Nutrition and Enjoyable Activity for Teenage Girls

INTERVENTION: This study will evaluate the Nutrition and Enjoyable Activity for Teenage Girls (NEAT Girls) program, which is a 12‐month school‐based physical activity and dietary intervention for low‐active adolescent girls from economically disadvantaged secondary schools. The program will provide students with an opportunity to increase their knowledge, skills and attitudes toward physical activity and nutrition. The NEAT Girls program was developed in reference to Bandura's Social Cognitive Theory and will target the following mediators of behaviour change: self‐efficacy, social support, personal regulation of health behaviour, environmental perceptions, outcome expectations and expectancies. The intervention will include the following components: (i) School sport physical activity sessions: An enhanced school sport program will be delivered during timetabled school sport (90 minutes/week x 40 weeks). During these sessions, students will participate in enjoyable lifetime activities (e.g. Pilates, yoga, aerobics, resistance training, dance, and boxing fitness) that aim to provide novel physical activity experiences not normally provided during physical education or school sport. The lifetime activity sessions will focus on fun, peer support and development of knowledge and skills around physical activity and fitness. A didactic component of the school sport sessions will deliver key messages and strategies for being physically active and healthy eating. These messages will focus on a revised version of the 10 key physical activity and nutrition messages from the successful pilot study Program X (eg. “Aim to eat 2 servings of fruit and 5 servings of vegetables each day”, “Regular physical activity is easier to achieve when you plan to participate with a friend or family member”). (ii) Lunchtime physical activity sessions: These sessions (30 minutes) will also have a lifetime activity focus and will be scheduled to follow on from the weekly school sport session for three school terms. The aim of these sessions is to encourage study participants to become “Physical Activity Leaders” in their school by taking ownership of the 30 minute weekly workouts. Study girls will be encouraged to run these sessions and invite their friends and younger peers to participate, thereby becoming physical activity role‐models. Specific leadership challenges and tasks will provide study participants with an opportunity to achieve a “physical activity leader” accreditation within the school. (iii) Interactive seminars: Three informational seminars will be delivered during the 12‐month intervention period. The first seminar will introduce key messages and strategies for being physically active and healthy eating at the beginning of the intervention. The second seminar will occur mid‐intervention and will have a “physical activity leaders” focus to complement the aim of the lunchtime physical activity sessions. The final seminar will take place at the conclusion of the intervention and will review key physical activity and dietary messages from the intervention. (iv) Pedometers for physical activity monitoring: Participants will be provided with pedometers to use as a motivational tools. A number of individual and group challenges that encourage goal‐setting and physical activity by using the pedometers will be organised throughout the intervention period (eg. group challenges through step‐count or distance accumulation over a set period of time). CONDITION: Low physical self‐esteem Obesity physical inactivity Poor dietary behaviours (v) Text messaging – Participants will be provided with social support for physical activity and healthy eating using automated text messaging. Messages will be provided by the research team and will reinforce key messages from the information sessions and provide encouragement for healthy behaviours. For individuals who do not have a phone that can receive text messages, the same information will be distributed via email, which can be accessed at the school. (vi) Parent newsletters: Parents will be provided with monthly newsletters for a period of 12‐months which aim to reinforce key messages and strategies delivered to students during information sessions, and encourage family support in the home environment for healthy eating and physical activity. PRIMARY OUTCOME: Body mass index (BMI). Height and weight ‐ will be measured to using a portable scale and stadiometer. Fat mass and fat‐free mass ‐ will be determined using the Tanita BC‐418MA Segmental Body Composition analyser. SECONDARY OUTCOME: Dietary behaviours ‐using the Australian Child and Adolescent Eating Survey (Watson et al, 2009). Health related fitness‐ core abdominal strength and upper‐body strength will be assessed by using the prone hold assessment and timed push‐up test respectively. Mediators of physical activity and dietary behaviour change‐ a questionnaire will be used to assess the following‐ physical activity and nutrition self‐efficacy, social support for physical activity and healthy eating, physical activity and nutrition intentions, physical activity and nutrition outcome expectations and expectancies, behavioural strategies for physical activity and healthy eating, environmental perceptions of the physical activity and nutrition environments. ; The questionnaires were developed for the current study. Physical activity using accelerometers (MTI model 7164 and GT1M) Physical self‐perception ‐ will be assessed using scales from the Physical Self‐Description Questionnaire (Marsh, Richards, Johnson, Roche, & Temayne, 1994). Sedentary behaviours‐ will be assessed using the Adolescent Sedentary Activity Questionnaire (Hardy, Booth & Okely, 2007). INCLUSION CRITERIA: Adolescent girls in Year 8 (age 12‐15) attending a secondary school in areas of low‐socioeconomic status (SES). Schools will be classified as low‐SES based on having a Socio‐Economic Indexes for Areas (SEIFA) of less than or equal to 5. Girls will be identified as low‐active by physical education teachers at the study schools.