Four-year follow-up of the community intervention '10,000 steps Ghent'

The purpose of this study was to examine the 4-year follow-up effects of the '10,000 steps Ghent' project, which had shown increases in pedometer steps after the first year of implementation (2005-06). All adults who had participated in 2005-06 (n = 866) were recontacted in 2009 and invited to complete the International Physical Activity Questionnaire and a 7-day pedometer log. Long-term effects were analysed using repeated measures analysis of variance tests (time × community, n = 420). In subgroup analyses, age, gender, educational level, employment status, health and risk profile were also included. Results showed that daily step counts increased slightly from 2005 to 2009 in the intervention community (Ghent) and decreased in the comparison community (Aalst) (time × community: P = 0.008). Subgroup analyses showed a positive interaction effect for higher educated (P = 0.026) and healthy (P = 0.005) participants and a negative interaction for those with a poor to moderate health (P = 0.026). For self-reported physical activity, a positive interaction effect was found in those who had already reached 10,000 steps in 2005 (P = 0.037). To conclude, the positive effects seen after 1 year were not maintained after 4 years. However, a decrease from baseline to follow-up, which was seen in the comparison community, was prevented in all Ghent participants, except those with a poor to moderate health.     

Moderators and mediators of pedometer use and step count increase in the "10,000 Steps Ghent" intervention

Background  

The European pedometer-based "10,000 Steps Ghent" whole community intervention for 228,000 residents was found to be effective in increasing step counts by an average of 896 steps/day in a sub-sample of adults. The present study aimed to examine the characteristics of intervention participants (n = 438) who (1) used a pedometer and (2) increased their step counts. Additionally, the third aim was to examine the mediational effect of pedometer use on step count change.     

Physical activity promotion in primary care: bridging the gap between research and practice

BACKGROUND: While a growing literature supports the effectiveness of physical activity interventions delivered in the primary care setting, few studies have evaluated efforts to increase physician counseling on physical activity during routine practice (i.e., outside the context of controlled research). This paper reports the results of a dissemination trial of a primary care-based physical activity counseling intervention conducted within the context of a larger, multi-strategy, Australian community-based, physical activity intervention, the 10,000 Steps Rockhampton Project. METHODS: All 23 general practices and 66 general practitioners (GPs, the Australian equivalent of family physicians) were invited to participate. Practice visits were made to consenting practices during which instruction in brief physical activity counseling was offered, along with physical activity promotion resources (print materials and pedometers). The evaluation, guided by the RE-AIM framework, included collection of process data, as well as pre- and post-intervention data from a mailed GP survey, and data from the larger project's random-digit-dialed, community-based, cross-sectional telephone survey that was conducted in Rockhampton and a comparison community. RESULTS: Ninety-one percent of practices were visited by 10,000 Steps staff and agreed to participate, with 58% of GPs present during the visits. General practitioner survey response rates were 67% (n =44/66 at baseline) and 71% (n =37/52, at 14-month follow-up). At follow-up, 62% had displayed the poster, 81% were using the brochures, and 70% had loaned pedometers to patients, although the number loaned was relatively small. No change was seen in GP self-report of the percentage of patients counseled on physical activity. However, data from the telephone surveys showed a 31% increase in the likelihood of recalling GP advice on physical activity in Rockhampton (95% confidence interval [CI]=1.11-1.54) compared to a 16% decrease (95% CI=0.68-1.04) in the comparison community. CONCLUSIONS: This dissemination study achieved high rates of GP uptake, reasonable levels of implementation, and a significant increase in the number of community residents counseled on physical activity. These results suggest that evidence-based primary care physical activity counseling protocols can be translated into routine practice, although the initial and ongoing investment of time to develop partnerships with relevant healthcare organizations, and the interest generated by the overall 10,000 Steps program should not be underestimated.     

Effects of a community-based intervention on physical activity: the Pawtucket Heart Health Program.

OBJECTIVES: The effect of a community-based physical activity program in Pawtucket, RI, was evaluated relative to one in a comparison community. METHODS: Cross-sectional surveys of 7529 residents of Pawtucket, RI, and 7732 residents of the comparison city were conducted at 2-year intervals during 7 years of intervention. RESULTS: There were no differences in self-reported knowledge of the benefits of physical activity, attempts to increase exercise, or prevalence of physical inactivity between Pawtucket and the comparison community. CONCLUSIONS: Future community-based physical activity interventions should attempt to involve a wider range of individuals.     

