Miss Sarah Kennedy

Background: Cardiorespiratory fitness (CRF) is an important marker of current and future health status. The primary aim of our study was to evaluate the impact of a time-efficient school-based intervention on older adolescents' CRF. Methods: Two-arm cluster randomised controlled trial conducted in two cohorts (February 2018 to February 2019 and February 2019 to February 2020) in New South Wales, Australia. Participants (N=670, 44.6% women, 16.0±0.43 years) from 20 secondary schools: 10 schools (337 participants) were randomised to the Burn 2 Learn (B2L) intervention and 10 schools (333 participants) to the control. Teachers in schools allocated to the B2L intervention were provided with training, resources, and support to facilitate the delivery of high-intensity interval training (HIIT) activity breaks during curriculum time. Teachers and students in the control group continued their usual practice. The primary outcome was CRF (20 m multi-stage fitness test). Secondary outcomes were muscular fitness, physical activity, hair cortisol concentrations, mental health and cognitive function. Outcomes were assessed at baseline, 6 months (primary end-point) and 12 months. Effects were estimated using mixed models accounting for clustering. Results: We observed a group-by-time effect for CRF (difference=4.1 laps, 95% CI 1.8 to 6.4) at the primary end-point (6 months), but not at 12 months. At 6 months, group-by-time effects were found for muscular fitness, steps during school hours and cortisol. Conclusions: Implementing HIIT during curricular time improved adolescents' CRF and several secondary outcomes. Our findings suggest B2L is unlikely to be an effective approach unless teachers embed sessions within the school day. Trial registration number: Australian New Zealand Clinical Trials Registry (ACTRN12618000293268).

Introduction: Secondary schools have the potential to promote health-related fitness (HRF) and physical activity within and outside school hours. As such, schools are often chosen as the setting to implement child and adolescent physical activity programs. School-based programs often utilise teachers as delivery agents, but few studies examine effects on teacher-level outcomes. Purpose: The primary aim of this study was to determine the impact of teacher training embedded within a physical activity intervention on teacher-level outcomes. The secondary aim of this study was to evaluate process data, including implementation, satisfaction and fidelity. Methods:Resistance Training for Teens (RT for Teens) was evaluated using a cluster randomised controlled trial in 16 secondary schools. Teachers (N = 44; 48% female/52% male; mean ± SD years teaching experience = 10.6 ± 8.0) from 16 secondary schools were assessed at baseline. Intervention group teachers (i.e. from eight schools) delivered a structured school-based physical activity program over 10-weeks. Teacher outcomes included confidence to teach health-related fitness (HRF) activities, perceived barriers to teaching HRF activities, and perceived fitness. Detailed process evaluation data were also collected. Assessments were conducted at baseline and 6-months (post-program), and outcomes were assessed using repeated measures analysis of variance. Results: There was a positive group-by-time effect for the confidence composite score (p =.010, partial eta squared = 0.29), but no effects for the two (contextual, interpersonal) barrier composite scores. Also, there was a significant effect for perceived ¿general fitness¿ (p = 0.044, partial eta squared = 0.13), but not for specific fitness subdomains. Teachers were highly satisfied with both the training and the program, believing it was beneficial for students. Resource usage and adherence to the SAAFE (Supportive, Active, Autonomous, Fair, Enjoyable) delivery principles was high. Conclusion:RT for Teens improved teachers¿ confidence and perceived fitness. These findings highlight the potential for high-quality teacher training and program delivery to positively influence teacher-level outcomes. This may provide support for the use of teacher professional development to improve HRF-related pedagogy.

Objective: To evaluate the effectiveness of interventions targeting alcohol consumption, drug use and smoking for college/university students.Participants: College/University students.Methods: Studies were eligible if: (1)included students attending universities/colleges; (2)implemented in a university/college setting; (3)aimed to improve at least one of the following behaviors: alcohol and/or drug use and/or smoking; (4)were RCTs. The effect of the interventions on behaviors was determined by the percentage of studies that reported an effect. Due to the heterogeneity of outcomes meta-analysis was not conducted.Results: 88 studies met criteria. University-based interventions were effective for reducing alcohol-related outcomes (drinking patterns, BAC, consequences, problem drinking). Inconsistent findings for drug and smoking were observed.Conclusions: University-based interventions have the potential to improve health for students. While there is a breadth of research examining the efficacy of interventions to reduce alcohol consumption, further research is needed to determine the best approach for addressing smoking and drug use among students.

