ambivalence. Healthcare professionals may consider motivational interviewing techniques to address this ambivalence.
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