Increasing physical activity among church members: community-based participatory research

BACKGROUND: Faith-based interventions using a community-based participatory approach hold promise for eliminating ethnic health disparities. This study evaluated the effects of a volunteer-led statewide program to increase physical activity among members of African-American churches. METHODS: African Methodist Episcopal churches within six regions (Conferences) were randomly assigned to receive training in the program immediately or 1 year later. A cohort of 20 randomly selected churches and 571 members within them took part in telephone surveys at baseline (May-September 2003) and 1 year (May-August 2004) and 2 years later (June-September 2005). Primary outcomes were physical activity participation, meeting physical activity recommendations, and stage of readiness for physical activity change. Statistical analyses were completed in April 2006. RESULTS: Volunteers (N=889) from 303 churches were trained. Among survey respondents, physical activity did not increase significantly over time, although 67% were aware of the program. Program awareness was significantly related to all three physical activity outcomes and to fruit and vegetable consumption. Pastoral support was significantly associated with physical activity. CONCLUSIONS: Although this intervention reached a large number of churches and created awareness of intervention components, no effects on physical activity behaviors were found. Potential reasons for the lack of significant effects are discussed.     

Evaluation of a community-based intervention to promote physical activity in youth: lessons from Active Winners

PURPOSE: To test the effects of a community-based physical activity intervention designed to increase physical activity and to conduct an extensive process evaluation of the intervention. DESIGN: Quasi-experimental. SETTING: Two rural communities in South Carolina. One community received the intervention, and the other served as the comparison. SUBJECTS: Public school students who were in fifth grade at the start of the study (558 at baseline) were eligible to participate. A total of 436 students participated over the course of the study. INTERVENTION: The intervention included after-school and summer physical activity programs and home, school, and community components designed to increase physical activity in youth. The intervention took place over an 18-month period. MEASURES: Students reported after-school physical activity at three data collection points (prior to, during, and following the intervention) using the Previous Day Physical Activity Recall (PDPAR). They also completed a questionnaire designed to measure hypothesized psychosocial and environmental determinants of physical activity behavior. The process evaluation used meeting records, documentation of program activities, interviews, focus groups, and heart rate monitoring to evaluate the planning and implementation of the intervention. RESULTS: There were no significant differences in the physical activity variables and few significant differences in the psychosocial variables between the intervention and comparison groups. The process evaluation indicated that the after-school and summer physical activity component of the intervention was implemented as planned, but because of resource and time limitations, the home, school, and community components were not implemented as planned. CONCLUSIONS: The intervention did not have a significant effect on physical activity in the target population of children in the intervention community. This outcome is similar to that reported in other studies of community-based physical activity intervention.     

Promoting physical activity in middle school girls: Trial of Activity for Adolescent Girls

BACKGROUND: Physical activity is important for weight control and good health; however, activity levels decline in the adolescent years, particularly in girls. DESIGN: Group randomized controlled trial. SETTING/PARTICIPANTS: Middle school girls with English-speaking skills and no conditions to prevent participation in physical activity in 36 schools in six geographically diverse areas of the United States. Random, cross-sectional samples were drawn within schools: 6th graders in 2003 (n=1721) and 8th graders in 2005 (n=3504) and 2006 (n=3502). INTERVENTION: A 2-year study-directed intervention (fall 2003 to spring 2005) targeted schools, community agencies, and girls to increase opportunities, support, and incentives for increased physical activity. Components included programs linking schools and community agencies, physical education, health education, and social marketing. A third-year intervention used school and community personnel to direct intervention activities. MAIN OUTCOME MEASURES: The primary outcome, daily MET-weighted minutes of moderate-to-vigorous physical activity (MET-weighted MVPA), was assessed using accelerometry. Percent body fat was assessed using anthropometry. RESULTS: After the staff-directed intervention (pre-stated primary outcome), there were no differences (mean= -0.4, 95% CI= -8.2 to 7.4) in adjusted MET-weighted MVPA between 8th-grade girls in schools assigned to intervention or control. Following the Program Champion-directed intervention, girls in intervention schools were more physically active than girls in control schools (mean difference 10.9 MET-weighted minutes of MVPA, 95% CI=0.52-21.2). This difference is about 1.6 minutes of daily MVPA or 80 kcal per week. There were no differences in fitness or percent body fat at either 8th-grade timepoint. CONCLUSION: A school-based, community-linked intervention modestly improved physical activity in girls.     

