A revised teaching assistant-led extracurricular physical activity programme for 8- to 10-year-olds: The Action 3:30R feasibility cluster RCT

Jago, Russ; Tibbitts, Byron; Porter, Alice; Sanderson, Emily; Bird, Emma; Powell, Jane; Metcalfe, Chris; Sebire, Simon

Abstract

Abstract
Background
Many children do not meet the recommended guidelines for physical activity (PA). The after-school period may be a critical time for children to participate in PA. Teaching assistants are important within the school system and could be trained to deliver after-school PA programmes. Our previous work showed promise for a teaching assistant-led after-school PA intervention.
Objectives
To examine the feasibility, evidence of promise and cost of Action 3:30R, a revised after-school PA intervention.
Design
A cluster-randomised feasibility study, including process and economic evaluations.
Setting
Twelve primary schools in Southwest England.
Participants
Year 4 and 5 children (8 to 10 years old).
Intervention
Two teaching assistantss from each intervention school attended a 25-hour (five day) training course focused on how to deliver an after-school PA programme. As Action 3:30 is grounded in Self-Determination Theory, the training focussed on promoting children’s autonomy, belonging and competence. Teaching assistants received resources to aid delivery of a 60-minute after-school PA programme twice per week for 15 weeks (30 sessions).
Main outcome measures
Measures focused on feasibility outcomes and evidence of promise. Feasibility measures included recruitment of schools and pupils and attendance of the after-school programme. Evidence of promise was measured by comparison of accelerometer-determined minutes of moderate to vigorous PA between arms at follow up. Process evaluation measures were conducted using the RE-AIM framework. The cost of delivery was also assessed.
Results
Twelve primary schools were recruited.. 41% of eligible pupils consented, 49% of which were girls. Schools were randomised after baseline measures; six intervention (n=170 pupils) and six control (n=165 pupils). Two schools allocated to the intervention arm withdrew from the study before the start of the intervention leaving n=111 pupils in the intervention group. Intervention training was well attended and positively received; 8 of 9 teaching assistants attended 100% of sessions. Action 3:30R clubs were well attended; 74% of pupils attended at least 50% of the 30 sessions. Mean weekday moderate to vigorous PA did not differ between arms at T1 (-0.5, 95% CI = -4.57, 3.57). The process evaluation revealed Action 3:30R was received positively by pupils, teaching assistants and key contacts in intervention schools. Pupils enjoyed Action 3:30R and teaching assistants and pupils perceived the teaching style to be autonomy-supportive. Economic evaluation showed that Action 3:30R is inexpensive; the estimated cost of the programme after one year was £1.64 per pupil per session.
Limitations
Reason for withdrawal was given by one school but not the other. The reason given was inability to release staff for training.
Conclusions
Action 3:30R is a low-cost, feasible after-school programme which engages a range of pupils and offers continuous professional development to teaching assistants. However, Action 3:30R does not show evidence of promise to increase levels of moderate to vigorous PA and does not warrant a trial evaluation.
Future work
Future research should focus on improving the quality of current after-school provision in primary schools to increase PA.

• Journal Article Type: Article
• Acceptance Date: Apr 16, 2019
• Online Publication Date: Nov 1, 2019
• Publication Date: Dec 1, 2019
• Deposit Date: Sep 23, 2019
• Publicly Available Date: Jan 26, 2021
• Print ISSN: 2050-4381
• Electronic ISSN: 2050-439X
• Publisher: NIHR Journals Library
• Peer Reviewed: Peer Reviewed
• Volume: 7
• Issue: 19
• Pages: 1-158
• DOI: https://doi.org/10.3310/phr07190
• Public URL: https://uwe-repository.worktribe.com/output/3222377