Physical Activity Clinical Trial
Official title:
The RIGHT TRACKS Study - Development and Feasibility of an Incentive Scheme to Promote Active School Travel in Year 5 Children
The aim of this study is to investigate whether an incentive scheme is a feasible approach to increase walking/cycling to school.
This will be a feasibility study using a two-arm cluster randomised controlled design; the
Year 5 group (and respective school) will be the unit of randomisation. Participants will be
Year 5 pupils, aged 9-10.
Data will be collected throughout approximately three months. In total, assessments will be
carried out over a nine week period, which excludes an interval week between baseline and
the first intervention week, and half-term (school holidays).
All children in Year 5's in the selected schools will be approached to participate and will
be allocated randomly (according to the school they attend) to the two arms: (i)
intervention group taking part in the incentive scheme and (ii) control group receiving
ongoing curricular advice on active travel.
Parents' participation consists in completing a socio-demographic questionnaire and consent
form, and in completing a daily form (or answering daily text messages) reporting whether
child has actively traveled to school (AST report) .
A number of schools will be invited to participate by email. A reply by post, phone or email
to the lead researcher will be requested within two weeks, at the end of which pending
schools will be contacted by phone to confirm their decision. Of those interested, two
schools will be selected, ideally matched for characteristics such as location, free school
meals and AST rates.
Once the two participating schools have been identified, a meeting in person will be
arranged with each head teacher at a time/place of their choice.
The researcher will then visit the schools and introduce the RIGHT TRACKS study to the Year
5 class. After the study has been presented and questions answered, an information pack will
be sent home in the pupil's school folder. This pack will include an information leaflet for
child, an information leaflet for the parent/carer, a parent questionnaire, a participant
information sheet and a consent form. Two of the points stressed are confidentiality and the
freedom to drop out of the study at any time without giving justification. After reading and
having the chance of asking questions (by phone/email to the lead researcher), parents will
be required to formally consent (opt in procedure) to their and to their child's
participation.
Parental questionnaires and consent forms are expected to be filled in at home but phone or
email inquiries may be made to the researcher during working hours. Within one week after
delivery, parents will be requested to return completed and signed documents to the
researcher. Specific methods of distribution and collection will be decided with the school
beforehand to accommodate local circumstances and preferences.
Questionnaire completion will be requested of parents, however only return of the signed
consent form will be essential to determine the child's participation. In addition,
participating children will complete an assent form in the classroom.
Baseline assessment Following the identification of participants, children in both schools
will be given and instructed to wear an accelerometer on a waist band above the lateral hip
over the ensuing seven days, from the moment they get up until they go to bed, except for
water-based activities and certain sports.
Together with the accelerometer, the child will be given the parent AST report form, which
he/she must take home and return at the end of the seven day period, completed by the
parent, together with the accelerometer. Four questions will be asked to parents in the
parent AST report form, in relation to each day of the week: e.g. "On Monday did your child
walk or cycle to school, all or part of the journey?", "At what time did your child leave
home?", "At what time did your child arrive at school?", "Did your child stop anywhere on
the way? If yes, how long was the stop for? ____ minutes".
Upon collection of the accelerometer and completed parents AST report forms, children's AST
form will be filled out in the classroom retrospectively in relation to the five previous
school days (mornings). The only question to be asked to children in relation to the five
days is: e.g. "On Monday did you walk or cycle to school, all or part of the journey?" At
the end of the baseline week, those complying with the study protocol will be rewarded, as
stated in advance on the information materials: a prompt return of the completed parent AST
report form and undamaged accelerometer, and completed child AST report form in the
classroom, will be essential requisites for receiving a £5 thank you voucher.
Intervention phase The next stage of the RIGHT TRACKS consists in testing the feasibility of
the incentive scheme. Similar to baseline, the quality of data from the three sources -
accelerometry, parental AST report and child self-report of AST - will be examined. In
particular, the validity of parental and child-reported AST will be assessed vis-à-vis
accelerometry, currently considered to be one of the gold-standards. However, parental
report of AST will be used as the basis of the incentive scheme. Once again, in both
intervention and control conditions, there will be a £5 thanks voucher for every child
taking part in the measurement procedures, in compliance with the protocol. At the end of
the study, a debrief sheet will be handed to all participants, including parents and
children, and to the two head teachers.
Intervention group - incentive scheme The incentive scheme will be explained to the
intervention group in an introductory session. Partway active trips will be given particular
emphasis. Each subsequent session is anticipated to take no more than 25 minutes per week of
the classroom time.