"ASUKI Step" pedometer intervention in university staff: rationale and design

ABSTRACT: BACKGROUND: We describe the study design and methods used in a 9-month pedometer-based worksite intervention called "ASUKI Step" conducted at the Karolinska Institutet (KI) in Stockholm, Sweden and Arizona State University (ASU) in the greater Phoenix area, Arizona. Methods/design "ASUKI Step" was based on the theory of social support and a quasi-experimental design was used for evaluation. Participants included 2,118 faculty, staff, and graduate students from ASU (n = 712) and KI (n = 1,406) who participated in teams of 3--4 persons. The intervention required participants to accumulate 10,000 steps each day for six months, with a 3-month follow-up period. Steps were recorded onto a study-specific website. Participants completed a website-delivered questionnaire four times to identify socio-demographic, health, psychosocial and environmental correlates of study participation. One person from each team at each university location was randomly selected to complete physical fitness testing to determine their anthropometric and cardiovascular health and to wear an accelerometer for one week. Study aims were: 1) to have a minimum of 400 employee participants from each university site reach a level of 10, 000 steps per day on at least 100 days (3.5 months) during the trial period; 2) to have 70% of the employee participants from each university site maintain two or fewer inactive days per week, defined as a level of less than 3,000 steps per day; 3) to describe the socio-demographic, psychosocial, environmental and health-related determinants of success in the intervention; and 4) to evaluate the effects of a pedometer-based walking intervention in a university setting on changes in self-perceived health and stress level, sleep patterns, anthropometric measures and fitness. Incentives were given for compliance to the study protocol that included weekly raffles for participation prizes and a grand finale trip to Arizona or Sweden for teams with most days over 10,000 steps. DISCUSSION: "ASUKI Step" is designed to increase the number of days employees walk 10,000 steps and to reduce the number of days employees spend being inactive. The study also evaluates the intra- and interpersonal determinants for success in the intervention and in a sub-sample of the study, changes in physical fitness and body composition during the study. Trial registration Current Controlled Trials NCT01537939.     

Physical activity and physical function improved following a community-based intervention in older adults in Georgia senior centers

We evaluated a community-based physical activity intervention in Georgia senior centers. Participants were a convenience sample that completed the pre-test only (n = 592), or the pre-test, the intervention, and a post-test (n = 418, 98% aged 60 and older, mean age = 75, 83% female, 56% black). The 4-month physical activity intervention, based on the Health Belief Model, included 16 sessions that focused on educator-led chair exercises, promotion of walking, using a pedometer, and recording daily steps. Pre- and post-tests assessed physical activity and physical function, categorized as poor, moderate, or good (Short Physical Performance Battery). Following the intervention, participants improved their physical function (good physical function at pre-test vs. post-test: 16.5% vs. 25.3%, P < or = 0.001), increased minutes of physical activity by 26% (P < or = 0.001) and step counts by 29% (P < or = 0.0001, sub-sample, n = 95), and decreased reports of "it's not safe" as a barrier to physical activity (P < or = 0.05). Increased physical activity (P < or = 0.01) was associated with improved physical function following the intervention. The results of this evaluation provide an evidence base for the effectiveness of this community intervention for improving physical activity and physical function in older adults.     

The relationship between community participation and physical activity among individuals with serious mental illnesses

IntroductionThe importance of physical activity (PA) and health outcomes for individuals with serious mental illnesses (SMI) has been well documented. It is also established that individuals with SMI engage in high amounts of sedentary behavior and low amounts of physical activity, which contributes to poor health outcomes. This study explores the relationship between community participation, physical activity, and sedentary behavior among individuals with SMI.MethodsThis study used a sample of individuals with SMI who were receiving community mental health services in a large urban area of the United States. Of the 526 individuals approached, 308 were interested in the study; 173 consented and completed data collection. This study reports on 152 participants who had complete data. Using the Temple University Community Participation Scale, participants reported on community-based activities completed independently in the previous 30 days. Additionally, participants were asked to wear a tri-axial accelerometer (ActiGraph GT3X) on the non-dominant wrist for seven days. The total number of community participation days was correlated with PA variables including steps, sedentary, light, and moderate-vigorous PA. Two groups of step data were analyzed using t-tests: ≥7500 steps, and ≥10,000 steps. Logistic regressions were run to examine the relationship between amount, breadth and sufficiency of community participation and having ± 7500 steps and ± 10,000 daily steps, controlling for age, gender, and income.ResultsAmount of community participation was inversely associated with the % of time in sedentary activity and positively associated with the % of time in moderate to vigorous PA. Those with at or more than 7500 steps and 10,000 steps reported significantly more days of community participation.ConclusionThis study highlights the contribution of everyday activities for increased physical activity and reduced time spent in sedentary activity. Practitioners should consider recommendations for engagement in the community to increase opportunities for walking.     

