Exploring the psychological impact of contact tracing work on staff during the COVID-19 pandemic.

BACKGROUND: Contact tracing is a key control measure in the response to the COVID-19 pandemic. While quantitative research has been conducted on the psychological impact of the pandemic on other frontline healthcare workers, none has explored the impact on contact tracing staff. METHODS: A longitudinal study was conducted using two repeated measures with contact tracing staff employed in Ireland during the COVID-19 pandemic using two-tailed independent samples t tests and exploratory linear mixed models. RESULTS: The study sample included 137 contact tracers in March 2021 (T1) and 218 in September 2021 (T3). There was an increase from T1 to T3 in burnout related exhaustion (p < 0·001), post-traumatic stress disorder (PTSD) symptom scores (p < 0·001), mental distress (p < 0·01), perceived stress (p < 0·001) and tension and pressure (p < 0·001). In those aged 18-30, there was an increase in exhaustion related burnout (p < 0·01), PTSD symptoms (p < 0·05), and tension and pressure scores (p < 0·05). Additionally, participants with a background in healthcare showed an increase in PTSD symptom scores by T3 (p < 0·001), reaching mean scores equivalent to those of participants who did not have a background in healthcare. CONCLUSIONS: Contact tracing staff working during the COVID-19 pandemic experienced an increase in adverse psychological outcomes. These findings highlight a need for further research on psychological supports required by contact tracing staff with differing demographic profiles.

An exploration of food industry led reformulation on fortified food staples in Ireland.

BACKGROUND: Food industry led reformulation efforts have attempted to address the prevalence of obesity by modifying nutrient compositions in food products. This study explored progress in nutrient composition alterations in products in Irish supermarkets by comparing the nutrient labels of products sold in 2014 and 2017. METHODS: We conducted two supermarket audits in 2014 and 2017 to examine the changes in the nutrient profile of cereals, breads, spreads, unflavoured milks, yogurts and juices. Information on the nutrients of interest to the study (energy, protein, fat, carbohydrate, saturated fat, salt, sugar and some micronutrients) were extracted and stored in Microsoft Excel. The nutrient profile of each product was compared across the two timepoints. Our study shows that the mean level of sugars in cereals remains high and that the mean level of salt remains high in cereals, breads, and spreads. RESULTS: In total, 143 products were directly compared (86 cereals, 26 breads, 17 spreads and 14 milks). Our study shows that the composition of salt and sugar in cereal, bread, spreads and milk has declined by 12 and 7%, respectively. Saturated fat has declined in cereals (7%), but has increased in breads (12%), spreads (1%), and milks (5%). Manufacturers increased the serving sizes in nine cereals and one milk. CONCLUSIONS: From a population health perspective, the results are encouraging but care should be exercised by the food industry not to allow total fat and saturated fat levels to creep upwards. Further research and engagement of public health specialists and the food industry are needed.

Co-design of a school-based physical activity intervention for adolescent females in a disadvantaged community: insights from the Girls Active Project (GAP).

BACKGROUND: Globally, adolescents' physical activity (PA) participation rates are low, particularly among lower socioeconomic groups, with females consistently the least active. The aim of this study was to co-design, with adolescent females, a school-based PA intervention in a single-sex, females-only designated disadvantaged post-primary school in Ireland. This involved using the Behaviour Change Wheel (BCW) and Public and Patient Involvement (PPI). This paper outlines the novel methodological approach taken. METHODS: The three stages 1) understand the behaviour, 2) identify intervention options, and 3) identify content and implementation options of the BCW guide is described. A student PPI Youth Advisory Group (YAG) (n = 8, aged 15-17) was established. Mixed-methods were used with students (n = 287, aged 12-18) and teachers (n = 7) to capture current self-reported PA levels and to identify factors influencing adolescent females' PA behaviour in their school setting. The intervention options, content and implementation options were identified through discussion groups with the YAG. The Template for Intervention Description and Replication (TIDieR) checklist was used to specify details of the intervention. RESULTS: Just 1.4% of the students in this sample reported meeting the recommended PA guidelines. Students identified having more 'time' as the strongest predictor to becoming more active in school (Mean = 4.01, 95% CI 3.91 to 4.12). Social influences, environmental context and resources, behavioural regulation, beliefs about capabilities, goals, and reinforcement emerged from the qualitative data as factors influencing PA behaviour at school. The BCW co-design process resulted in the identification of seven intervention functions, four policy categories and 21 Behaviour Change Techniques. The Girls Active Project (GAP) intervention, a peer-led, after-school PA programme was proposed. CONCLUSIONS: This paper describes how the BCW, a comprehensive, evidence-based, theory-driven framework was used in combination with PPI to co-design a school-based intervention aimed to increase adolescent females' PA levels. This approach could be replicated in other settings to develop targeted behavioural interventions in populations with specific demographic characteristics.

