Physical activity (PA) is associated with numerous health benefits for children and adolescents [1
], and children and young people (<18 years) are currently recommended to take part in at least 60 min, and up to several hours of moderate-to-vigorous PA (MVPA) per day [2
]. Despite this, many young people are failing to meet current recommendations for PA [3
]. Evidence also consistently demonstrates females are less likely to meet the PA recommendations compared with their male counterparts [3
]. Schools represent a fertile environment for the promotion of PA behaviours; however, there is a lack of consensus on how best to promote PA within the school setting to ensure the maintenance of PA behaviours into late adolescence, and adult life [5
]. Furthermore, whilst evidence has highlighted the importance of a whole-school approach to the promotion of PA, the onus for further promoting PA within the school environment generally falls to physical education (PE) teachers and the PE curriculum [6
School-based PE provides an opportunity for young people to participate in structured, regular PA [7
], and has the potential to contribute towards time spent in MVPA [7
]. Time spent in PE has been shown to decrease as adolescent females’ progress through post-primary education [9
]. This, coupled with curriculum squeezes on PE, means that other opportunities within the school setting may be increasingly important in promoting overall PA in this age group. Such opportunities may include increasing the provision of non-curricular PA at break and lunch-time (recess periods), or developing strategies to utilise timetabled PE [10
], so that the school setting can be more effective in helping adolescent females meet the PA recommendations.
The provision of extra-curricular activities within school has been shown to increase PA, with active travel to school, summer camps and school recess identified as possible opportunities to promote PA outside of timetabled PE [11
]. The contribution of school recess to total PA in young people has been shown to decline as children make the transition from primary to post-primary education [12
], with females less likely to be active during recess [13
]. The limited number of PA interventions targeted at school recess periods, particularly in adolescent females, limits conclusions on the effectiveness of such interventions on PA in children and adolescents [15
]. Furthermore, the intervention components within these studies (playground markings and equipment) may be less feasible within the post-primary setting [16
]. Evidence has highlighted that school-based interventions that target females only may be more effective than mixed-gender interventions at increasing PA [17
Walking has been at the cornerstone of PA promotion in adults [18
], and is recognised as a suitable means of PA promotion for adolescents also [19
]. Brisk walking can contribute to their MVPA guidelines in children [20
] and may overcome some frequently cited barriers to adolescent female PA participation at school (e.g., uniforms, not wanting to exercise in front of peers) and the challenges associated with changing priorities in this population [21
]. Walking interventions have the potential to increase PA in children and adolescents [22
]; however, to date, there are limited interventions in adolescent females [22
]. Research examining the potential for walking to increase PA in adolescent females has received increased focus in recent years [16
]; however, less is known about the acceptability of such interventions. When developing and implementing interventions, it is important that policy makers and practitioners actively consult with adolescent females to gain an understanding of what works in this age group and to identify facilitators and barriers to PA in this population, which can inform the design of future interventions [25
], as well as engaging adolescent females in such interventions [17
]. In addition, there is limited evidence on the acceptability of such interventions from a schools’ perspective, and further research is needed to understand how PA interventions, in particular walking, can meet the needs of schools and female students in terms of increasing opportunities for non-curricular PA.
The aim of this study was to examine the potential of using the school environment to promote walking behaviours among adolescent females. The study involved a mixed-methods approach to a) understand the experiences of adolescent females involved in a school-based walking programme, and factors that may influence their participation; and b) assess stakeholders’ (schools’) perceptions of implementing a walking programme in the target population.
The aim of this study was to examine the experiences of adolescent females involved in a school-based walking intervention, and the potential of using the school environment to promote walking behaviours among adolescent females, from the point of view of the target population (adolescent females) and key stakeholders (school representatives). Phase 1 of the study identified walking as an acceptable form of PA to participate within the school day from the perspective of the target population (adolescent females) and demonstrated the importance of social support in encouraging adolescent females to be more active. Phase 2 of the study highlighted that schools recognise the need to target adolescent females when promoting PA, and emphasised a number of practical issues that need to be considered when promoting PA (walking) within the school setting.
Based on qualitative data from the present study, adolescent females perceived walking to be an acceptable form of PA during the school day. Respondents noted that walking was a non-competitive activity that could be completed routinely within the school day without any specialist skills or competencies. Furthermore, the responses highlighted that walking could overcome some previously cited barriers to PA at school, including not wanting to wear a PE uniform or feeling conscious in front of peers [21
]. The perceived ability amongst adolescent females has been identified as a barrier to participation in lunchtime PA [28
]; therefore, presenting opportunities for adolescent females to walk during the school day provides an ideal opportunity to engage this group in PA that requires no skill/competency and that does not involve competition [29
]. Evidence suggests that such activities are likely to be more acceptable to adolescent females [29
]. A recent study on the acceptability of walking breaks during the school day reported 95% of students were satisfied with walking as a form of PA during the school day [24
]; however, this study included both males and females. Although further research is needed to fully explain why males are more active during school recess [31
], the differences in school time PA between genders is likely to be associated with gender roles [32
]. Therefore, overcoming the identified barriers to PA and providing activities that are acceptable such as walking during the school day is of particular importance for PA promotion in adolescent females.
