A Community-Based Participatory Action Research with Women from Disadvantaged Populations: Strengths and Weaknesses of a Multiple Health Behaviour Change Intervention.

Disadvantaged populations usually adopt risk behaviours, resulting in obesity and mental health-related disorders. Grounded in the socioecological model and self-determination theory, the aims were firstly to describe and implement a two-year multiple health behaviour change intervention, and secondly, to assess the strengths and weaknesses of the intervention. In total, 11 women from a disadvantaged population participated in this programme, which encompassed 117 sessions. Qualitative techniques were used to collect data and a thematic analysis was conducted. The variety of activities and the group-based intervention were the main strengths, and the decrease in attendance and the programme's tight schedule were the main weaknesses. This is the first intervention in a disadvantaged population mainly comprised of Roma women. The design described in detail and its assessment provide relevant knowledge to improve their health status and decrease inequalities. The practical implications for future research are useful for replicating interventions in similar contexts.

Barriers to Physical Activity in Disadvantaged Population: A Qualitative Comparison between Roma and Non-Roma Women.

Purpose: Despite the well-known health benefits of physical activity (PA), disadvantaged populations usually have lower PA levels than the rest of the population. Some intra- and interpersonal factors such as different types of barriers to PA may influence PA levels, particularly among disadvantaged adult women. The first aim of this qualitative study was to identify the barriers to PA perceived by disadvantaged adult women. The second aim was to analyse the differences in perceived barriers to PA between adult Roma and non-Roma women. Methods: Eleven disadvantaged adult women participated in the current study (M = 37.72; SD = 8.34), seven of whom belonged to the Roma population. Data were obtained from discussion groups as well as from one-to-one interviews, and these were analysed by NVivo Pro 11. Results: Three categories of perceived barriers to PA were identified: personal (i.e., economy, labour, physical limitations, illness, and psychological characteristics) social (i.e., culture, lack of social support, and family), and environmental. Family was identified as the main common and most frequent barrier to PA in disadvantaged adult women. Differences in perceived barriers to PA between adult Roma and non-Roma women were found. While Roma women perceived culture, physical limitations, and lack of social support barriers to PA, non-Roma women mainly perceived labour-related barriers to PA. Conclusions: Multilevel interventions addressing specific barriers to PA for disadvantaged adult women are required to overcome barriers to PA and, consequently, increase PA levels. Particular attention should be paid to specific barriers to PA among adult Roma and non-Roma women, respectively.

Development of the 'Sigue la Huella' physical activity intervention for adolescents in Huesca, Spain.

Engaging in physical activity (PA) on a regular and adequate basis generates considerable benefits for health. In developed countries, the time spent doing PA is decreasing, whilst sedentary time (ST) is increasing. A multicomponent school-based intervention programme, called 'Sigue la Huella' (Follow the Footprint), was developed to reduce sedentary lifestyles and increase PA levels. This programme has proven to be effective in increasing the daily levels of moderate to vigorous PA, in decreasing ST and in improving motivational outcomes in secondary education students, in the city of Huesca (Spain). The study design was quasi-experimental, longitudinal and by cohorts, and it was carried out in four schools, two as an experimental group (n = 368) and two as a control group (n = 314). During the 25 months' intervention, this programme adopted a holistic approach aiming to create favourable environments to engage in PA, and the empowerment of students to get actively involved in the design and execution of the activities, assuming responsibility for managing and optimizing their own PA. The programme is theoretically based on the social-ecological model and self-determination theory, and it provided evidence for four actions or components that can be used in school-based PA promotion: tutorial action, Physical Education at school, dissemination of information and participation in institutional programmes and events. The aim of this article is to describe the main characteristics of the intervention programme that have proved to be effective with respect to the objectives proposed.

Which School Community Agents Influence Adolescents' Motivational Outcomes and Physical Activity? Are More Autonomy-Supportive Relationships Necessarily Better?

The first aim of this work was to examine the independent influence of students' perceived autonomy support for leisure-time physical activity (LTPA), from different school community agents, on motivational outcomes in a LTPA context and objective PA levels. Using both a variable- and person-centered approach, the second aim was to examine how different combinations of autonomy-support were associated with students' motivational outcomes in a LTPA context and PA levels. A sample of 178 secondary students (M = 13.26 ± 0.64) participated in the study. Autonomy support for LTPA from the PE teacher, mother, father, and peers were the only agents that significantly and positively predicted motivational outcomes in a LTPA context and PA levels. While the two- and three-way interactions of some of these four significant sources significantly increased the explained variance of some motivational outcomes, the plots revealed that the lowest values of motivational outcomes were associated with low values of perceived autonomy support. A cluster analysis revealed five profiles. The "high autonomy support" group reported the most optimal outcomes, whereas the "low autonomy support" group showed the opposite pattern. However, mixed autonomy support profiles did not differ in any of the outcomes. The adoption of a whole-of-school approach seems decisive to empower adolescents to be active in and out of school.

