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Open AccessArticle

Pathways to Increasing Adolescent Physical Activity and Wellbeing: A Mediation Analysis of Intervention Components Designed Using a Participatory Approach

1
UKCRC Centre for Diet and Activity Research (CEDAR) and MRC Epidemiology Unit, University of Cambridge, Cambridge CB2 1TN, UK
2
Department of Physical Education, Universidade Estadual Paulista “Júlio de Mesquita Filho” (UNESP), Presidente Prudente 19000-000, Brazil
3
Food & Mood Centre, Centre for Innovation in Mental and Physical Health and Clinical Treatment, School of Medicine, Faculty of Health, Deakin University, Melbourne 3004, Australia
4
IMPACT Strategic Research Centre, School of Medicine, Deakin University, Barwon Health, Geelong 3220, Australia
5
Department of Psychiatry, University of Cambridge and Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge CB2 0SZ, UK
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(2), 390; https://doi.org/10.3390/ijerph17020390
Received: 4 December 2019 / Revised: 16 December 2019 / Accepted: 19 December 2019 / Published: 7 January 2020
(This article belongs to the Special Issue Participatory Research in Health Promotion)
We assessed which intervention components were associated with change in moderate-to-vigorous physical activity (MVPA) and wellbeing through proposed psychosocial mediators. Eight schools (n = 1319; 13–14 years) ran GoActive, where older mentors and in-class-peer-leaders encouraged classes to conduct two new activities/week; students gained points and rewards for activity. We assessed exposures: participant-perceived engagement with components (post-intervention): older mentorship, peer leadership, class sessions, competition, rewards, points entered online; potential mediators (change from baseline): social support, self-efficacy, group cohesion, friendship quality, self-esteem; and outcomes (change from baseline): accelerometer-assessed MVPA (min/day), wellbeing (Warwick-Edinburgh). Mediation was assessed using linear regression models stratified by gender (adjusted for age, ethnicity, language, school, BMI z-score, baseline values), assessing associations between (1) exposures and mediators, (2) exposures and outcomes (without mediators) and (3) exposure and mediator with outcome using bootstrap resampling. No evidence was found to support the use of these components to increase physical activity. Among boys, higher perceived teacher and mentor support were associated with improved wellbeing via various mediators. Among girls, higher perceived mentor support and perception of competition and rewards were positively associated with wellbeing via self-efficacy, self-esteem and social support. If implemented well, mentorship could increase wellbeing among adolescents. Teacher support and class-based activity sessions may be important for boys’ wellbeing, whereas rewards and competition warrant consideration among girls. View Full-Text
Keywords: intervention; physical activity; mental health; adolescent; school; health promotion intervention; physical activity; mental health; adolescent; school; health promotion
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Corder, K.; Werneck, A.O.; Jong, S.T.; Hoare, E.; Brown, H.E.; Foubister, C.; Wilkinson, P.O.; van Sluijs, E.M. Pathways to Increasing Adolescent Physical Activity and Wellbeing: A Mediation Analysis of Intervention Components Designed Using a Participatory Approach. Int. J. Environ. Res. Public Health 2020, 17, 390.

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