An exploration of the levels of clinical autonomy of advanced nurse practitioners: A narrative literature review.

AIMS AND OBJECTIVES: The aims of the review are to synthesise current evidence about advanced nurse practitioner clinical autonomy and consider how this may inform clinical practice and research. BACKGROUND: Clinical autonomy is one of the cornerstones of advanced nursing practice globally, yet there is limited synthesis of clinical autonomy in the literature. DESIGN: This is a narrative literature review. DATA SOURCES: The databases Cumulative Index to Nursing and Allied Health Literature, EBSCO host, Cochrane Library, CINAHL and MEDLINE were searched for publications between 2005 and 2020 inclusive. REVIEW METHODS: A systematic approach was used to analyse the literature reviewed. Two reviewers undertook quality appraisal. RESULTS: Nineteen articles were selected. Four major themes emerged: (1) 'ANP Stepping Up'-moving into and accepting advanced nursing practice roles and clinical responsibilities; (2) 'ANP Living It'-ANPs' ability to act independently including an understanding of task mastery and self-determination; (3) 'ANP Bounce-back ability'-depicted in challenges that threaten their ability to practice clinically autonomously; (4) 'ANP Setting in Motion'-indirect care activities and service-level improvements. CONCLUSION: A clearer understanding of advanced nurse practitioner clinical autonomy could help develop more in-depth knowledge. Research of advanced nurse practitioners' clinical autonomy would improve full utilisation in clinical practice.

Experiences of residents, family members and staff in residential care settings for older people during COVID-19: A mixed methods study.

AIM: The aim of this study was to explore the COVID-19 pandemic as it was experienced by people on the front line in residential care settings for older people in the Republic of Ireland (ROI). BACKGROUND: The COVID-19 pandemic had a disproportionate effect in residential care settings for older people in Ireland. METHODS: A two-phased mixed methods study was conducted, consisting of an online survey administered shortly after the first wave of the virus to staff, residents and family members and one-to-one interviews with family members shortly after wave 2 of the virus. RESULTS: Isolation, loss of connectedness as well as a reduction in the level/quality of care provision led to significant adverse impacts for both residents and their families. Staff reported high levels of stress, trauma and burnout. Family input to care was suspended, with adverse consequences. CONCLUSION: The pandemic had an extremely adverse impact on residents, family members and staff in care settings for older people. IMPLICATIONS FOR NURSING MANAGEMENT: Strategies to ensure that residents' physical, emotional and social needs and staffs' professional and personal needs are appropriately supported during future waves of the pandemic should now be implemented.

Voluntary folic acid fortification levels of food staples in Ireland continue to decline: further implications for passive folic acid intakes?

BACKGROUND: Ireland previously had widespread voluntary fortification but research at Dublin City University carried out in 2014 by our research group demonstrated a major decline in the number of food staples fortified with folic acid in Irish supermarkets over the previous 10 years. The aim of the study was to repeat the audit conducted 3 years ago to compare the levels of folic acid fortification of foodstuffs over this time-frame. METHODS: Over a period of 8-weeks between June and August 2017, the nutrition labels of all foodstuffs that might typically be fortified with micronutrients for sale in the supermarkets with the majority of market share in Ireland were examined. The amount of added folic acid detailed on the label was compared with those captured in 2014. RESULTS: In total, 1081 products with added micronutrients were examined. In percentage terms, there has been a decline of Folic Acid (FA) fortified products within the food groups-spreads, breads, cereals, cereal snacks, milks, fruit juices, yogurts/yogurt drinks and energy drinks since 2014. DISCUSSION: The number of food staples fortified with FA continues to decline demonstrating that voluntary fortification in Ireland is no longer an effective measure for passively augmenting the folic acid levels of consumers.

