Plain English Summary
Background and study aims
Rising levels of inactivity and poor diet are important concerns to public health, considering the increased incidence of obesity. While physical activity declines across the life course, this may be accelerated as a result of particular life events. One key point is during adolescence and early adulthood, and it is possible that leaving school (i.e., losing all the opportunities and encouragement for physical activity that school attendance entails), may be a contributor to this. Similarly, young people develop greater control over their diet during late adolescence (e.g., leaving controlled school and home eating environments to go to work), and potentially set down habits for how they will eat over coming years. Young people with low incomes and social resources are at particular risk of developing risky health behaviours (e.g., poor diet and an inactive lifestyle). We see the transition from school to employment to provide an opportunity to change behaviour; this is because it is much easier to break habits when your environment changes than when routines are established. This work will test an intervention to promote and maintain healthy lifestyle habits in young people leaving school for work. Engaging young people in health promoting initiatives is notoriously difficult, so to try and ensure good participation levels we will also test whether incentives can be used to prompt such changes. Findings from this work will provide valuable information to inform policy on the feasibility of health promotion with this under-researched and hard-to-reach group.
Who can participate?
All pupils in their final year of education before taking up employment or work-based learning within participating schools can take part in this study.
What does the study involve?
Students will be recruited to the project before leaving school, and invited to an information session at their local leisure centre. They will be randomly allocated to one of three groups: behavioural support, behavioural support with incentives or information only control group.
What are the possible benefits and risks of participating?
Participants in the intervention groups will benefit from receiving 3 months of free access to their local leisure centre, plus behavioural support to help them to set and reach their own physical activity and dietary goals. Participants in the control group will receive information about healthy lifestyles. There are no obvious risks related to participation.
Where is the study run from?
The study is run from secondary schools in the Bath & North East Somerset (UK) and Wiltshire (UK).
When is the study starting and how long is it expected to run for?
The study began in February 2009 and ran until in June 2011.
Who is funding the study?
National Prevention Research Initiative (NPRI), UK.
Who is the main contact?
Dr Martyn Standage
M.Standage@bath.ac.uk
Trial website
Contact information
Type
Scientific
Primary contact
Dr Martyn Standage
ORCID ID
Contact details
Department for Health
University of Bath
Bath
BA2 7AY
United Kingdom
-
m.standage@bath.ac.uk
Additional identifiers
EudraCT number
ClinicalTrials.gov number
Protocol/serial number
G0701878
Study information
Scientific title
The use of incentives in the formation of healthy lifestyle habits following the school to work transition: a cluster randomised controlled trial
Acronym
Study hypothesis
1. The study will test whether a theoretically derived intervention (based on the principles of self-determination theory) can promote the adoption of healthy physical activity and dietary habits in young people leaving school for work.
2. Financial incentives (in the form of 4 x £10 vouchers) contingent on continued attendance at behavioural support sessions (rather than target behavioural outcomes) will promote engagement with the programme; this will foster better outcomes through promoting higher exposure to intervention content.
3. Participant outcomes in terms of health behaviours and well-being will be mediated by increases in their perceptions of an autonomy supportive teaching context, satisfaction of autonomy, competence, relatedness and also by improved levels of autonomous motivation.
Ethics approval
University of Bath, School for Health Research Ethics Approval Panel, March 2009
Study design
Cluster randomised controlled trial
Primary study design
Interventional
Secondary study design
Cluster randomised trial
Trial setting
Other
Trial type
Quality of life
Patient information sheet
Not available in web format, please use the contact details to request a patient information sheet
Condition
Health promotion (physical activity and diet)
Intervention
Participants are randomised to one of three groups
1. Three months of behavioural support for promoting a healthy diet and physical activity
2. Three months of behavioural support with incentives (4 x £10 voucher for driving lessons or mobile phone top-ups)
3. An information only control group.
The intervention was developed by a team of experts in motivation, habit theory, and the delivery of behavioural interventions. A full need assessment was conducted through interviewing young people in the target population, and conducting a thorough literature review. The intervention was then systematically constructed through a process of intervention mapping, that is, matching specific evidence-based behaviour change strategies to the specific determinants of behaviour change important in this context. Leisure centre advisors were provided with a half-day training event prior to participation, which included a rationale of the study, and aims within the study, and provided experience of delivering study content in a style that supported participants sense of autonomy, and confidence in their ability to take control over their health behaviours. Advisors also received a reference manual to consult following the training, and were provided with ongoing support from the research manager. A participant booklet (one issued for each person allocated) guided advisors and participants through the goal-setting process at each appointment. The focus of the intervention was for participants to set their own personal goals for improving/maintaining their diet and physical activity, and monitor their progress against these goals over a three month period. All costs for leisure centre use were covered during the study period, and participants in the intervention arm of the trial received £10 vouchers for continued attendance. At the end of the trial, advisors discussed long-term goals with participants, and facilitated the process of extending membership, or seeking other ways of achieving these goals locally.
Intervention type
Behavioural
Phase
Drug names
Primary outcome measure
1. Objectively assessed moderate-vigorous physical activity (MVPA), assessed using Actigraph GT1M accerlerometers
2. Diet quality, assessed using a European Food Frequency questionnaire
Outcomes measured at baseline, 12 weeks, and 52 weeks.
Secondary outcome measures
1. Weight and height (to provide Body Mass Index scores)
2. Motivation towards exercise (BREQ-2)
3. Perceived autonomy support for exercise (from study personnel)
4. Strength of habits for physical activity
5. Strength of habits for dietary intake
Outcomes measured at baseline, 12 weeks, and 52 weeks.
Overall trial start date
01/05/2009
Overall trial end date
01/09/2011
Reason abandoned (if study stopped)
Eligibility
Participant inclusion criteria
Students in participating schools who are in their final year of study before leaving school for work or work-based learning
Participant type
Other
Age group
Adult
Gender
Both
Target number of participants
350
Participant exclusion criteria
Students in participating schools leaving school for higher education, or further study (not work-based)
Recruitment start date
01/05/2009
Recruitment end date
01/09/2011
Locations
Countries of recruitment
United Kingdom
Trial participating centre
University of Bath
Bath
BA2 7AY
United Kingdom
Sponsor information
Organisation
University of Bath (UK)
Sponsor details
c/o Lisa Austin
Department for Health
Bath
BA2 7AY
United Kingdom
-
L.Austin@bath.ac.uk
Sponsor type
University/education
Website
Funders
Funder type
Research council
Funder name
Medical Research Council (MRC) - National Prevention Research Initiative (NPRI) (UK) Ref: G0701878
Alternative name(s)
Funding Body Type
Funding Body Subtype
Location
Results and Publications
Publication and dissemination plan
Not provided at time of registration
Intention to publish date
Participant level data
Not provided at time of registration
Basic results (scientific)
Publication list
2014 protocol in: http://www.ncbi.nlm.nih.gov/pubmed/24592967
Publication citations
-
Protocol
Gillison F, Standage M, Verplanken B, A cluster randomised controlled trial of an intervention to promote healthy lifestyle habits to school leavers: study rationale, design, and methods., BMC Public Health, 2014, 14, 221, doi: 10.1186/1471-2458-14-221.