Bristol Girls Dance Project: A cluster randomised controlled trial of an after-school dance programme to increase physical activity among 11- to 12-year-old girls

Jago, Russell; Edwards, Mark; Sebire, Simon; Bird, Emma; Tomkinson, Keeley; Kesten, Joanna; Banfield, Kathryn; May, Thomas; Cooper, Ashley; Blair, Peter; Powell, Jane

Abstract

Background: Many children do not meet UK physical activity (PA) guidelines. Girls are less active than boys, and the age-related decline in activity is steeper for girls. Dance is the favourite form of PA among adolescent girls in the UK. Participation in after-school dance classes could significantly contribute to girls’ PA. Therefore, after-school dance may be effective for increasing PA levels.

Objectives: To determine the effectiveness and cost effectiveness of a dance-based intervention to increase the objectively assessed mean weekday minutes of moderate- to vigorous-intensity physical activity (MVPA) of Year 7 girls (11- and 12-year olds) 1 year after baseline measurement.

Design: Two-arm cluster randomised controlled trial and economic evaluation. Year 7 girls in participant schools received a ‘taster’ session and were invited to participate. Up to 33 girls per school were able to participate. Schools were randomly assigned (equal numbers) to intervention or control arms.

Setting: A total of 18 mainstream secondary schools across greater Bristol.

Participants: Year 7 girls in participating schools who could participate in physical education.

Intervention: Nine intervention schools received an after-school dance intervention (40 × 75-minute sessions) underpinned by self-determination theory, which attempts to improve intrinsic motivation for being active, and delivered by external dance instructors. Control schools continued as normal.

Main outcome measures: The main outcome was accelerometer-assessed mean minutes of MVPA at T2. Measures were assessed at baseline (T0), the end of the intervention (T1) and at T0 + 52 weeks (T2).

Results: Baseline MVPA levels were high. A total of 508 girls were included in the primary analysis, which found no difference in weekday MVPA between trial arms. There was no effect on secondary accelerometer outcomes. Data were subjected to a per-protocol analysis and no effect was found. However, at T1, girls who attended dance classes had 4.61 minutes more of MVPA and 14.27 minutes more of light-intensity activity between 15.00 and 17.00 on the days on which they attended intervention sessions. The intervention was inexpensive at £73 per participant (£63 when excluding dance instructor travel) but was not cost-effective owing to the ineffectiveness of the intervention. The European Quality of Life-5 Dimensions Youth survey data were unresponsive to changes in the sample. The process evaluation reported that girls in attendance enjoyed the sessions, that exertion levels were low during sessions and that attendance was low and declined. Fidelity to the session-plan manual was low but theoretical fidelity (to self-determination theory) was good. Qualitative information provides information for improving future interventions.

Conclusions: The intervention was enjoyed by participants. However, there was no difference in the MVPA levels (which were high at baseline) of girls allocated to receive dance compared with girls receiving the control. High baseline MVPA levels indicate that the study appealed to an already active cohort and, therefore, may not have targeted those most in need of an intervention. Dance is an enjoyable activity for adolescent girls and could be further trialled as a means by which to increase PA. Research might consider the impact of dividing the intervention period into smaller blocks.

• Journal Article Type: Article
• Acceptance Date: Dec 1, 2015
• Publication Date: Jan 1, 2016
• Publicly Available Date: Jun 7, 2019
• Journal: Public Health Research
• Print ISSN: 2050-4381
• Publisher: NIHR Journals Library
• Peer Reviewed: Peer Reviewed
• Volume: 4
• Issue: 6
• DOI: https://doi.org/10.3310/phr04060
• Keywords: physical activity, dance, school, RCT
• Public URL: https://uwe-repository.worktribe.com/output/920091
• Publisher URL: http://dx.doi.org/10.3310/phr04060