Motivational Outcomes and Predictors of Moderate-to-Vigorous Physical Activity and Sedentary Time for Adolescents in the Sigue La Huella Intervention.

PURPOSE: The purpose of this study was to investigate the effects of the multicomponent Sigue la Huella intervention on selected motivational outcomes and whether any of these outcomes, in addition to relevant socio-demographic, biological, and behavioral factors, served as predictors of moderate-to-vigorous physical activity and sedentary time among participants through the intervention. METHOD: This quasi-experimental, cohort study took place in four secondary schools in Huesca (Spain) during three academic years (students aged 12-15 years). Two schools were assigned to the experimental condition (n = 368) and two schools to the control condition (n = 314). Outcome variables were assessed objectively. RESULTS: A total of 553 participants met study inclusion criteria. Compared to the control group, participants in the experimental group reported greater enjoyment of physical activity, intrinsic and extrinsic motivation in physical education, perceived autonomy in physical education, perceived competence in physical education, and perceived importance of physical education over time. Participants in this group reported also lower amotivation in physical education over time. In subsequent analyses, gender, organized physical activity out of school, sedentary time, and perceived importance of physical education predicted moderate-to-vigorous physical activity. Type of school (public vs. private), moderate-to-vigorous physical activity, and perceived autonomy in physical education emerged as predictors of sedentary time. CONCLUSION: Sigue la Huella had a positive effect on motivational outcomes relevant to moderate-to-vigorous physical activity, sedentary time, and, particularly, student engagement in physical education. The analyses identified shared and unique determinants of moderate-to-vigorous physical activity and sedentary time, suggesting that specific intervention strategies may be required to address each outcome.

Effects of the 3-year Sigue la Huella intervention on sedentary time in secondary school students.

BACKGROUND: To examine the effects of the Sigue la Huella (Follow the Footstep) intervention on adolescents' daily sedentary time (ST). METHODS: This quasi-experimental, cohort study took place in four secondary schools in Huesca (Spain) during the 2009-2010, 2010-2011 and 2011-2012 academic years (students aged 12-15 years). Two schools were assigned to the experimental condition (n = 368) and two schools to the control condition (n = 314). Sigue la Huella adopted a whole school approach and used both curricular and non-curricular intervention channels to empower students to make better decisions. ST was measured for 7 days on four occasions using accelerometers. Growth curve models were used to analyze the data. RESULTS: In the model with all participants, a significant interaction indicated that the effect of the intervention was dependent on the study cohort considered. While in cohort 1 there were no significant differences in rate of linear change of ST between the experimental and the control group (P = 0.148), in cohorts 2 and 3 significant differences were observed in favor of the experimental group (ß = -13.88, 95% CI = -25.00 to -2.76, P = 0.015; ß = -76.73, 95% CI = -110.68 to -42.78, P < 0.001), independent of type of school (public vs. private) and gender. CONCLUSIONS: Sigue la Huella had mainly a protective effect in two of the three study cohorts. Whereas in cohort 2 the intervention prevented increases in ST, in cohort 3 the intervention reduced considerably the increase in ST noted in the control group.

Data for action: the use of formative research to design a school-based intervention programme to increase physical activity in adolescents.

Formative research is a critical step for the development of interventions aimed at changing behaviours, as is the case of physical activity. This process permits obtaining detailed information about the programme application context. 'Follow the Footstep' is a quasi-experimental and longitudinal study in secondary schools, the aim of which is to increase levels of physical activity among adolescents. To inform the design of the intervention programme, formative research has been carried out to analyse the perceptions of parents, teachers and students, through six focus groups.The social-ecological model was used both to carry out the formative research and then to design the programme, including five levels of influence on behaviour (individual, interpersonal, organizational, community and political), which are important when it comes to adopting a comprehensive intervention approach. The authors describe how the results of formative research were transferred to guide the design and development of the intervention. As results indicate, parents, teachers and students agreed on a need to intervene by engaging adolescents and their close social environment. The school centre is the key organizational structure to implement this intervention, supported by professionals and the community.

Promising school-based strategies and intervention guidelines to increase physical activity of adolescents.

This narrative review describes the available scientific evidence regarding promising school-based strategies to increase physical activity of adolescents. We conducted a literature search for studies published up to 2011, regarding adolescent physical activity intervention studies that resulted in increased physical activity (regardless of measurement) and reviewed 52 intervention articles and 21 review articles. We identified several promising strategies and grouped into five broad intervention guidelines. These guidelines are as follows: (i) design multi-component interventions that foster the empowerment of members of the school community; (ii) develop improvements to Physical Education curricula as a strategy to promote physical activity to adolescents; (iii) design and implement non-curricular programmes and activities to promote physical activity; (iv) include computer-tailored interventions during the implementation and monitoring of physical activity promotion programmes and (v) design and implement specific strategies that respond to the interests and needs of girls. On the basis of our review of the adolescent physical activity promotion literature, we suggest that these five guidelines should be taken into account in school-based interventions geared towards achieving an increase in adolescent physical activity.