Physical Activity Clinical Trial
Official title:
Social Mechanisms for Promoting Physical Activity in After School Programs for Underserved Middle School Youth: A Feasibility Trial
The primary goal of the Connect feasibility trial was to develop and test the feasibility of
a physical activity (PA) social-climate-based intervention within pre-existing after school
programs (ASPs) that targets youth social goals (e.g., building friendships through PA) and
social competencies (e.g., friendship-building skills) to increase the positive PA affect,
cognitions, and moderate-to-vigorous (MV) PA of underserved (i.e., low income, minority
status) middle school youth. The 8-week intervention was designed to improve several key
social mechanisms within ASPs overlooked in previous interventions (e.g., developing
friendship and connection to peers and staff through PA; group belonging, including positive
peer PA norms and tangible support) that are key predictors of youth PA and included: 1) "Get
to know you" sessions aimed at providing youth guided social opportunities to foster
friendship-building skills, and to promote acceptance, cooperation, contribution, and
friendship affiliation, and; 2) a novel socially-oriented physical activity curriculum
tailored to meet the social goals and needs of program staff and participating youth.
Comparison of ASPs receiving the 8-week "Connect" intervention (N=3 ASPs) with ASPs
randomized to receive the general ASP curriculum (wait-list control condition; N=3 ASPs) will
yield preliminary data on the effectiveness of social mediators for improving
moderate-to-vigorous physical activity (MVPA) and preventing obesity among at-risk youth that
can inform future intervention design and youth programming policy. Results of this proposed
project will provide the basis for conducting a large scale efficacy trial.
First, it is hypothesized that the Connect program will be documented to be feasible as shown
by: 1) youth's greater perceived connectedness and PA affiliation goal orientation from
baseline to post-intervention; 2). changes in targeted social climate components from
baseline to post-intervention as measured by systematic observations, and; 3) adequate dose
and fidelity of program implementation as indicated by weekly process evaluations. Second, it
is hypothesized that youth in the social climate program (vs. comparison) demonstrate greater
increases in positive PA affect, cognitions, and MVPA from baseline to post-intervention.
Physical inactivity has been identified as a primary contributor of childhood obesity and
related diseases, with underserved youth (minority and low-income status) at greatest risk of
inactivity and its health consequences. However, physical activity (PA) interventions have
attained limited-to-no sustained behavior change and thus, have rarely affected targeted
physiological or anthropometric health outcomes. Extensive research on participation
motivation in sport and physical education shows highly engaged youth report an affiliation
orientation towards PA, identifying social reasons and goals (e.g., being with, and making
friends) as their primary motivations for participation, and defining PA competence as
achieving these social goals. Despite substantial research noting the importance of social
goals on PA-based self-determined motivation and participation, PA-based interventions have
almost exclusively emphasized approaches centered on constructs related to physical ability
(e.g., mastery, self-efficacy). To date, little research has focused on understanding the
contributions that affiliation orientations (social goals) make toward promoting sustained
youth PA. The investigators argue that adolescents' desire for social connections is a
primary goal of action underpinning their PA behavior and thus, a key mechanism to target for
sustained behavior change. The Active by Choice Today (ACT) program, conducted by the
investigative team is one of the first after school programs (ASPs) to implement a
climate-based intervention based on Self-Determination theory that showed significant
improvements in PA in underserved youth. However, limited sustained effects found
post-intervention, and data from interviews with ACT staff and youth which indicated the
presence of several interpersonal barriers (e.g., cliques, teasing) to program effectiveness,
suggests additional socially-based climate components still need to be addressed. Systematic
observations of ASPs using an observational tool that the PI has developed and tested and
additional interviews conducted with ASP staff and youth further suggests that targeting
youth social goals (e.g., building friendships through PA) and social competencies (e.g.,
Friendship-building skills) may be particularly effective for increasing and sustaining the
PA of underserved youth. Thus, the proposed study aims to test the feasibility of augmenting
the Active by Choice Today (ACT) program through the addition of three key "PA affiliation
orientation" elements shown by previous research to be particularly important to adolescents
within physical domains: 1) Connecting strengthened friendships to increased PA (developing
youth social skills and providing a PA environment that emphasizes friendship building as the
goal of PA), 2) Improving peer connectedness and group belonging through PA participation,
and 3) Improving interpersonal connections with ASP staff through PA participation. These
elements have not been explored in prior research. Enhancing ACT to include these elements in
the resultant ACT version 2-Connect intervention is expected to lead to sustained positive PA
affect, cognitions, and behaviors in underserved youth. Comparison of ASPs receiving the
"Connect" intervention (N=3 ASPs) with ASPs randomized to receive the general ASP curriculum
(control condition; N=3 ASPs) will yield preliminary data on the effectiveness of social
mediators for improving moderate-to-vigorous (MV)PA and preventing obesity among at-risk
youth that can inform future intervention design and youth programming policy. Results of
this proposed project will provide the basis for conducting a large scale efficacy trial.
Specific Objectives:
Apply essential social climate elements identified from interviews and the investigators'
previous research to design and test the feasibility of the 8-week "Connect" social climate
intervention for increasing PA affect, cognition, and MVPA of underserved youth within ASPs.
Primary Aims (Program Development and Feasibility):
1. Through qualitative interviews with program staff and youth at 4 ASP sites serving
at-risk youth: a) identify conceptual constructs most relevant for facilitating and
supporting youth PA social affiliation goals; b) determine the barriers present within
ASPs for meeting youth PA social goals, and; c) obtain staff/youth input on the
feasibility and acceptability of initially- developed program components.
2. Explore the feasibility of the Connect program. The Connect program will be documented
to be feasible in these ASP programs as shown by: 1) youth's greater perceived
connectedness and affiliation goal orientation toward PA from baseline to 12- weeks
post-intervention; 2). changes in targeted social climate components from baseline to
post-intervention as measured by systematic observations, and; 3) adequate dose and
fidelity of program implementation as indicated by weekly process evaluations.
Secondary Aims (Document the preliminary impact of the Connect program on PA outcomes):
1. Assess whether youth in the social climate program (vs. comparison) demonstrate greater
increases in positive PA affect, cognitions, and MVPA from baseline to 2-weeks
post-intervention.
2. Explore whether youth in the social climate program (vs. comparison) demonstrate
healthier BMI trajectories (e.g., slight reduction) from baseline to 2-weeks
post-intervention.
3. Assess whether changes in targeted social mechanisms will mediate the effects of the
intervention on changes in PA affect, cognitions, and MVPA from baseline to
post-intervention.
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