'We know what we should eat but we don't ': a qualitative study in Irish secondary schools.

Healthy eating opportunities for young people need to be provided in the school setting. Links between formal education and local policies and practices, and active involvement of students are emphasized in whole school approaches to health promotion. In many jurisdictions, schools struggle to provide nutritious food that is acceptable to students. The aim of this study was to conduct an in-depth exploration of school food and students' food choice with students, teachers and principals in six Irish secondary schools. Students conducted their own focus groups with peers, and a researcher conducted focus groups with teachers and one-to-one interviews with principals. Students, teachers and principals expressed dissatisfaction with food provision within their respective schools and reported unhealthy dietary behaviours among the student body as the norm. Divergent views, however, emerged regarding education, knowledge and the primary drivers of food choice. Teachers and principals saw a role for more education modules and students believed environmental infrastructures, practices and policies needed to be addressed to improve behaviours. This consultation with students, teachers and principals highlight that, in addition to education, the social and environmental aspects of food choice and eating at school deserve attention in future research and policy.

Developing a national undergraduate standardized curriculum for future healthcare professionals on "Making Every Contact Count" for chronic disease prevention in the Republic of Ireland.

This report describes the development of the first national undergraduate interprofessional standardized curriculum in chronic disease prevention for healthcare professionals in the Republic of Ireland. This project brought together for the first time all higher education institutions nationwide in a novel collaboration with the national health service i.e. the Health Service Executive (HSE), to develop a standardized national curriculum for undergraduate health care professions. The curriculum sits within the framework of Making Every Contact Count, the goal of which is to re-orientate health services to embed the ethos of prevention through lifestyle behavior change as part of the routine care of health professionals. The core focus of Making Every Contact Count is chronic disease prevention, targeting four main lifestyle risk factors for chronic disease; tobacco use, alcohol consumption, physical inactivity and unhealthy eating. Making Every Contact Count is a key component of Healthy Ireland, the Irish national framework for health and wellbeing. The aim of the curriculum is to prepare newly qualified health professionals with the skills needed to support patients to achieve lifestyle behavior change delivered as part of routine clinical care.

Researchers' experiences and lessons learned from doing mixed-methods research with a population with intellectual disabilities: Insights from the SOPHIE study.

Researchers are challenged to provide opportunities for people with intellectual disabilities (IDs) and their families to become participants in research. This article explores the processes and procedures involved in conducting a mixed-methods study. The preparation for the study is described and explained. Recruitment is examined by describing the process and analysing phone calls made to potential participants. Reflections of research team members help to develop the analysis and contribute to a discussion of the fieldwork. Lessons learned show that research projects involving people with IDs and their families need careful planning and have additional costs. The research team requires a mix of expertise. Traditional recruitment methods may not be suitable, and researchers need to build good relationships with gatekeepers so that participants can be contacted directly. Good quality research with people with IDs and their families is possible once suitable strategies are employed throughout the research process.

Optimization of folic acid supplementation in the prevention of neural tube defects.

Background: We examined the relationship between timing and duration of folic acid (FA) supplementation in achieving red blood cell (RBC) folate levels in early pregnancy which are optimal (>906 nmol/l) for the prevention of neural tube defects (NTDs). Methods: Clinical, FA supplementation and dietary folate details were computerized at the first antenatal visit. Maternal blood samples were analysed for RBC and serum folate. Results: Of the 502 women, 98.2% (n = 493) reported taking FA. There was a positive correlation between duration of supplementation and both RBC folate (r = 0.43, P < 0.001) and serum folate (rho = 0.29, P < 0.001). The optimal RBC folate level was achieved in 80.4% (n = 46) of women who started FA 400 µg 4-8 weeks before their LMP compared with only 53.6% (n = 153) in women who started 4-8 weeks after their LMP (P < 0.001). Conclusions: This study provides, for the first time, information on both the timing and duration of FA that will achieve the optimum RBC folate levels associated with the prevention of NTDs. Women who are taking FA (400 µg) need to start before they conceive.