Culturally tailored aerobic exercise intervention for low-income Latinas

PURPOSE: To determine the efficacy of community-based, culturally tailored exercise intervention on the moderate and vigorous physical activity and physiologic outcomes of low-income Latino women (Latinas). DESIGN: A randomized trial contrasted safety education to an aerobic dance intervention. SETTING: Interventions were held in a "store-front" exercise site near a community clinic. SUBJECTS: Sedentary low-income Latinas (N = 151; 18-55 years; 70% overweight/obese) were recruited. Retention was 91% for follow-up measures. INTERVENTION: Three sessions per week of supervised aerobic dance were provided for 6 months. Controls attended 18 safety education sessions over 6 months. MEASURES: Physical activity and aerobic fitness (VO2max) were primary outcomes. RESULTS: Participants in the exercise group reported more vigorous exercise (p < .001) and walking (p = .005) at post-test than controls. Aerobic dance and unsupervised activity resulted in a five-fold greater increase in relative VO2max compared with controls (p < .001). Although exercise and fitness decreased at follow-up, vigorous exercise (p = .001) and relative VO2max (p < .001) remained higher in the exercise group, suggesting maintenance at 1 year. CONDUSION:. Culturally tailored aerobic dance can increase vigorous physical activity, possibly generalizing to walking, and the combination can improve cardiorespiratory fitness in low-income, overweight, sedentary Latinas.     

Physical activity among adults with intellectual disabilities living in community settings

OBJECTIVE: The aim was to objectively monitor steps accrued by a sample of adults with intellectual disabilities and to describe physical activity patterns by monitoring steps taken across weekdays, weekends, and hours of the day using time-stamped technology. METHOD: This study used pedometers with time-stamped recording capabilities to measure physical activity behavior of 131 adults with mild to moderate levels of intellectual disabilities living in community-based supported living group settings in Iowa. Participants wore a pedometer for seven consecutive days. All data was collected in 2006 and analyzed in 2007. RESULTS: The participants accrued 6508+/-3296 steps/day. Controlling for age, participants with mild intellectual disability were more active than participants with moderate intellectual disability (F=7.03, p<.01). A total of 14.1% accumulated 10,000 steps/day. Participants were more active on weekdays than on weekends (Z=-7.36, p<.01), and least active during the evening period compared to the morning and afternoon hours (F(r)=103.3, p<.01). CONCLUSION: Physical activity (steps/day) achieved by the majority of this population is insufficient for health benefits, particularly among individuals with moderate intellectual disability. Evenings and weekends are especially inactive time periods.     

Wheeling Walks: a community campaign using paid media to encourage walking among sedentary older adults

BACKGROUND: Mass media may effect communitywide changes in health awareness, attitude, and behavior, but the approach remains unproven for physical activity. METHODS: Wheeling Walks promoted walking among sedentary 50- to 65-year-old adults in a West Virginia city of 31,420 people. This quasi-experimental communication intervention used theory of planned behavior and transtheoretical model constructs to change behavior by promoting 30 min of daily walking through paid media, public relations, and public health activities. Impact was determined by pre- and postintervention telephone surveys with 719 adults in the intervention community and 753 adults in the comparison community and observations of walkers at 10 community sites. RESULTS: Behavior observation showed a 23% increase in the number of walkers in the intervention community versus no change in the comparison community (OR = 1.31, 95% CI = 1.14-1.50). Thirty-two percent (32.2) of the baseline sedentary population in the intervention community reported meeting the CDC/ACSM/Surgeon General recommendation for moderate-intensity physical activity by walking at least 30 min at least five times per week versus 18.0% in the comparison community (OR = 2.12, 95% CI = 1.41-2.24). The intervention community also realized a pre to post increase in positive stage change (P < 0.001). CONCLUSIONS: This theory-based mass media campaign demonstrated increases in those meeting the recommended standard for moderate-intensity physical activity through walking and significant positive stage change.     

