With the global health crisis stemming from physical inactivity intensifying, novel interventions based on robust psychological frameworks are on the rise. A recent study, entitled “A school-based intervention based on self-determination theory to promote girls’ physical activity: study protocol of the CReActivity cluster randomized controlled trial,” stands as a taste-tester for how innovative approaches could revolutionize physical activity levels, especially among high-risk groups such as girls with lower socioeconomic status.
Published in BMC Public Health (DOI: 10.1186/s12889-019-6817-y), the research by Demetriou et al. (2019) outlined the intention, design, and expected outcomes of the CReActivity trial, aiming to stimulate physical activity (PA) in sixth-grade girls by tapping into the psychological needs of autonomy, competence, and relatedness as described by Self-Determination Theory (SDT).
Keywords
1. Physical Activity Intervention
2. Self-Determination Theory
3. School-Based Health Promotion
4. Cluster Randomized Controlled Trial
5. Adolescent Girls Physical Activity
Background Context
Data from the World Health Organization (WHO) indicate that physical inactivity ranks as the fourth leading cause of premature death worldwide, a threat not spared from children and adolescents in Germany – the focus group of this study. Reports such as those from the German Clinical Trials Register (DRKS00015723) and other longitudinal studies suggest falling short of daily recommended activity levels with variations across socioeconomic backgrounds and gender. Girls, specifically, have been identified as more inactive than boys, prompting public health initiatives tailored to this demographic.
Study Imperatives
The primary objective of the CReActivity trial was to examine the effects of a theory-driven intervention on girls’ physical activity during PE lessons and free time, scrutinizing possible mediating factors like autonomy, competence, relatedness, and self-efficacy and moderators such as socioeconomic background and environmental factors.
Research Design
This innovative intervention program took the form of a two-arm cluster-randomized controlled trial with a three-month follow-up period, involving 600 girls from lower secondary schools in Bavaria, Germany. The intervention’s unique selling point was its adherence to SDT and social cognitive theory, arguably robust theoretical foundations that could explain how psychological mediators affect physical activity behaviors.
Methodology
Physical education teachers, the intervention’s conductors, operated a five-month program where girls experienced tailored lesson plans meant to enhance their autonomy, relate to others, and boost their sense of competence in physical activities. While it is a randomized controlled trial, the study design meticulously accounted for various factors such as BMI, teacher characteristics, socioeconomic status, and environment, striving to isolate the pure effect of the intervention.
Monitoring and Outcome Measurement
The girls’ physical activity was rigorously measured using accelerometers and systematic observations. These primary outcome tools sought to capture the essence of the behavioral change, above and beyond self-reported measures that are often plagued by bias.
Expected Outcomes and Contributions
The authors anticipated that the CReActivity intervention would raise physical activity levels among participating girls. More significantly, they aimed to peek behind the curtains of physical activity behavior change, uncovering the mechanisms that drive or dampen children’s desire to move more.
Theoretical Foundations
The study is grounded in SDT, a robust theory of motivation that posits that fulfilling the innate psychological needs for autonomy (sense of volition), competence (sense of skill and mastery), and relatedness (sense of connection with others) is essential for motivation and, consequently, behavior change. Combined with Bandura’s social cognitive theory, which emphasizes the role of observational learning, social experiences, and reciprocal determinism in behavior change, the intervention holds promise for a substantial impact on girls’ PA levels.
Relevance and Implications
As sedentary lifestyles are increasingly common, the CReActivity study provides a beacon for public health—in-action. Its implications reach beyond school-based interventions, laying blueprints for future public health endeavors that wish to address alarming sedentary trends among adolescents, with a special lens on gender disparities.
Progress and Updates
While results from the trial are not yet published, the expected impact resonates with the sentiments of existing literature, suggesting that school-based interventions that take into account the psycho-social dimensions of behavior change can be successful.
Conclusion
The school can serve as a critical milestone in establishing lifelong habits of physical activity. The CReActivity trial stands as an important step in advancing our understanding of how, by leveraging psychological theories, we can craft interventions that not only tackle the issue of inactivity but do so in a way that is empowering and enduring.
References
1. Demetriou, Y., & Bachner, J. (2019). A school-based intervention based on self-determination theory to promote girls’ physical activity: study protocol of the CReActivity cluster randomized controlled trial. BMC Public Health, 19(1), 519. doi: 10.1186/s12889-019-6817-y
2. WHO. (2010). Global recommendations on physical activity for health. Geneva: WHO Press.
3. Cooper, A. R., Goodman, A., Page, A. S., Sherar, L. B., Esliger, D. W., van Sluijs, E. M., et al. (2015). Objectively measured physical activity and sedentary time in youth: the international children’s accelerometry database (ICAD). International Journal of Behavioral Nutrition and Physical Activity, 12(1), 1. doi: 10.1186/s12966-015-0274-5
4. Kalman, M., Inchley, J., Sigmundova, D., Iannotti, R. J., Tynjälä, J. A., Hamrik, Z., et al. (2015). Secular trends in moderate-to-vigorous physical activity in 32 countries from 2002 to 2010: a cross-national perspective. European Journal of Public Health, 25(suppl 2), 37–40. doi: 10.1093/eurpub/ckv024
5. Demetriou, Y., & Höner, O. (2012). Physical activity interventions in the school setting: a systematic review. Psychology of Sport and Exercise, 13(2), 186–196. doi: 10.1016/j.psychsport.2011.11.006
The CReActivity study is a testament to the importance of interdisciplinary approaches in devising health interventions. By intertwining psychological theories with physical activity research, this study may give rise to more nuanced and effective strategies to combat sedentary behaviors and foster a healthier generation of youth.