A comparison of physical activity, physical fitness levels, BMI and blood pressure of adults with intellectual disability, who do and do not take part in Special Olympics Ireland programmes: Results from the SOPHIE study.

People with an intellectual disability are less physically active, live more sedentary lives, have lower fitness levels and are more likely to be overweight or obese than the general population. No evidence exists on the impact of participation in Special Olympics Ireland (SOI) on physical activity and physical fitness levels. Adults with intellectual disabilities (16-64 years) were recruited from services and SOI clubs. Physical measures included waist circumference, height, weight, blood pressure, heart rate and 6-min walking test. Self-report questionnaires gathered data on physical activity levels. Actigraph (GT3X) accelerometers were used to gain an objective measure of physical activity. SOI participants accumulated more moderate to vigorous physical activity per day, had higher fitness levels and more positive health profile scores than those not taking part in SOI. SOI has the potential to make a positive difference to people's physical health and subsequently their overall health and well-being.

School lunches in the Republic of Ireland: a comparison of the nutritional quality of adolescents' lunches sourced from home or purchased at school or 'out' at local food outlets.

OBJECTIVE: To compare the energy, nutrient and food group compositions of three sources of school-day lunches among students in five secondary schools in the Republic of Ireland (ROI). DESIGN: Cross-sectional study conducted between October 2012 and March 2013. Students completed self-report food diaries over two school days. The energy, nutrient, nutrient density and food group composition of school-day lunches from home, school and 'out' in local food outlets were compared using ANCOVA and Tukey's Honest Significant Difference post hoc analysis. SETTING: Five secondary schools in the ROI. SUBJECTS: Male and female students aged 15-17 years (n 305). RESULTS: Six hundred and fifteen lunches (376 home lunches, 115 school lunches and 124 lunches sourced 'out' in the local environment) were analysed. School and 'out' purchased lunches were significantly higher than packed lunches from home in energy (2047 kJ (489 kcal), 2664 kJ (627 kcal), 1671 kJ (399 kcal), respectively), total fat (23·5 g, 30·1 g, 16·6 g, respectively) and free (added) sugars (12·6 g, 19·3 g, 7·4 g, respectively). More home lunches contained more fruit, wholemeal breads, cheese and red meat than lunches from school or 'out'. Meat products, chips and high-calorie beverages were sourced more frequently at school or 'out' than home. Fibre and micronutrient contents of lunches from all sources were low. CONCLUSIONS: Home-sourced lunches had the healthiest nutritional profile in terms of energy and macronutrients. Foods high in energy, fat and free sugars associated with school and local food outlets are of concern given the public health focus to reduce their consumption. While school food should be improved, all sources of lunches need to be considered when addressing the dietary behaviours of secondary-school students.

An examination of the nutritional intake and anthropometric status of individuals with intellectual disabilities: Results from the SOPHIE study.

The prevalence of obesity appears greater in people with intellectual disabilities than those in the general population. This study aimed to examine the nutritional intake and anthropometric status of individuals with intellectual disabilities. Participants aged 16-64 years were recruited from intellectual disability service provider organizations ( n = 131). Data were collected using questionnaires; 4-day food dairies and weight, height and waist circumference measurements. Participants' mean body mass index (BMI) was 29.4 kg/m2 ± 6.1, 2.4% were underweight, 22.6% were normal weight, 28.2% were overweight and 46.8% were obese. Having a diagnosis of Down syndrome ( p = 0.03) was associated with increasing BMI. Increasing waist circumference was associated with increasing severity of ID ( p = 0.04). The mean-reported energy intake was 1890 kcal/day. Mean energy intakes from sugar, fat and saturated fat were above recommendations and few participants met micronutrient recommended daily amounts. This study highlights the alarming prevalence of overweight and obesity and poor diet quality of individuals with intellectual disabilities.