Healthy Alberta Communities: Impact of a three-year community-based obesity and chronic disease prevention intervention

Objective

To assess the impact of a 3 year (2006–2009) community-based intervention for obesity and chronic disease prevention in four diverse “Healthy Alberta Communities” (HAC).

Methods

Targeted intervention development incorporated the ANGELO conceptual framework to help community stakeholders identify environmental determinants of obesity amenable to intervention. Several inter-related initiatives were implemented. To evaluate, we surveyed separate samples of adults in HAC communities before and after the interventions and compared responses to identical survey questions asked of adults living in Alberta in two waves of the Canadian Community Health Survey (CCHS).

Results

The HAC sample included 4761 (2006) and 4733 (2009) people. The comparison sample included 9775 and 9784 respondents in 2005 and 2009–10 respectively. Self-reported body mass index showed no change, and neither were there significant changes in behaviors relative to secular trends. Most significant outcomes were relevant to social conditions, specifically sense of belonging to community in the intervention communities.

Conclusion

Health outcome indicators at the community level may not be sufficiently sensitive to capture changes which, over a relatively short term, would only be expected to be incremental, given that interventions were directed primarily to creating environmental conditions supportive of changes in behavioral outcomes rather than toward health outcome change directly.     

An ethnography of clinic "noise" in a community-based, promotora-centered mental health intervention

Community-based health interventions have emerged as a growing focus for anthropological research. The application of ethnographic approaches in clinical practice settings reveals that community-based interventions must grapple with "noise," or unanticipated factors such as patients' own perceptions of illness and treatment, primary care providers' non-adherence to guidelines-based treatment, the social dynamics of the clinic site itself, and incomplete understanding and acceptance of an intervention by a clinic's staff members. Such noise can influence the implementation and quality of treatment. Thus, identifying clinic-based noise is critical in assessments of fidelity to intervention protocols as well as outcomes of community-based interventions. This paper highlights findings from an evaluation of a mental health intervention focusing on the role of promotoras (briefly trained, non-professional community health workers) as mental health practitioners in two urban New Mexico, USA, community health centers. Our research identified three areas of clinic-based noise: the clinics' physical ability to "absorb" the intervention, the challenges of co-worker instability and interpersonal relationships, and balancing extra workplace demands. The findings demonstrate the value of ethnographic approaches in community-based intervention research.     

Effectiveness of a lifestyle intervention and a structured exercise intervention in older adults

OBJECTIVE: To evaluate the effects of a lifestyle intervention and a structured exercise intervention on physical activity in older adults. METHOD: Participants were randomly assigned to a lifestyle intervention (n=60), including an individualized home-based program supported by phone calls, or to a structured intervention (n=60) consisting of three weekly supervised sessions. Results were compared with a control group (n=66). Physical activity was measured with self-report questionnaires, pedometers, and accelerometers before the start (pretest), at the end (11 months, posttest), and after 23 months (follow-up). The study took place in Belgium from March 2004 until April 2006. RESULTS: At posttest, both intervention groups had significantly increased their total physical activity compared with the control group. At follow-up, the lifestyle group showed significantly larger increases in active transportation and total steps than the control and structured group respectively. There were no longer significant differences between the structured intervention and the control group. CONCLUSIONS: The structured and lifestyle interventions were equally effective at the end of the intervention. One year after the intervention the lifestyle group maintained a significant increase in physical activity, which highlights the potential of lifestyle programs in the battle against inactivity in older adults.     

社区综合干预对居民体力活动水平的短期影响

目的评价社区综合干预对杭州市3个社区成人体力活动水平的短期影响.方法采用平行对照、非随机分组的类实验设计,以杭州市下城区和拱墅区作为干预区,开展为期2年的社区综合干预,同期以西湖区作为对照区,并在干预前后通过两次独立横断面问卷调查评价社区综合干预对居民体力活动水平的短期影响.结果基线和随访各完成调查2016人(干预区1016人和对照区1000人).干预区居民在干预前后对体力活动益处的认知水平有下降趋势；对照区未见有统计学意义的变化.干预区居民总体力活动水平(代谢当量,MET-mir/w)由1204显著性增长到1386(P=0.023),对照区由918增长至924,变化的差异无统计学意义(P=0.201),控制调查对象年龄构成变化的可能影响后,结果不变.结论经2年干预,干预区人群总体力活动水平得到有益的改变.在杭州市城区针对居民体力活动水平开展以社区为基础的综合干预项目具有可行性和有效性.     