Purpose: Guidelines recommend that young people engage in muscle-strengthening activities on at least 3 dIwkj1. The purpose of this study was to examine the effect of a school-based intervention focused on resistance training (RT) for adolescents. Methods: The ''Resistance Training for Teens'' intervention was evaluated using a cluster-randomized, controlled trial with 607 adolescents (50.1% girls; 14.1 T 0.5 yr) from 16 secondary schools. Teachers were trained to deliver the intervention, which included the following: (i) an interactive student seminar; (ii) a structured physical activity program, focused on RT; (iii) lunchtime fitness sessions; and (iv) Web-based smartphone apps. The primary outcome was muscular fitness (MF) and secondary outcomes included body mass index, RT skill competency, flexibility, physical activity, self-efficacy, and motivation. Assessments were conducted at baseline, 6 months (postprogram; primary end point), and 12 months (follow-up). Outcomes were assessed using linear mixed models, with three potential moderators tested using interaction terms (and subgroup analyses where appropriate). Results: For the primary outcome (MF), a group-time effect was observed at 6 months for the upper body (2.0 repetitions; 95% confidence interval (CI), 0.8-3.2), but not the lower body (j1.4 cm; 95% CI, j4.7-1.9). At 6 months, there were intervention effects for RT skill competency and self-efficacy, but no other secondary outcomes. Effects for upper body MF and RT skill competency were sustained at 12 months. Despite overall no effect for body mass index, there was a group-time effect at 12 months among students whowere overweight/obese at baseline (j0.55 kgImj2; 95% CI, j1.01 toj0.08). Conclusions: The school-based RT intervention resulted in immediate and sustained improvements in upper body MF and RT skill competency, demonstrating an effective and scalable approach to delivering RT within secondary schools.

Objective: To examine the impact of a school-based physical activity intervention on adolescents' self-esteem and subjective well-being, and to explore moderators and mediators of intervention effects. Methods: Resistance Training for Teens was evaluated using a cluster RCT in 16 schools located in New South Wales, Australia. Adolescents (N = 508; 14.1 ± 0.5 years; 49.6% female) completed measures of global self-esteem, subjective well-being, and hypothesized mediators (i.e., perceived fitness, resistance training self-efficacy, and autonomous motivation) at baseline (April¿June, 2015) and post-intervention (October¿December). The school-based physical activity program was delivered by teachers over 10-weeks via Physical Education, co-curricular school sport, or an elective subject known as Physical Activity and Sport Studies, and involved once-weekly fitness sessions and additional lunch-time sessions. Intervention effects and moderator analyses were tested using multi-level linear regression analyses with interaction terms. Multi-level mediation analyses were used to explore potential mediators of changes in well-being outcomes. Results: Intervention effects for self-esteem (ß = 0.05, p =.194) and wellbeing (ß = 0.03, p =.509) were not statistically significant. Moderator analyses showed effects for self-esteem were greater for the overweight/obese subgroup (p =.069 for interaction), and resistance training self-efficacy was a significant mediator of changes in self-esteem (product-of-coefficients [AB] = 0.021, SE = 0.010, 95% CIs = 0.002 to 0.040). No other significant indirect effects were observed. Conclusion: Overall, Resistance Training for Teens did not improve adolescents' self-esteem or subjective well-being. However, our mediation findings lend support to resistance training self-efficacy as a mechanism explaining the positive effect of resistance training on self-esteem.