People with intellectual disability and their families' perspectives of Special Olympics Ireland: Qualitative findings from the SOPHIE study.

Previous research has highlighted that while involvement in Special Olympics can have benefits for athletes and their families, there can also be many barriers to participation. This qualitative study, which was part of a large mixed-method study, examined the experiences and perspectives of people with intellectual disability, their families and staff who work with them, about Special Olympics Ireland (SOI). A total of 47 participants (15 athletes, 6 non-athletes, 18 family members and 8 staff members) participated in focus group and individual interviews. Supplemental data, gathered as part of the larger study extracted from open-ended survey questions completed by 97 family members also informed this element. Findings revealed four main themes: impact of participation on athletes, impact of involvement on families, barriers to participation and how to enhance participation rates. Involvement in Special Olympics impacted positively on the quality of life of athletes and families. Enhanced availability of user-friendly information and service accessibility were important drivers identified for enhancing participation rates in Special Olympics.

Lessons learned about primary weight maintenance and secondary weight maintenance: results from a qualitative study.

BACKGROUND: Obesity is now a worldwide problem and Ireland is no exception with approximately two thirds of the adult population now overweight or obese. A recent report has found that 53% of Irish adults aged 50 years and over are classified as centrally obese and at substantially increased risk of metabolic complications. While most studies investigating weight maintenance have been conducted on those who have managed to lose weight and/or achieved weight loss maintenance (secondary weight maintainers), few studies have been undertaken to understand the attitudes, behaviours, motivations and strategies of those who maintain their weight within normal weight ranges over their lifetime, so called primary weight maintainers. This study aims to explore this issue through qualitative exploration of primary weight maintainers in an Irish University. METHODS: Seven focus groups were conducted (including three single interviews) with 17 participants in total across three different groups, 1) primary weight maintainers, 2) secondary weight maintainers, and 3) those unable to sustain or achieve weight loss. The interviews were transcribed and thematic analysis was applied to interpret the findings. RESULTS: After analyzing the participant's interviews, planning and organization or lack of, emerged as themes across the three groups in varying degrees. Strategizing, perseverance and willpower were seen as integral to weight maintenance and weight loss in groups one and two, these were lacking in group three. Prioritizing exercise and perseverance in maintaining a high level of activity was evident in groups one and two and was lacking in group three. Motivational influences were equal across the groups however, group three found it difficult to turn this into action. Group one had behavioural control of calorie intake maintaining a balance between week and weekend eating. Group three found it difficult to control calorie intake and portion size. Self-image differed across the three groups with cognitive dissonance evident amongst those in group three. CONCLUSIONS: This study showed that there are many factors that influence primary weight maintenance. Considering that we live in a society that is predominantly sedentary, predominantly overweight and with poor food choice options facing us every day, fighting our way through to ensure healthy weight maintenance requires active, conscious efforts. The factors identified in this study which are important in healthy weight maintenance are all potentially modifiable with life-coach, nutrition, exercise and cognitive interventions particularly if peer support and a whole family approach are incorporated.

Autistic pupils' experiences in primary and post-primary schools: A scoping review and consultation with autistic pupils in Ireland.