The incentive scheme run in the intervention school consists of a prize draw taking place
once a week. The prize is a £5 shopping gift voucher valid in a number of high street shops.
Chances of winning depend entirely on the number of "points": the number of active trips to
school reported exclusively by the parent on the AST report form, through the same questions
used at baseline. For each week day that they travel to school the child gets one point.
This point is the equivalent to a ticket with the child's ID number that will then be
entering the draw. Each child can earn between zero and five tickets per week, depending on
the number of active travel trips to school reported by the parent. Discrepant numbers
between parental reports and those reported by the child or recorded on the accelerometer
are of great interest for measurement, but will be disregarded for the purposes of the draw.
In the absence of the parent AST report, the child report may be use for point count, but
the child will be reminded that the parental report will be necessary for the next draw.
A difference between baseline and intervention phase concerns the format of the parent AST
report form, which may now be completed in writing as before, or by SMS text messages on the
weeks the child is not wearing the accelerometer. Preference for either of the options can
be stated in advance in the consent form. Parents will be asked to keep them, fill in and
return on time every week (personally or via the child), as the programme proceeds. Mobile
phone respondents will be notified daily by SMS, to which they can reply directly. Questions
asked will be the same in the paper version and mobile phone. However, on the two weeks the
child wears the accelerometer, all participants will be asked to use the parent AST report.
When the child is not wearing the accelerometer, the only question asked on the parental
form or text messages is whether the child walked/cycled to school all or part of the
journey. For those wearing the accelerometer in the intervention school, the point will be
credited as long as the first question is answered (i.e. if parent indicated whether child
actively traveled but failed to complete questions on times).
During the intervention phase, three tasks will be expected from children: (1) wearing an
accelerometer for another seven-day period, which they must return to the classroom,
together with the parent AST report form, (2) returning the parent AST report form in the
remaining weeks (if applicable) and (3) complete an AST report form in the classroom each
day of the draw.
Thank you vouchers (£5) will be issued on timely receipt of the accelerometer (together with
AST forms), even if the accelerometer turns out to not have been worn for the requested time
(i.e. at least four days, including at least one weekend day, and 10 hours each day).
The researcher will retire to a different room (or section of the school) and based on the
parent AST report form only, points relative to the five previous days will be calculated.
In the case of SMS, responses will be gathered in the evening, at the researcher's
workplace, and next day's point will only be credited if received before 12noon (this will
be stated in every text message that parents receive on a draw day). Class scores will be
anonymously displayed on a graphic/chart week-after-week, in a printed version if possible
or by hand if necessary. Depending on the school's preferences and availability, the
logistics of counting points and producing tickets may be slightly different. For example, a
teacher may agree to return all the completed parent AST reports to the school office in the
morning, in which case the researcher could collect them and prepare the tickets in advance.
After producing all the tickets, the researcher will return to the classroom to distribute
the accelerometers to the next batch of users. Once the thank you vouchers and
accelerometers have been sorted out, the draw will finally take place in the classroom. A
ticket will be picked out of a black string bag, probably by a school staff member of by the
researcher. Depending on parental choice specified on the consent form, the incentive scheme
voucher will be provided to the winner straight away, or will be left in the school office
for later collection by the parent. The class score graphic/chart will be put on display on
the wall.
Control group - normal curricular AST advice With the exception of the incentive scheme,
identical procedures will be followed in both intervention and control groups. Each week,
new groups of participants (e.g. the next five on the list) will be requested to wear the
accelerometer, return the parent AST report form (if applicable) and complete their own AST
report form.
Qualitative study One component of this study consists of semi-structured interviews with
children, parents/carers and stakeholders, both from experimental and control groups, to
explore different perspectives associated with the proposed intervention and trial
procedures and to help refine both. Willingness to be interviewed will be expressed in the
consent form before baseline in the case of parents (in addition to assent form in the case
of children), from which a purposive sample will be selected based on the socio-demographic
variables assessed in the questionnaire. The researcher will directly invite teachers and
head teachers, who in turn will suggest other stakeholders for interview among their
acquaintances (snowball sampling).
The aim will be to interview dropout participants throughout the intervention phase (as soon
as they leave the study), and full participants immediately after the study has ended
(January 2015). Sessions are expected to last between 30-45 minutes for adults and 15-30
minutes for children. Verbal consent to take part and to have the session audio-taped will
be requested at the onset (in the case of children, to parents first and then by verbal
assent), and the confidential nature of all records will be reiterated. Data will be
securely stored in compliance with Newcastle University's regulations.
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