Pau te Hau: Curriculum-based high-intensity interval training for young adolescents

INTERVENTION: This cluster‐randomised controlled trial will be conducted within intermediate level schools in Auckland – one low decile (1‐3) and one high decile (8‐10) ‐ in order to determine provisional efficacy and feasibility of delivery in different settings. Total number of participants is therefore expected to be 80‐100 school students subject to recruitment rate. Two classes will be recruited from each school; one will be randomly allocated to HIIT, and the other to a control group who will continue with usual practice Physical Education class delivery. Assessments will be conducted at baseline and post intervention period ( 10 weeks). The primary outcome measure will be aerobic fitness. Secondary outcome measures will include a range of physiological outcomes, body composition, muscular fitness, cognitive function, and psychological wellbeing. Additionally, participants’ attitudes to, and perceptions of exercise will be assessed, and the teachers’ perceptions of their competence and willingness to continue delivery of HIIT will be determined. Teachers will receive resources and a professional development session (with approximately 4 ongoing brief feedback sessions throughout the term) to deliver the intervention, which will consist of brief HIIT sessions to fit within two PE periods per week. The sessions will be designed to be deliverable in a variety of settings such that specialist space is not required, and with minimal, portable equipment. Specific aspects related to Level 4 Health and Physical Education Curriculum in New Zealand will be incorporated into succinct discussions after sessions. Analysis will account for moderators (i.e.., decile, initial fitness level, score on the strengths and difficulties questionnaire, classification of weight status) and relative efficacy. The single pre‐intervention one‐day teacher professional development session and ongoing brief feedback throughout the intervention will contribute towards the 12 practising teacher criteria requirements for maintenance of teacher registration within NZ. They will address the latest evidence on the benefits of HIIT across all outcomes in order to enhance teacher buy‐in and understanding. Importantly, teachers will learn to deliver the HIIT using the SAAFE principles developed by Lubans and colleagues, within an Aotearoa New Zealand context. A written HIIT resource will then be provided to teachers, along with brief videos of exercises to be used. They will also receive a 'class‐pack' of heart rate monitors. Teachers will be encouraged to complete an action plan and identify barriers and solutions to facilitate the integration of HIIT into their PE lessons. WHO The professional development session will be delivered by the research team (all full‐time academic staff members, PhD’s) to the teachers of the intervention class. The HIIT sessions will be delivered by the teachers to the participant students in class. INTERVENTION MODE Teachers will deliver sessions to student participants in class. Members of the research team will deliver the professional development to the intervention class teachers in person. The HIIT sessions delivered by the teachers will be structured to fit within 10‐15 minutes, twice per week, and involve a variety of work to rest ratios based on existing HIIT protocols. Participants will wear heart rate monitors and have their de‐identified heart rate displayed on screen for them to target at least 85% of predicted heart rate maximum as a guideline intensity towards the end of each work phase. Movement concepts and motor skills strand, and achievement objectives: • Movement skills through the process of acquisition of exercise competency • Positive attitudes though the aspects of resilience and perseverance. Brief reflective questions at the end of each HIIT session will prompt critical thinking around the participant’s own relationship with vigorous physical activity and how that evolves over the course of the intervention period. The questions will be developed in conjunction with the teachers. Specific NZ Health and Physical Education Level 4 Curriculum learning area strands, achievement objectives, and key competencies addressed will include: Personal Health and Physical Development strand, and achievement objectives: • Managing self and sense of responsibility for incorporating regular and enjoyable physical activity into personal lifestyle to enhance wellbeing. NUMBER OF TIMES FOR INTERVENTION DELIVERY Over one school term (8‐10 weeks), 16‐20, 10‐15 minute sessions in total will be delivered in class by the teachers. LOCATION All HIIT sessions will be delivered in school (Year 8 level) during usual Physical Education class times. The professional development session will be delivered to the teachers involved with the intervention class at the University facility of the research team. ADHERENCE Will be assessed via recording of class attendance. No strategy will be employed to enhan CONDITION: Aerobic fitness PRIMARY OUTCOME: Aerobic fitness using the PACER multi‐stage fitness test, and also for comparative purposes a sub‐maximal cycle