Over half of the responding schools agreed that walking would be an effective means of promoting PA within the school day, indicating that walking interventions may also be acceptable from a stakeholder (schools) point of view. A number of practical issues to implementation were identified from a schools’ perspective, including safety, supervision and a lack of suitable environments for walks. Walking interventions have previously been shown to be practically acceptable from a schools’ point of view, placing few organisational demands on teachers [24
]. Addressing the identified barriers from schools is important in future intervention delivery and development, as such barriers may have an impact on how interventions are implemented and delivered in the real-life school setting.
Research has previously identified factors such as supporting teacher autonomy [33
], time and a supportive school environment [34
] as key indicators of successful intervention implementation in the school setting. The use of older pupils (peer leaders) to facilitate the walking sessions within the WISH study was novel [16
], and may provide a valuable resource to overcome barriers such as staffing issues time constraints within schools. Approximately half of responding schools indicated that pupils, trained as walk leaders would be suitably placed to help deliver walking-based interventions within the school setting. Participants involved in the WISH study had mixed opinions on the role of the walk leaders, with some highlighting that they could organise and facilitate the walks themselves, without the need for older peers, while others felt it was important to have older peers present to ensure that the walks were conducted properly. Identifying ways to increase social support for PA, particularly from peers, should be a priority for schools when trying to promote PA during school recess [35
], for example, through peer mentoring schemes [28
The role of friends in providing support and encouragement was key in helping promote PA from the adolescent females’ perspective. A number of participants (intervention group) highlighted that peers could provide positive support while others in the control arm suggested that peers may have a negative influence on participation in PA. School staff also identified friends as the main influence on adolescent females’ willingness to take part in walking interventions at school. The involvement of friends and peers is directly associated with PA amongst adolescents [37
], and can influence PA both positively and negatively [38
]. Peer support, peer acceptance and the presence of friends/peers are all positively associated with PA in adolescents and should be considered in interventions targeted at this population [38
]. Given that the WISH study was the first intervention to explore the use of older peer leaders to promote walking behaviours, further research is needed to understand the relationship between peers with regards to walking.
Providing PA opportunities that enable adolescent females to socialise with their friends was identified from focus group discussions as a key component within the WISH intervention. Giving adolescent females a peer network to engage in PA with during the school day can overcome the barrier of having no-one to be active with, which has been previously cited as preventing adolescents from being active during school recess [39
]. Given that enjoyment [40
] and opportunities to socialise with peers [40
] are strongly correlated with PA participation in adolescent females, the positive experiences of participants within this intervention in relation to enjoyment and socialising should be highlighted when planning recruitment strategies for future school-based walking programmes [42
The tendency for extra-curricular PA to reflect the content of timetabled PE is well documented within the literature [6
], and was reflected within the present study. Team training sessions for selected players, games activities and inter-school matches were the most common extra-curricular activities offered within responding schools on a regular basis, which is consistent with previous research in post-primary schools [6
]. With the exception of games activities for all pupils, the extra-curricular activities commonly offered by schools within the present study were all team-based, competitive sports for a select group of pupils, usually the most skilled. Placing an emphasis on such sports within the provision of extra-curricular PA can mean that many students who would benefit from participation in additional PA are excluded [25
]. Providing fun, non-traditional activities in an environment where young people felt comfortable has been identified as a strategy to engage adolescent females in PA [21
]. Thus, further approaches to providing non-competitive, informal opportunities for PA such as walking should be explored in this target population.
5. Strengths and Limitations of the Study
This study has provided insight into the acceptability of walking and, specifically, a school-based brisk walking programme (the WISH study) both from the perspective of participants involved in the study and from the perspective of post-primary schools who may implement similar interventions in their provision of extra-curricular PA during the school day. The rich, qualitative data generated from the focus group discussions provide detailed insight into the experiences of adolescent females involved in a school-based walking intervention. The survey targeted at staff in post-primary schools is the first to provide detailed information on the provision of non-curricular PA within schools in Northern Ireland, and has highlighted the barriers currently facing schools in relation to the provision of extra-curricular PA. Schools represent a key stakeholder in terms of the provision of PA to adolescents and this survey has provided insight into the potential for schools to further promote PA outside of PE. Comparisons between the responding schools in Phase 2 of the study (survey) and the Northern Ireland average shows that the study sample was representative of the wider post-primary school setting. Furthermore, non-PE members of staff, who were familiar with the schools extra-curricular provision of PA, were asked to complete the questionnaire, to reduce the risk of bias in over-reporting the current provision of extra-curricular PA.
Participants from the WISH study were randomly selected to participate in the focus group discussions to evaluate the intervention; therefore, the views expressed by those selected may not be representative of all participants who participated in the study. In addition, it is possible that participants may not have been completely honest when discussing certain aspects of the intervention, as they wanted to present themselves in a positive light to the researcher. Participants were familiar with the focus group facilitator from previous data collection, which may also have impacted upon the validity of their responses. The response rate from post-primary schools was low (28.4%) despite the use of incentives to promote responses. A lack of information on the response rates of schools to surveys limits comparisons [44
]; however, the response rate within the present survey was comparable with surveys of school staff in relation to other health-related behaviours, for example, the emotional health of adolescents [45
] and online-based surveys conducted in other educational establishments [46