The aim of this study is to examine the prevalence and correlates of adolescents¿ resistance training (RT) skill competence. Participants were 548 adolescents (14.1¿±¿0.5¿years) from 16 schools in New South Wales, Australia. RT skills were assessed using the Resistance Training Skills Battery. Demographics, BMI, muscular fitness, perceived strength, RT self-efficacy, and motivation for RT were also assessed. The proportion demonstrating ¿competence¿ and ¿near competence¿ in each of the six RT skills were calculated and sex differences explored. Associations between the combined RT skill score and potential correlates were examined using multi-level linear mixed models. Overall, the prevalence of competence was low (range¿=¿3.3% to 27.9%). Females outperformed males on the squat, lunge and overhead press, whereas males performed better on the push-up (p¿<.05). Significant associations were seen for a number of correlates, which largely differed by sex. Muscular fitness was moderately and positively associated with RT skills among both males (ß¿=¿0.34, 95%CIs¿=¿0.23 to 0.46) and females (ß¿=¿0.36, 95%CIs¿=¿0.23 to 0.48). Our findings support a link between RT skills and muscular fitness. Other associations were statistically significant but small in magnitude, and should therefore be interpreted cautiously.

Objective Regular participation in resistance training (RT) is critical to health and recommended in most international physical activity guidelines. Few people, however, participate in RT. The purpose of this review was to assess the demographic, behavioural, intrapersonal, interpersonal and environmental factors associated with participating in RT. Data sources Eligible studies were from English peer-reviewed published articles that examined correlates or determinants of RT in adult samples. Searches were performed from August 2015 to April 2016 in six databases. Results We identified 51 independent data sets, from nine countries, primarily of moderate to high quality, and 23 factors related to participating in RT. Education, perceived health status, quality of life, affective judgements, self-efficacy, intention, self-regulation behaviours, subjective norm and programme leadership were associated with RT. Conclusion Low education levels and poor health status were associated with low participation rates in RT. Intrapersonal factors including affective judgements, self-efficacy, and self-regulation behaviours, and interpersonal factors including subjective norms and programme leadership may be important for promoting RT behaviours.

Current physical activity and fitness levels among adolescents are low, increasing the risk of chronic disease. Although the efficacy of high intensity interval training (HIIT) for improving metabolic health is now well established, it is not known if this type of activity can be effective to improve adolescent health. The primary aim of this study is to assess the effectiveness and feasibility of embedding HIIT into the school day. A 3-arm pilot randomized controlled trial was conducted in one secondary school in Newcastle, Australia. Participants (n= 65; mean age = 15.8(0.6) years) were randomized into one of three conditions: aerobic exercise program (AEP) (n = 21), resistance and aerobic exercise program (RAP) (n = 22) and control (n = 22). The 8-week intervention consisted of three HIIT sessions per week (8-10. min/session), delivered during physical education (PE) lessons or at lunchtime. Assessments were conducted at baseline and post-intervention to detect changes in cardiorespiratory fitness (multi-stage shuttle-run), muscular fitness (push-up, standing long jump tests), body composition (Body Mass Index (BMI), BMI-z scores, waist circumference) and physical activity motivation (questionnaire), by researchers blinded to treatment allocation. Intervention effects for outcomes were examined using linear mixed models, and Cohen's d effect sizes were reported. Participants in the AEP and RAP groups had moderate intervention effects for waist circumference (p = 0.024), BMI-z (p = 0.037) and BMI (not significant) in comparison to the control group. A small intervention effect was also evident for cardiorespiratory fitness in the RAP group.

To examine the effectiveness of interventions aimed at improving physical activity, diet, and/or weight-related behaviors amongst university/college students. Five online databases were searched (January 1970 to April 2014). Experimental study designs were eligible for inclusion. Data extraction was performed by one reviewer using a standardized form developed by the researchers and checked by a second reviewer. Data were described in a narrative synthesis and meta-analyses were conducted when appropriate. Study quality was also established. Forty-one studies were included; of these, 34 reported significant improvements in one of the key outcomes. Of the studies examining physical activity 18/29 yielded significant results, with meta-analysis demonstrating significant increases in moderate physical activity in intervention groups compared to control. Of the studies examining nutrition, 12/24 reported significantly improved outcomes; only 4/12 assessing weight loss outcomes found significant weight reduction. This appears to be the first systematic review of physical activity, diet and weight loss interventions targeting university and college students. Tertiary institutions are appropriate settings for implementing and evaluating lifestyle interventions, however more research is needed to improve such strategies.