A systematic literature review of peer-led strategies for promoting physical activity levels of adolescents

Background. Low levels of physical activity (PA) in adolescents highlight the necessity for effective intervention. During adolescence, peer relationships can be a fundamental aspect of adopting and maintaining positive health behaviors. Aim. This review aims to determine peer-led strategies that showed promise to improve PA levels of adolescents. It will also identify patterns across these interventions, including training provided and the behavior change techniques (BCTs) employed. Method. Adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, PubMed, PsychINFO, and Scopus were searched using key concepts of peer, PA and adolescent for articles that examined interventions that had a peer-led component and reported on at least one PA outcome in 12- to 19-year-olds. Following title and abstract screening of 1,509 studies, and full text review stage, 18 progressed to data synthesis. Methodological quality was assessed using an adapted scale. Results. Quality assessment identified 11 studies as high quality. Half of the included studies (n = 9) reported improved PA outcomes in the school setting. The most prominent behavioral change techniques were social support, information about health consequences, and demonstration of the behavior. Older adolescents leading younger peers and younger adolescents leading those of the same age showed potential. Seldom have older adolescents been targeted. Gender-specific interventions showed the most promise. Conclusion. Peer leadership requires careful planning and in the school setting can be a resourceful way of promoting adolescent PA

Differences in parental perceptions of walking and cycling to high school according to distance

Background: Parental perceptions towards different modes of transport correlate with adolescents’ mode choice for school trips. Whether parental attitudes differ for walking versus cycling and/or home-to-school distance is unknown. We compared parental perceptions of walking versus cycling to school in adolescents in Dunedin, New Zealand and examined whether mode-specific barriers differ by distance to school. Methods: Parents (n = 341; age: 47.5 ± 5.2 years; 77.1% females) completed a survey about their adolescent’s (age: 13–18 years; 48.1% boys) school travel and their own perceptions of walking/cycling to school. Participants were categorised into three groups according to distance to school as ‘walkable’ ( 2.25 km), ‘cyclable’ (>2.25– 4.0 km) and ‘beyond cyclable’ (>4.0 km). Results: Common modes of transport to school differed significantly across the ‘walkable’/’cyclable’/’beyond cyclable’ categories (car passenger: 25.7%/40.5%/60.6%; public/ school bus: 5.5%/15.4%/28.4%; walking: 66.2%/28.2%/1.2%; cycling: 0.0%/7.7%/0.5%; all p < 0.001). Compared to walking, parents perceived cycling to school to be less important (walking/cycling: 87.5%/62.5%), with less social support from parents (46.2%/17.1%), peers (20.6%/4.8%) and school (24.5%/12.4%), less interest from adolescents (48.5%/31.9%), fewer cycle paths (26.5%) versus footpaths (65.0%) and more safety concerns (35.0%/64.6%; all p < 0.001). As distance to school increased, parents’ social support decreased whereas personal, environmental and safety-related barriers increased for both modes, with less consistent findings for cycling. Overall, 68.2% of parents expected to participate in adolescents’ walking/cycling to school decision-making. Conclusions: Parents favoured walking compared to cycling to school with parental attitudes for both modes changing with increasing distance to school. The findings illustrate the importance of addressing parental concerns, considering the specificity of walking and cycling and taking into account distance to school in active transport to school initiative

A feasibility study of an exercise intervention to educate and promote health and well-being among medical students: the ‘MED-WELL’ programme

Background: Medical School programme workloads challenge the physical and mental health of students particularly in compressed graduate entry programmes. There is evidence that physical activity (PA) can improve holistic care and help maintain wellness among medical students. We tested the feasibility of introducing an exercise programme to the medical school curriculum which would educate and promote health and well-being among its students. Methods: This study was conducted in a single graduate entry medical school at the University of Limerick (UL). The ‘MED-WELL’ programme was a six-week programme of 1 hour-long weekly sessions, each involving a different type of PA (45 min). These sessions were prefaced by an interactive lecture about how to incorporate exercise theory into daily medical practice (15 min). The study was conducted in a single graduate entry medical school at UL and involved year one and year two graduate entry medical students. Three parameters were used to test feasibility: 1. Recruitment and retention of participants, 2. Acceptability of the programme and 3. Efficacy in terms of health and well-being. The latter was assessed by administering questionnaires pre and post the intervention. The questionnaires used the following validated measurement scales: EQ-VAS; WHO-5 Well-Being Index; 3-item Loneliness Scale; Social Support Measure 3-item scale. Free text boxes also encouraged participants to discuss the merits of the programme Results: In total, 26% (74/286 students) participated in the programme. Of those who participated, 69 students (93%) attended one or more sessions of the programme and completed questionnaires at baseline and at followup. Significant improvements were seen in scores after the programme in the WHO-5 Well-Being Index which increased from 63.2 (95%CI: 48–78.4) to 67.5 (95%CI: 55.1–79.9); (P < 0.01), the sleep scale which increased from 3.1 (95%CI: 2.2–4.0) to 3.5 (95%CI: 2.5–4.5); (P < 0.001), and the loneliness scale which decreased from 4.1 (95%CI: 2.7– 5.5) to 3.5 (95%CI: 2.5–4.5); (P < 0.005). Students level of PA during a typical week also increased from 3.7 (95%CI: 2.1–5.4) to 4.0 (95%CI, 3.5–4.5); (P < 0.05). Conclusion: This study has shown it is feasible to deliver this programme in a medical school’s curriculum. The programme seems to be of benefit and is acceptable to students. Well-designed randomised controlled trials are needed to measure outcomes, durability of effect, and cost effectivenes

A school-based randomized controlled trial to promote cycling to school in adolescents: The PACO study

“Cycling and Walk to School” (PACO, by its Spanish acronym) that aims to promote cycling to and from school and physical activity (PA) in adolescents. This study will examine the effects of this intervention in cycling and active commuting to and from school (ACS), PA and several ACS-related factors based on self-determination theory (SDT) and a social-ecological model (SEM). A total of 360 adolescents attending six high schools (three experimental and three control) from three Spanish cities will participate in this randomized controlled trial. The intervention (four cycling sessions; 1–2 h per session, one session per week) will be conducted by the research staff; the control group will continue their usual activities. PA levels will be measured by accelerometers, whereas ACS and the other study variables will be self-reported using questionnaires at baseline and post-intervention. The primary outcomes will be: rates of cycling to school, ACS and PA levels. In addition, SDT-related variables and individual, interpersonal, community, and environment variables relevant to ACS will be based on SEM. The findings will provide a comprehensive understanding of the short-term effects of this school-based intervention on cycling to school behaviour, ACS and PA levels in Spanish adolescents