Physical Activity Clinical Trial
Official title:
One-on-one and Group-based Physical Activity Intervention Compared to a Wait-list Control for Post-secondary Student Mental Health and Well-being: A 3-arm Parallel Randomized Controlled Trial
NCT number | NCT06350877 |
Other study ID # | PA RCT |
Secondary ID | |
Status | Recruiting |
Phase | N/A |
First received | |
Last updated | |
Start date | January 8, 2024 |
Est. completion date | January 2025 |
Verified date | April 2024 |
Source | University of Toronto |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
Post-secondary students report alarming rates of feeling overwhelmed, hopeless, anxious, and depressed. To better support student mental health, there is a well-documented need to improve the range and quality of mental health services available to students. Focussing on formalized treatment approaches and strategies supporting well-being in the campus community more generally are needed. Physical activity is an alternative therapeutic approach that could be implemented as an evidence-based lifestyle intervention for supporting mental health and well-being on post-secondary campuses. Despite the growing evidence supporting physical activity for student mental health, there are significant knowledge gaps in the literature. First, there is a paucity of research exploring the effects of different delivery styles (i.e., one-on-one (1:1) vs. group) on primary (i.e., mental health symptomology including anxiety symptoms, depression symptoms, psychological distress) and secondary (i.e., social support, social connectedness) outcomes. Secondly, the maintenance effects of a physical activity program on mental health or sustained physical activity behaviour change are largely unknown. Lastly, limited research has explored contextual implementation factors (e.g., intervention reach, adherence, and program satisfaction) that may influence the sustainability and scale-up of physical activity programs for student mental health. Examining contextual implementation factors is critical for optimizing physical activity intervention delivery and for facilitating wider dissemination of research findings into practice. The goal of this 3-arm parallel randomized controlled trial is to test the effectiveness of 1:1 physical activity intervention and group-based physical activity intervention compared to a wait-list control group in supporting post-secondary student mental health. The main questions include: - Are there group differences between 1:1, group-based delivery, and waitlist control in the immediate (post-intervention) and follow-up (1-month) maintenance effects on the primary and secondary outcomes? - Grounded in recommendations for process evaluation of complex interventions, what are contextual implementation factors that may be linked to variation in primary and secondary outcomes while offering insight for wider dissemination? Trial participants will be randomly assigned to one of the following groups: 1. 1:1 physical activity training; 2. Group-based physical activity training consisting of small 5-8 person groups; or 3. Waitlist control. Students will participate in the physical activity intervention after the intervention and follow-up period (10 weeks); however, their participation will not be monitored or evaluated. The physical activity training will involve a 6-week physical activity intervention consisting of weekly 1-hour sessions. Each session involves: (1) 30-minutes of behaviour change coaching (e.g., goal setting, action-planning, brainstorming strategies to overcome barriers to engaging in physical activity); and (2) 30-minutes of supervised and structured physical activity training. To address the aims of the study, participants will complete self-report questionnaires at baseline, post-intervention (following completion of the 6-week physical activity intervention), and 1-month following completion of the physical activity intervention. Questionnaires will assess demographic characteristics, primary outcomes (i.e., mental health symptomology including anxiety symptoms, depression symptoms, psychological distress), secondary outcomes (i.e., social support, social connectedness, physical activity behaviour) and contextual implementation factors (e.g., intervention reach, adherence, and program satisfaction) that may be linked to variation in primary and secondary outcomes while offering insight for wider dissemination. It is hypothesized that there will be no group differences between 1:1 delivery and group-based delivery on the primary outcomes. It is also hypothesized that group-based delivery, in comparison to 1:1 delivery will achieve greater improvements and more favourable maintenance effects in the secondary outcomes. Lastly, it is hypothesized that in comparison to the control group, 1:1 delivery and group-based delivery will be more effective in achieving change in the primary and secondary outcomes.
