Rationale, study protocol and baseline findings from the NEAT and ATLAS 2.0 cluster randomised controlled trial and dissemination study

Background: Physical inactivity has been described as a global pandemic. Schools can provide students with the skills and knowledge to maintain lifelong physical activity habits. However, traditional school-based physical activity programs often focus on competitive team games. Interventions aimed at developing skills in lifelong physical activities may provide the foundation for an active lifestyle into adulthood. This study aims to assess the effectiveness of two physical activity promotion programs (i.e., NEAT and ATLAS) that have been modified for scalability. The second aim is to evaluate the dissemination of these programs throughout government funded secondary schools in New South Wales (NSW). Methods: In the first phase, the 10-week, modified NEAT and ATLAS interventions will be evaluated using a cluster randomised controlled trial involving 16 schools. Teachers were trained to deliver the modified NEAT and ATLAS programs, which includes: (i) interactive student seminars; (ii) structured physical activity programs; (iii) lunchtime fitness sessions; and (iv) web-based smartphone apps. Gender sensitive versions of the four intervention components were developed for girls (NEAT) and boys (ATLAS). Both the NEAT and ATLAS interventions include five evidence-based physical activity and nutrition messages, modified from the original interventions: (i) Move whenever you can; (ii) Get some vigorous physical activity on most days; (iii) Limit your recreational screen time; (iv) Avoid sugary drinks; and (v) Limit ‘sometimes’ foods. Study outcomes were assessed at baseline and 6-months (primary endpoint). Follow-up assessments will be conducted after 12-months. Muscular fitness is the primary outcome and secondary outcomes include: body composition, cardiorespiratory fitness, flexibility, resistance training skill competency and physical activity. Self-reported outcomes include recreational screen-time, sleep, sugar-sweetened beverage and junk food snack consumption, self-esteem, and well-being. In the second phase, the RE-AIM framework will be used to guide the design and evaluation of program dissemination throughout NSW, Australia. Results: A total of 607 adolescents (50.1% female; aged 14.13 ± 0.46) were recruited. At baseline, 27.5% of participants were overweight/obese/morbidly obese, 8.3% were meeting PA guidelines (60 min of MVPA on all days), and 39.2% were meeting screen-time guidelines (less than 2 h per day). Discussion: In general, school-based physical activity interventions targeting adolescents have produced modest results and few have been designed to be ‘scaled-up’ and disseminated. This study will provide evidence for the scalability of the NEAT and ATLAS interventions, and the extent to which the programs can become routine organisational practices within schools.

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