TITLE:
Association between Implementation and Effect in the Randomized Controlled Trial “Move for Well-Being in School”
AUTHORS:
Søren Smedegaard, Lars Breum Christiansen, Ruben Brondeel, Thomas Skovgaard
KEYWORDS:
Implementation, Physical Activity, School, Process Indicators, Degree of Implementation
JOURNAL NAME:
Advances in Physical Education,
Vol.11 No.2,
March
18,
2021
ABSTRACT: Background: Research in school-based physical activity interventions has primarily focused on effectiveness. The main aim of this paper is to assess the association between the degree of implementation of a multicomponent physical activity intervention and effectiveness on students’ physical self-worth (PSW). Methods: The Move for Well-being in School study used a cluster randomized controlled study design including 24 schools with a total of 3123 students 4th to 6th grade. 1269 students and 148 educators were, for a whole school-year, part of the activities at 12 intervention schools, The intervention program targeted settings for school-based physical activity in recess, in-class and Physical Education (PE). The association between change in PSW and implementation were analysed using multilevel linear regressions models estimated in R. Results: Three components were to be implemented at all intervention schools. For PE, half of the performed lessons were from the program, which was in line with the protocol aim. Classes with a higher implementation rate of the PE-component had a significant higher PSW at baseline. An average of 5.8 brain breaks was implemented per class per week, and no significant differences were established between implementation and change in PSW. Recess implementation was the hardest for most schools to implement, but schools with a high level of recess implementation had a significant increase in PSW at follow-up. Conclusions: This paper explores an important aspect of school interventions, showing that implementation varies both at school and class level and that this potentially has an effect on outcome measures. The discussion point to several methodological difficulties in linking implementation and effects in multicomponent school-based activity interventions. This area of research needs further development to increase the understanding of how physical activity-related interventions are implemented and how this affects final outcomes. Trial Registration:Date of registration: 24 April 2015 retrospectively registered at Current Controlled Trials with study ID ISRCTN12496336.