Status | Recruiting |
Enrollment | 93 |
Est. completion date | January 2025 |
Est. primary completion date | January 2025 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | Female |
Age group | N/A and older |
Eligibility | Inclusion Criteria: - a post-secondary undergraduate or graduate student enrolled either part-time or full-time at a Canadian post-secondary institution - fluent in English (e.g., proficiency in reading and verbal expression - written and oral) - able to attend in-person physical activity sessions at the campus athletics and recreation centre - moderately or insufficiently active ( < 23 units of weekly leisure activity) based on interpretation scores from the Leisure-Time Physical Activity Questionnaire - experiencing self-reported 'poor', 'fair' or 'good' mental health in the past month. Exclusion Criteria: - physically active (24 units or more of weekly leisure activity) based on interpretation scores from the Leisure-Time Physical Activity Questionnaire - unsuccessful exercise clearance using the physical activity readiness questionnaire (PAR-Q) - self-reported 'very good' or 'excellent' mental health |
Country | Name | City | State |
---|---|---|---|
Canada | University of Toronto, Mental Health and Physical Activity Research Centre | Toronto | Ontario |
Lead Sponsor | Collaborator |
---|---|
University of Toronto |
Canada,
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* Note: There are 37 references in all — Click here to view all references
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Depression | To measure depression symptoms, the Participant Health Questionnaire will be used. The 9-item questionnaire measures the presence and severity of depressive symptoms over the past 2 weeks ranging from 0 (not at all) to 3 (nearly every day). The total summed score ranging from 0-27 will be used in main analyses | T1 (0 days from baseline), T2 (42 days from baseline) T3 (72 days from baseline). | |
Primary | Anxiety | The Generalized Anxiety Disorder Questionnaire will be used to measure anxiety symptoms. The 7-item questionnaire assesses the frequency of symptoms associated with anxiety during the past two weeks ranging from 0 (not at all) to 3 (nearly every day). The total summed score ranging from 0-27 will be used in main analyses. | T1 (0 days from baseline), T2 (42 days from baseline) T3 (72 days from baseline). | |
Primary | Psychological distress | Psychological distress will be measured using the 10-item Kessler Psychological Distress Scale. Students will be asked to indicate how often over the last 30 days they experienced symptoms of psychological distress ranging from 1 (none of the time) to 5 (all of the time). The total summed score (ranging from 10 - 50) will be used in analyses, with higher scores reflecting more psychological distress. | T1 (0 days from baseline), T2 (42 days from baseline) T3 (72 days from baseline). | |
Secondary | Social Support | To measure social support, the 5-item Social Provision Scale will be used. The scale consists of 5-items, on a 4-point Likert scale ranging from 1 (strongly disagree) to 4 (strongly agree). A total summed score (ranging from 4 - 16) will be used in main analyses, where higher scores indicate more favorable perceptions of social support. | T1 (0 days from baseline), T2 (42 days from baseline) T3 (72 days from baseline). | |
Secondary | Social Connectedness | The 8-item Social Connectedness Scale will be used to measure social connectedness. The items portray a general emotional distance between the self and others and reflect behaviour, feelings, or both associated with a lack of connectedness on a 6-point Likert scale ranging from 1 (agree) to 6 (disagree). Scores will be reverse coded, thus higher scores will reflect a more reported sense of social connectedness with a potential range of 8-48. | T1 (0 days from baseline), T2 (42 days from baseline) T3 (72 days from baseline). | |
Secondary | Physical Activity Behaviour | Physical activity behaviour will be measured using the International Physical Activity Questionnaire-Short Form and reported as the total of a 7-day recall of the duration (in minutes) and frequency (days) of vigorous intensity, moderate intensity, and walking physical activity behavior. A total physical activity score will be computed using a sum of the reported minutes per week of vigorous, moderate, and walking intensity physical activity. | T1 (0 days from baseline), T2 (42 days from baseline) T3 (72 days from baseline). | |
Secondary | Intervention Reach | Intervention reach will be measured by descriptive data including recruitment and referral processes, the percentage of individuals who participate, the percent excluded, completion rates, and characteristics of participants compared with nonparticipants. | T2 (42 days from baseline) | |
Secondary | Therapeutic Alliance | Therapeutic alliance will be assessed using the 12-item Working Alliance Inventory. The Working Alliance Inventory has predominantly been studied and validated for use in psychotherapeutic contexts. Researchers, however, are increasingly supporting the importance of evaluating the coach-participant relationship for achieving favourable program outcomes. Participants will be asked to respond to each item on a 5-point Likert scale ranging from 1 (never) to 5 (always), wherein a higher score (ranging from 5 - 25) indicates a more positive therapeutic alliance. | T2 (42 days from baseline) | |
Secondary | Intervention Satisfaction | To assess intervention satisfaction a mix of closed-ended and open-ended questions will be used. The open-ended questions will assess general likes and dislikes towards the program and will be used to corroborate the closed-ended questions to provide an in-depth understanding of intervention satisfaction. Using closed-ended questions, students will be asked to self-report their physical activity session perceptions using 10-items on a 5-point Likert scale from 1 (strongly disagree) to 5 (strongly agree), with higher scores indicating more positive evaluations. Items will be treated as singular continuous variables, and descriptively analyzed. | T2 (42 days from baseline) | |
Secondary | Coach Perceptions | Participants will be asked to respond to 14-items on a 7-point Likert scale from 1 (Strongly disagree) to 7 (Strongly agree) assessing perceptions of the physical activity coach's ability to integrate core components of the program including providing a supportive environment, taking into account individual needs and preferences, and promoting engagement in enjoyable physical activity options. Higher scores ranging from 14 - 49 will indicate more favourable coach perceptions. Items will be treated as singular continuous variables, and descriptively analyzed. | T2 (42 days from baseline) |
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