Background and aims: Autistic pupils have the right to be heard in matters concerning their education and to be active agents in shaping their school experiences. Despite this, educational policies and research have rarely included the voices of autistic children, failing to identify what they consider to be beneficial and meaningful in their own education. This study aimed to (i) summarise existing literature exploring autistic pupils' experiences at school from their own perspectives and (ii) identify gaps for future research through a consultation with autistic pupils. Methods: A scoping review was conducted to identify studies exploring first-person accounts of autistic pupils' school experiences (primary and secondary; aged 4-18 years) published between 2005 and 2023. Thematic analysis was conducted to identify overarching thematic categories across the included studies. Review findings were discussed through a consultation with a Child and Youth Advisory Group (CYAG) comprised of autistic pupils in Ireland (N = 3), to seek feedback and inform a future research agenda. Main contribution: Thirty-six studies were included in the review and six themes were identified: Experiences of feeling misunderstood, of bullying and masking, of feeling excluded, of anxiety, of sensory needs in school, and of being overwhelmed during transitions. Consultation with the CYAG highlighted that these six themes were consistent with autistic pupils' experiences but that reports of positive experiences were missing in the literature. Conclusions: This study identified several gaps in the literature on the school experiences of autistic pupils, based on both the scoping review and consultation with the CYAG. While the CYAG validated the themes identified in existing literature, there is a need for greater diversity in the samples included and increased focus on the potential positive aspects of the school experience. Implications. These findings have important research implications. In particular, further studies are needed with autistic pupils at primary school level, including those who are minimally or non-speaking, as well as ensuring pupils with positive school experiences are also represented. Findings also highlight the need for continued collaboration with autistic pupils themselves in matters concerning their education.

Exploring the needs and experiences of contact tracing staff during the COVID-19 pandemic in Ireland.

BACKGROUND: Contact tracing is a key component in controlling the spread of COVID-19, however little research has focused on learning from the experiences of contact tracing staff. Harnessing learning from those in this role can provide valuable insights into the process of contact tracing and how best to support staff in this crucial role. METHODS: Thematic analysis was used to analyse 47 semi-structured interviews conducted with contact tracing staff via telephone or Zoom at three time points in 2021: March, May and September-October. RESULTS: Six themes related to the contact tracing role were identified, including training, workforce culture, systems issues, motivation and support. While initially nervous in the role, participants were motivated to contribute to the pandemic response and believed the role provided them with valuable transferable skills. Participants described the training as having improved over time while desiring more proactive training. Sources of frustration included a perceived lack of opportunity for feedback and involvement in process changes, feelings of low autonomy, and a perception of high staff turnover. Participants expressed a need for improved communication of formal emotional supports. Increased managerial support and provision of opportunities for career advancement may contribute to increased motivation among staff. CONCLUSIONS: These findings identify the experiences of contact tracing staff working during the COVID-19 pandemic, and have important implications for the improvement of the contact tracing system. Recommendations based on learning from participants offer suggestions as to how best to support the needs of contact tracing staff during a pandemic response.

Familial intergenerational and maternal aggregation patterns in nutrient intakes in the Lifeways Cross-Generation Cohort Study.

OBJECTIVE: The current study prospectively examines the intra-uterine hypothesis by comparing maternal, paternal and grandparental lineage influences on children's diet and also maternal­child aggregation patterns during pregnancy and early childhood. DESIGN: Prenatal dietary information was available for expectant mothers, fathers and up to four grandparents through a detailed validated semi-quantitative FFQ. At 6-year follow-up, when children averaged 5 years of age, dietary information was re-collected for mothers and a subset of maternal grandmothers using the same FFQ. Child's FFQ version was used for children. Anthropometric and sociodemographic variables were also collected. SETTINGS: Three-generation familial cohort representative of the contemporary Irish national population. SUBJECTS: Children aged 5 years (n 567) and their parents and grandparents. RESULTS: Associations for energy, macronutrient and fibre intakes were compared using Pearson's correlations, intra-class correlations (ICC) and linear regression models, adjusted for energy and potential confounders. Significant, moderatestrength positive correlations were observed for nutrient intakes in children's nuclear families (ICC (range)50?22­0?28). The father­child associations (r (range)5 0?13­0?20) were weaker than the mother­child associations (r (range)50?14­0?33). In general, associations were stronger for maternal postnatal intake­child intake than for maternal prenatal intake­child intake, except for percentage of energy from fat (adjusted b50?16, 95% CI 0?05, 0?26; P50?004), which was stronger for maternal prenatal intake, specifically in non-breast-fed children (adjusted b50?28, 95% CI 0?12, 0?44; P50?001). Among all grandparents, correlations were significant only for maternal grandmother­mother pairs (r (range)50?10­0?36). Significant positive ICC were observed for nutrient intakes of maternal grandmother­mother­child triads (ICC (range)50?12­0?27), not found in paternal lines. CONCLUSIONS: These findings suggest that maternal-environment programming influences dietary intake.

