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Randomized Controlled Trial
. 2021 May 13;18(1):63.
doi: 10.1186/s12966-021-01133-8.

Effectiveness and cost-effectiveness of the PLAN-A intervention, a peer led physical activity program for adolescent girls: results of a cluster randomised controlled trial

Russell Jago  1   2 , Byron Tibbitts  3 , Kathryn Willis  3 , Emily Sanderson  4   5 , Rebecca Kandiyali  4   5 , Tom Reid  3 , Ruth R Kipping  5 , Rona Campbell  5 , Stephanie J MacNeill  4   5 , William Hollingworth  4   5 , Simon J Sebire  3
Affiliations
Randomized Controlled Trial

Effectiveness and cost-effectiveness of the PLAN-A intervention, a peer led physical activity program for adolescent girls: results of a cluster randomised controlled trial

Russell Jago et al. Int J Behav Nutr Phys Act. .

Abstract

Background: Physical activity is associated with improved health. Girls are less active than boys. Pilot work showed that a peer-led physical activity intervention called PLAN-A was a promising method of increasing physical activity in secondary school age girls. This study examined the effectiveness and cost-effectiveness of the PLAN-A intervention.

Methods: We conducted a cluster randomised controlled trial with Year 9 (13-14 year old) girls recruited from 20 secondary schools. Schools were randomly assigned to the PLAN-A intervention or a non-intervention control group after baseline data collection. Girls nominated students to be peer leaders. The top 18 % of girls nominated by their peers in intervention schools received three days of training designed to prepare them to support physical activity. Data were collected at two time points, baseline (T0) and 5-6 months post-intervention (T1). Participants wore an accelerometer for seven days to assess the primary outcome of mean weekday minutes of moderate-to-vigorous physical activity (MVPA). Multivariable mixed effects linear regression was used to estimate differences in the primary outcome between the two arms on an Intention-to-Treat (ITT) basis. Resource use and quality of life were measured and a within trial economic evaluation from a public sector perspective was conducted.

Results: A total of 1558 girls were recruited to the study. At T0, girls in both arms engaged in an average of 51 min of MVPA per weekday. The adjusted mean difference in weekday MVPA at T1 was - 2.84 min per day (95 % CI = -5.94 to 0.25) indicating a slightly larger decline in weekday MVPA in the intervention group. Results were broadly consistent when repeated using a multiple imputation approach and for pre-specified secondary outcomes and sub-groups. The mean cost of the PLAN-A intervention was £2817 per school, equivalent to £31 per girl. Economic analyses indicated that PLAN-A did not lead to demonstrable cost-effectiveness in terms of cost per unit change in QALY.

Conclusions: This study has shown that the PLAN-A intervention did not result in higher levels of weekday MVPA or associated secondary outcomes among Year 9 girls. The PLAN-A intervention should not be disseminated as a public health strategy.

Trial registration: ISRCTN14539759 -31 May, 2018.

Keywords: Adolescent girls; Intervention; Peers; Physical activity; School.

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Conflict of interest statement

We have no competing interest to report.

Figures

Fig. 1
Fig. 1
CONSORT Flow Diagram
Fig. 2
Fig. 2
Treatment effect over differing levels of baseline sedentary time. Figure 3 shows the point estimate of the treatment effect (difference in mean weekday MVPA at T1) as a linear function of the proportion of sedentary time reported at T0 along with the 95% confidence interval bounds. We are not powered to draw conclusions from these estimates or confidence intervals, but this analysis could suggest that the Plan-A intervention has a more positive effect on those who have higher proportions of sedentary time prior to the intervention.
Fig. 3
Fig. 3
Cost-effectiveness acceptability curve
See this image and copyright information in PMC

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