Purpose: Adolescents spend the majority of the day sedentary, especially at school whilst sitting in class. As excessive sedentary behaviour is associated with adverse health indicators in adolescents, effective interventions are needed. To improve effectiveness, literature recommends participatory action research (PAR) in which end-users (i.e. adolescents) and stakeholders (i.e. teachers) are actively involved in the development, implementation and evaluation of the intervention. To structure this participatory process, an evidence-based systematic approach like the Intervention Mapping Protocol (IMP) is suggested. This study aimed to describe how PAR and the IMP were combined to develop an intervention to reduce adolescents’ sedentary behaviour at school and during school-related tasks at home, together with adolescents and teachers. Secondly, the participatory process will be evaluated from pupils’, teachers’ and the researchers’ perspectives.

Methods: A secondary school in Belgium has been recruited, in which one class from the 7th grade is selected as the pupils’ participatory group. Three teachers from the 7^th or 8^th grade will form a second participatory group. The IMP will be run through during weekly sessions with the pupils’ participatory group and biweekly sessions with the teachers’ participatory group (November 2021-February 2022). To evaluate the participatory process, 4 focus groups will be conducted with both participatory groups at four time points during the development process. In addition, the researchers will complete a reflection form after each session. The focus groups will be audiotaped and all data will be processed using a thematic approach in NVivo.

Results: How PAR and the IMP were combined and how we planned and conducted these sessions, will be presented at the conference. Further, we expect that the participatory process will lead to increased empowerment and ownership by pupils and teachers from the participatory groups. The role of the researcher and reflections on the process will be discussed as well.

Conclusion: This study will lead to an intervention to reduce sedentary behaviour at school and during school-related tasks at home, developed via an active collaboration between pupils, teachers and researchers. Therefore, this study can provide guidance to researchers planning to conduct participatory research.

Background: Sleep deprivation and reduced sleep quality are common in adolescents, which negatively impacts their physical and mental wellbeing and cognitive skills. This study examined the effect of a participatory developed intervention to promote healthy sleep in adolescents on their sleeping behavior and behavioral and cognitive determinants of sleep.

Methods: By combining Participatory Action Research with the Intervention Mapping Protocol, a sixteen week long intervention focusing on healthy sleep, regular sleep patterns, screen time, physical activity, nutrition and relaxation was co-created with adolescents and implemented in two intervention schools. Four schools participated to the study as control schools by taking part in the measurements. Data on sleep behavior and its determinants were collected in 1181 adolescents (15.0 ± 0.7 year; 54% boys) through a validated questionnaire using a pre-post-follow-up design. Repeated measures (M)ANCOVA analysis was performed in SPSS.

Findings: Between pre and post measurements, no significant intervention effects were found on adolescents’ sleep duration and quality, but a few effects were found on determinants of sleep. There were favorable intervention effects on adolescents’ knowledge of importance of sleep and sleep hygiene (F=13.44; p<0.001), physical activity on weekdays (F=5.14; p=0.024), regular sleep patterns on days off (F=5.11; p=0.024) and taking screens to bed (F=6.67; p=0.010). The intervention had an unfavorable effect on self-efficacy towards screen use in the evening (F=10.84; p=0.001) and perceived sleep behaviors of parents (F=4.05; p=0.044). Analysis of the data on follow-up measurements is still ongoing but will be finished by November 2021.

Conclusion: The intervention had some favorable effects on determinants of sleep on the short term but no effects on sleep behavior. However, long term effects still need to be investigated. It should further be explored to what extent the intervention has been properly implemented and has reached all adolescents. A different research design, such as adding a third arm to the study with a standard non-participatory developed intervention would be an added value to evaluate the true added value of developing an intervention via a participatory approach.

Background

Participatory action research (PAR) is by its nature locally situated meaning that it is grounded in the reality of daily life and work in a specific place and time [1]. This leads to the question to which extent a previously developed protocol for conducting PAR with children from deprived neighborhoods in Amsterdam, the Netherlands, can be transferred to the context of Zaragoza, Spain.

Methods

As part of the GrowH! study [2], we adapted the PAR-protocol that was implemented in the Kids in Action project to be transferred to the context of Zaragoza, Spain. Within the Kids in Action project (2016-2019), a detailed practical protocol was created, explaining the content of the overall project and all participatory meetings with 9-12-year-old children [3]. We adapted this protocol based on 1) lessons learned from the Kids in Action project; 2) insights from recent literature/work in this field; and 3) contextual factors specific for the Spanish context. This resulted in a practical protocol for the Chic@s in Acción project in Zaragoza, which will be implemented from November 2021.

To evaluate whether the adaptations to the PAR-protocol are adequate, we will monitor the process of implementing the adapted PAR-protocol by critically reflecting on the PAR meetings that will be held with 9-11-year-old children in Zaragoza. We will track all adaptations throughout the implementation process and adjust the adapted protocol where necessary.

Results

In this symposium we will present the (preliminary) findings of the evaluation of implementing the adapted PAR-protocol in Zaragoza: we will present the final adapted PAR protocol and subsequently discuss which adaptations were made to translate the protocol to the context of Zaragoza.

Conclusions

This presentation will provide insight in which aspects of the Kids in Action protocol need translation when applying to another context.

References

[1] International Collaboration for Participatory Health Research (ICPHR) (2013). Position Paper 1: What is Participatory Health Research?

[2] https://www.growh.eu/

[3] Anselma M, Altenburg TM, Chinapaw MJM (2019). Kids in Action: the protocol of a Youth Participatory Action Research project to promote physical activity and dietary behaviour. BMJ Open. 9(3): e025584.