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Table 1 Description by stages of the ACTIVITAL strategiesa

From: School-based intervention on healthy behaviour among Ecuadorian adolescents: effect of a cluster-randomized controlled trial on screen-time

INTERVENTION STRATEGIES FOR STAGE 1
  What When /Who/Where Why How
Individual-based strategies One textbook was included in the curriculum: Book 1 The book contained five chapters, and one (chapter2) of them addressed physical activity and TV time. This chapter was developed to be delivered in a lesson of 90 min The content of book was taught from September 2010 - February 2011 Each chapter was taught every two weeks./ School teachers and trained staff/ in the classroom - To introduce the notion that more than 2 h on TV/day is not healthy. - To create awareness regarding the importance of an adequate physical activity throughout adolescence - To increase knowledge and enhance decision making skills The textbooks and pedagogic materials were developed for teachers and students. The textbooks for teachers contained educational objectives, clear instructions for implementing the physical (ludic games) and educational activities during the classes without additional training and theoretical information. The textbooks of adolescents were a workbook and contained theoretical information.
Environment-based strategies Workshop with parents ------------------------------------ One workshop was performed and focused on decreasing TV time and increasing physical activity. The workshop included the distribution of informative leaflets to each participant. Each leaflet included theoretical information, advices and benefits on the particular topic of the workshops The workshops were performed from October 2010 till February 2011/ the ACTIVITAL staff delivered the workshop/in the school meeting room To increase the awareness of parents regarding the importance of decreasing TV time and of regular physical activity for adolescents. - To support healthy behaviour regarding the physical activity and TV time of adolescents at home The parents were summoned through a letter signed by each school principal. The workshop lasted 1 h. ACTIVITAL staff gave a presentation about the main messages during the first 35min of the workshop. Afterwards the parents could ask questions to clarify the messages, and finally the leaflets were distributed.
Social event One pep talk was organized during the intervention/the young athletes were incharge of the pep talks/in the school auditorium To encourage physical activity through the positive influence of social models A 1 hour interactive session with young athletes was organized. Athletes shared their personal sport experiences and gave advice on an active lifestyle and physical activity.
Pep talks were organized in each school. The pep talks had the participation ofsuccessful and well-knownyoung male (n = 3) and female (n = 2) athletes, whowere international young champions in BMX, swimming, racquetball and weight lifting.
Posters for classroom and food tuck shop The poster were suspended monthly from October 2010 to February 2011/the ACTIVITAL staff suspended the poster/on the walls of classroom and food trucksshop - To encourage students to be active and eat healthy Posters including key messages to be active were suspended on the classroom walls and in front of the food tuckshops. Not all poster were suspended on the walls at once: A new poster was suspended on the walls each month.
Five different posters with pictures of young athletes and key messages to promote physical activity and healthy eating behaviours.
INTERVENTION STRATEGIES FOR STAGE 2
Individual-based strategies One textbook was included in the curriculum: Book 2 The book contained 8 chapters in total and one (chapter 8) corresponded to the physical activity. This chapter was focused on how to remove barriers in order to be more physically active. This chapter was planned to be though in 90 min. The lessons were delivered from September 2011-January 2012. Each chapter was taught every two weeks (i.e. 1 lesson every two weeks). /School teachers and trained staff delivered the lessons / in the classroom - To give ideas on how to deal with barriers to be physically active. - To increase knowledge and enhance decision making skills A second set of textbooks and pedagogic materials were developed for teachers and students. The textbooks of teachers contained educational objectives, clear instructions for implementation the physical and educational activities during the classes without additional training and theoretical information. The textbooks of adolescents were workbooks and contained theoretical information.
Environment-based strategies Parental workshops _________________________________ One workshop about dealing with barriers for physical activity was organized. Informative leaflets supporting the content of the workshop were distributed to each participant of workshop The workshops were performed from October 2011 till January 2012 /the ACTIVITAL staff was in charge of the workshop/in the school meeting room - To give ideas on how to deal with barriers to be physically active. - To support healthy behaviour regarding to how to overcome the barriers to be physically active at home Parents’ attendance was mandatory through a letter signed by each school principal The workshop was delivered in 1 hour. Each leaflet included theoretical information, advices and benefits on the particular topic of the workshops.
Walking trail and posters - Using line markings, a walking trail was drawn on the school’s playground. The length of the trail was the perimeter of playground. - 3 posters suspended on the school walls adjacent to the trail, with phrases like: “Do you like to talk? Walk and Talk” The walking trails on each school were implemented on September 2011, and were used between September 2011 – January 2012 until the marks disappear because of the rain/the physical education teachers explained the objective of walking trails to students/on the school’s playground - To increase the availability and accessib ility to opportunities for physical activity inside the schools - To motivate the students to walk more during recess After the walking trail was drawn on the school’s playground, the physical education teacher explained the students about the importance of being physically active and how the students could use the walking trail to be more active during recess.
  1. aThe “ACTIVITAL” trial aimed at improving diet and physical activity. This table only summarizes the physical activity and screen-time components of the trial by stages, which aimed at improving both physical activity and sedentary behaviour. The pedagogic material of ACTIVITAL trial is available on http://ucuenca.edu.ec/la-investigacion/unidades-de-investigaci%C3%B3n/vlir-uos/programas/nuthealth/servicios