Feasibility of a peer-led, after-school physical activity intervention for disadvantaged adolescent females during the COVID-19 pandemic: results from the Girls Active Project (GAP).

INTRODUCTION: There is a critical need for interventions that can be feasibly implemented and are effective in successfully engaging adolescent females in physical activity (PA). A theory-based, peer-led, after-school PA intervention, the Girls Active Project (GAP), was codesigned with adolescent females. This study aimed to assess the feasibility of implementing and evaluating the GAP programme. SETTING: One single-sex, female-only, designated disadvantaged postprimary school (students aged 12-18) in Dublin, Ireland. METHODS: Mixed methods were applied with multiple stakeholders over a 12-week trial (March to May 2021). A single-arm study design was used to examine intervention: reach, dose, fidelity, acceptability, compatibility and context. Feasibility of using proposed self-reported outcome measures (moderate-to-vigorous PA levels, self-rated health, life satisfaction, PA self-efficacy and PA enjoyment) was also explored. Due to school closure resulting from the COVID-19 pandemic, the intervention was delivered both online and in person in the school setting. RESULTS: Eight exercise classes were peer delivered by project leaders (n = 6, students aged 15-17) to intervention recipients (students aged 13-14). Recruitment was low (n = 8, 10% of eligible students, mean age: 13.3 SD: 0.46), yet retention was high (n = 7/8, 88%). Attendance rates were satisfactory (68%), and the intervention was implemented with high fidelity (87%). Data completion rates suggested proposed self-reported outcome measures were deemed appropriate (≥ 95%), except for weight (50%) and height data (80%). Despite COVID-19 hindering intervention implementation, both quantitative and qualitative data suggested that stakeholders were satisfied and perceived the in-person delivered intervention to be compatible with the school setting. Recommended refinements included extending class duration, introducing different rewards, and boosting programme awareness. CONCLUSIONS: Further thought must be given on how to increase recruitment. Overall, the in-person delivered after-school PA programme was well-received by stakeholders and shows promise as an intervention that can be feasibly implemented and evaluated. Suggested improvements to the GAP intervention programme are recommended, before continuing to a more robust evaluation. TRIAL REGISTRATION: 10.17605/OSF.IO/75HWJ (prospectively registered, date of registration: 9th December 2020).

Self-Esteem, Meaningful Experiences and the Rocky Road-Contexts of Physical Activity That Impact Mental Health in Adolescents.

Abundant evidence shows that physical activity benefits adolescents' mental health and wellbeing. Quantitative evidence has shown that adolescents engaging in leisure time physical activity, a number of sports, and team sport, display better mental health outcomes than their peers. The specific contextual factors that contribute to increased mental health and wellbeing through physical activity are, as yet, unconfirmed. The purpose of this study was to identify the contexts of physical activity and sport that positively impact mental health and wellbeing as perceived by adolescents. A sample of 58 adolescents participated in 13 focus groups discussing various factors related to physical activity, sport and mental health. Participants brought an object that represented physical activity and an image that represented wellbeing to each focus group to aid in the discussion and representation of both. An inductive thematic analysis was conducted on transcripts of the focus groups using a six-phase approach. Five key themes were identified: (1) achievements and improvements leading to increased self-esteem; (2) the importance of meaningful experiences, a sense of belonging and contributions to identity; (3) development of resilience and responding to setbacks; (4) social connectedness and relatedness, and (5) an opportunity to experience mindfulness, distraction and flow-states. In order to enhance and support wellbeing through physical activity, adolescents should be encouraged and provided with opportunities to engage in enjoyable activities with people with whom they experience a sense of belonging, where there is an opportunity to experience mastery and improvement and that includes an element of autonomy or choice.