ergometer workload / heart rate relationship test. That is, 1‐3 incremental (35 Watts) stage cycle with heart rate recorded. ; Individual interviews with teachers will be conducted post intervention to determine their impressions and experiences with intervention delivery, and solicit reflective feedback on possible future implementation and sustainability of the HIIT programme in their school. Insulin via blood analysis on a Roche Modular Diagnostics Instrument at the AUT Roche Diagnostics Laboratory. Blood will be drawn via standard venepuncture procedures after an overnight fast by trained and experienced phlebotomists LDL via blood analysis on a Roche Modular Diagnostics Instrument at the AUT Roche Diagnostics Laboratory. Blood will be drawn via standard venepuncture procedures after an overnight fast by trained and experienced phlebotomists Muscular fitness using well‐established procedures: 90° push‐up to failure, a modified pull‐up (supine pull), a body mass squat, and grip strength. Psychological ill‐being. Using the validated Strength and Difficulties Questionnaire. Psychological well‐being: The Warwick‐Edinburgh Mental Wellbeing Scale is a 7‐item questionnaire. Participants respond on a 5‐point scale that best describes the frequency with which they experience thoughts such as "I’ve been feeling optimistic about the future" over the last 2 weeks. Teacher perceptions of competence and willingness to continue the HIIT sessions in futture via interview The International Fitness Scale (IFIS) for youth to determine self‐perceived physical fitness using a 5 question, 5 point scale response survey. This will be used in conjunction with a newly developed six item HIIT self efficacy measure. SECONDARY OUTCOME: Autonomous motivation for exercise using the Behavioural Regulations in Exercise Questionnaire – Version 2 (BREQ‐2) (Markland & Tobin, 2004). The BREQ‐2 includes sub‐scales for intrinsic and identified regulations, and the mean of these sub‐scales is calculated to create an autonomous motivation variable. Body composition (muscle mass, fat, visceral fat mass) using dual‐energy x‐ray absorptiometry (DEXA) and bio‐electrical impedance analysis for comparative purposes. Classroom behaviour. The classroom behaviour questionnaire is a 25‐item questionnaire, divided into 5 sub‐scales with established reliability and validity to be completed by teachers. Executive function: The Trail Making Test (TMT) is a measure of visual attention, speed, scanning, speed of processing and mental flexibility and has been validated in youth. The TMT involves a two part visual task in which participants are required to draw a line from one point to the next as quickly as possible. Lower scores indicate greater cognitive performance, Glucose via blood analysis on a Roche Modular Diagnostics Instrument at the AUT Roche Diagnostics Laboratory. Blood will be drawn via standard venepuncture procedures after an overnight fast by trained and experienced phlebotomists HDL via blood analysis on a Roche Modular Diagnostics Instrument at the AUT Roche Diagnostics Laboratory. Blood will be drawn via standard venepuncture procedures after an overnight fast by trained and experienced phlebotomists In order to specifically address the acceptability of intervention, separate interviews will be conducted with student participants and teachers. ‘Student Voice’ will be heard through small group interviews to be conducted with student participants post intervention period. Focus group discussions are regularly used with children and youth as they are generally more comfortable discussing matters in groups. These group discussions will be semi‐structured with a casual approach that will be adapted for the specific age group targeted to ensure the discussion is more engaging for this cohort. The main focus of these group discussions is to enable the participants to express their views in regards to HIIT itself as well as their views, preferences, and perspectives toward vigorous activity in general and if that changed over the course of the intervention. Discussions will be conducted at the school and will recorded and transcribed verbatim by members of the research team. Transcripts will then be coded and thematically analysed and the key themes identified will be organized into higher and lower level themes. ; ; ; Sanchez‐Lopez M, Martinez‐Vizcaino V, Garcia‐Hermoso A, Jimenez‐Pavon D, Ortega FB. Construct validity and test‐retest reliability of the International Fitness Scale (IFIS) in Spanish children aged 9‐12 years. Scandinavian Journal of Medicine and Science in Sports Total cholesterol via blood analysis on a Roche Modular Diagnostics Instrument at the AUT Roche Diagnostics Laboratory. Blood will be drawn via standard venepuncture procedures after an overnight fast by trained and experienced phlebotomists Triglycerides via blood analysis on a Roche Modular Diagnostics Instrument at the AUT Roche Diagnostics Laboratory. Blood will be drawn via standard venepuncture procedures after an overnight fast by trained and experienced phlebotomists Weight in kg by scale ; INCLUSION CRITERIA: All students in Year 8 able to participate in normal Physical Eduction class activity