Findings from a cluster randomised feasibility study of a school-based physical activity role model intervention (CHARMING) for 9-10-year-old girls

Abstract

Background: Girls' physical activity levels decline to a greater extent than boys as they enter adolescence. Role model interventions offer a potential solution to combat this public health issue. This study reports findings of a feasibility study of the CHARMING (CHoosing Active Role Models to INspire Girls) programme, a 6-week after-school primary school-based, community linked, role-model intervention.

Methods: Between January 2021 and August 2022, a feasibility cluster randomised controlled trial (cRCT), with process and health economic evaluations was conducted in South Wales. Secondary schools were recruited, along with their adjoining primary schools to recruit Year 5 girls (aged 9-10 years). Role models were recruited from the surrounding school community (community role models) and from each secondary school (peer role models). A survey of self-reported outcome measures and accelerometers were administered at baseline and at 12 months. Following baseline, six primary schools were randomly allocated to intervention or control (usual practice) on a 2:1 basis. Post-intervention delivery, observations (n = 30), focus groups (n = 13) and interviews (n = 22) were conducted to explore study and intervention acceptability, feasibility and fidelity. Five pre-specified progression criteria included: implementation, attendance rates, and acceptability of the intervention, as well as completion of the primary outcome, including levels of completeness.

Results: One hundred and fifty-six girls from six primary schools (four intervention and two control) were eligible to take part. Of these, 96 (62%) and 97 (62%) Year 5 girls took part in the survey and accelerometer measures respectively, with 78 (81%) and 77 (79%) participating in the 12-month follow-up. Findings indicate that it is feasible to collect health-related quality of life information from 9- to 10-year-olds using a digital self-report survey completed in schools. Despite the impacts of the COVID-19 pandemic, three of the five criteria (implementation, acceptability and completion of primary outcome) for progressing to a full-scale evaluation were met. Process evaluation data provide understandings of why two criteria (attendance and completeness of the primary outcome) were not met. Overall, data suggest that acceptability and feasibility of the intervention were high, and that the intervention was broadly delivered as intended. Alterations to the study measures and the intervention were suggested to increase intervention acceptability and feasibility, including recruitment and retention and extending the length of delivery in line with original intentions (12 weeks).

Conclusions: Findings suggest the CHARMING intervention and cRCT design are likely to be acceptable and feasible, subject to further intervention and evaluation design optimisation.

Trial registration: ClinicalTrials.gov ISRCTN36223327. Registered March 29, 2021.

Keywords: Girls; Intervention; Peers; Physical activity; School.

Fig. 1

CONSORT diagram for survey for participants and schools by trial arm

Fig. 2

CONSORT diagram for the accelerometer for participants and schools by trial arm

Fig. 3

Percentage of participants in the intervention schools attending specific sessions, overall and by school

Fig. 4

Percentage of participants in the intervention group attending total number of sessions