Title: The Walking in ScHools (WISH) Trial: a cross-border trial to evaluate a walking intervention in adolescent girls.
Funder: Public Health Agency, NI

Abstract: "Background: Physical activity (PA) is associated with improved physical and mental health and promotion of PA at a population level is a key focus for public health. PA during adolescence is a determinant of activity levels in adulthood [1], therefore establishing a PA habit from an early age is important. Ireland and Northern Ireland share a common concern with only a minority of children and adolescents currently meeting PA recommendations, among the lowest rates in Europe. PA levels decline as children move into adolescence and through to adulthood [2], with an earlier onset of PA decline in girls and physical inactivity most prevalent amongst adolescent girls. Walking is the second largest contributor to PA in adolescents and is a form of activity that can be maintained into adult life. Aside from home, children and adolescents spend more time in school than in any other setting, so schools represent a key environment for promoting health-related behaviours. Additionally, school-based promotion of PA has the potential to overcome (or at least not reinforce) some of the factors leading to unintended health inequalities in interventions, as all adolescents can participate irrespective of socioeconomic status. Walking is the most prevalent PA among adults who meet current activity guidelines and given its popularity amongst adults, focus should be given to the promotion of walking, particularly in adolescent girls as they move towards adulthood. Following a systematic review of interventions in children and adolescents [3], we conducted focus groups to explore attitudes of adolescents to PA [4] and these findings informed the design of the peer-led, school-based walking intervention, the Walking In ScHools (WISH) intervention which was feasibility/pilot tested in Northern Ireland (NI) [5]. Aim: This definitive Health Intervention Trial will investigate the effectiveness of this novel, low-cost, peer-led, school-based intervention (WISH) at increasing PA in low-active adolescent girls within NI and the Border region of Ireland. Methods: Using a clustered randomised controlled trial, adolescent girls (12-14yrs) will be recruited from 16 schools located across NI (n=8) and Border region of Ireland (n=8) with 24 pupils per school being enrolled as participants. Post-baseline measures, schools will be randomised to control (n=8) or intervention (n=8). Intervention participants will have opportunities to participate in up to three 10-15min peer-led walks/day in school, led by older pupils (aged 16-18yrs) who have been trained as walk leaders. The intervention will be delivered across the school year with longer-term follow-up (sustainability) assessed. Outcome measures: Effectiveness will be determined by change in objectively measured total PA (primary outcome). Secondary outcomes will include change in moderate-to-vigorous intensity PA, sedentary behaviour, proportion of pupils meeting PA guidelines, change in body composition, motivation, perceptions of autonomy, relatedness and competence, self-efficacy and quality of life. A multilevel statistical model will assess changes in total PA, and intention-to-treat analysis conducted. Impact: If the intervention increases PA, it would benefit adolescent girls in the defined target area will potential for adoption by schools across the island of Ireland resulting in sustainable, long-term, positive impact on child population health."


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: STROKE;ORAL AND GASTROINTESTINAL;METABOLIC AND ENDOCRINE;CARDIOVASCULAR;CANCER AND NEOPLASMS