Peer Reviewed: Vigorous Physical Activity Among Tweens, VERB Summer Scorecard Program, Lexington, Kentucky, 2004-2007

Introduction

Empirical examinations of the efficacy of community-based programs to increase and sustain physical activity among youth are lacking. This study describes changes in vigorous physical activity during a 3-year period among children aged 9 to 13 years (tweens) in Lexington, Kentucky, following introduction of the VERB Summer Scorecard (VSS) intervention.

Methods

A community coalition, guided by a marketing plan that addressed motivators for tweens to participate in physical activity, designed and implemented VSS. Youth used a scorecard to monitor their physical activity, which was verified by adults. There were 3,428 students surveyed in 2004; 1,976 in 2006; and 2,051 in 2007 (mean age for 2004, 2006, and 2007, 12 y). For each year, we performed Χ ² tests and computed summary statistics for age, sex, and grade. Chi-square tests and cumulative logit models were used to analyze physical activity trends among VSS participants, VSS nonparticipants, and a reference group.

Results

The proportion of youth who reported frequent vigorous physical activity increased from 32% in 2004 to 42% in 2007. The proportion of VSS participants with moderate or high levels of vigorous physical activity increased by approximately 17 percentage points, more than twice the proportion of nonparticipants.

Conclusion

Interventions such as VSS may empower communities to take action to encourage greater physical activity among youth.     

General practitioner advice on physical activity--who gets it?

PURPOSE: To evaluate the prevalence and characteristics of patients who received physical activity counseling from a general practitioner. METHODS: Data presented are from a cross-sectional survey of approximately 2000 Queensland (Australia) adults conducted as part of a multi-strategy, community-based, physical activity intervention (10,000 Steps Rockhampton). The survey included self-reported receipt of general practitioner advice on physical activity as well as demographic, medical, and physical activity questions. RESULTS: Receipt of advice on physical activity was reported by 24.2% of respondents, with advice more likely to be given to males, overweight/obese people, those with chronic conditions, and those more frequently visiting their general practitioners. DISCUSSION: Rates of physical activity advice and characteristics of patients receiving advice are similar to those reported overseas and suggest that while there is room for improvement, general practitioners are targeting their advice to patients most in need.     

A school-based intervention to promote physical activity among adolescent girls: Rationale,design, and baseline data from the <Emphasis Type="Italic">Girls in Sport</Emphasis> group randomised controlled trial

Background

Physical activity levels decline markedly among girls during adolescence. School-based interventions that are multi-component in nature, simultaneously targeting curricular, school environment and policy, and community links, are a promising approach for promoting physical activity. This report describes the rationale, design and baseline data from the Girls in Sport group randomised trial, which aims to prevent the decline in moderate-to-vigorous intensity physical activity (MVPA) among adolescent girls.

Methods/Design

A community-based participatory research approach and action learning framework are used with measurements at baseline and 18-month follow-up. Within each intervention school, a committee develops an action plan aimed at meeting the primary objective (preventing the decline in accelerometer-derived MVPA). Academic partners and the State Department of Education and Training act as critical friends. Control schools continue with their usual school programming. 24 schools were matched then randomized into intervention (n = 12) and control (n = 12) groups. A total of 1518 girls (771 intervention and 747 control) completed baseline assessments (86% response rate). Useable accelerometer data (≥10 hrs/day on at least 3 days) were obtained from 79% of this sample (n = 1199). Randomisation resulted in no differences between intervention and control groups on any of the outcomes. The mean age (SE) of the sample was 13.6 (± 0.02) years and they spent less than 5% of their waking hours in MVPA (4.85 ± 0.06).

Discussion

Girls in Sport will test the effectiveness of schools working towards the same goal, but developing individual, targeted interventions that bring about changes in curriculum, school environment and policy, and community links. By using community-based participatory research and an action learning framework in a secondary school setting, it aims to add to the body of literature on effective school-based interventions through promoting and sustaining increased physical activity participation among adolescent girls.

Trial Registration Number

Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12610001077055