Features of effective staff training programmes within school-based interventions targeting student activity behaviour: a systematic review and meta-analysis.
The international journal of behavioral nutrition and physical activity 2022 ; 19: 125.
PubMed ID : 36153617
Evaluations of school-based activity behaviour interventions suggest limited effectiveness on students' device-measured outcomes. Teacher-led implementation is common but the training provided is poorly understood and may affect implementation and student outcomes. We systematically reviewed staff training delivered within interventions and explored if specific features are associated with intervention fidelity and student activity behaviour outcomes.
We searched seven databases (January 2015-May 2020) for randomised controlled trials of teacher-led school-based activity behaviour interventions reporting on teacher fidelity and/or students' device-measured activity behaviour. Pilot, feasibility and small-scale trials were excluded. Study authors were contacted if staff training was not described using all items from the Template for Intervention Description and Replication reporting guideline. Training programmes were coded using the Behaviour Change Technique (BCT) Taxonomy v1. The Effective Public Health Practice Project tool was used for quality assessment. Promise ratios were used to explore associations between BCTs and fidelity outcomes (e.g. % of intended sessions delivered). Differences between fidelity outcomes and other training features were explored using chi-square and Wilcoxon rank-sum tests. Random-effects meta-regressions were performed to explore associations between training features and changes in students' activity behaviour.
We identified 68 articles reporting on 53 eligible training programmes and found evidence that 37 unique teacher-targeted BCTs have been used (mean per programme = 5.1 BCTs; standard deviation = 3.2). The only frequently identified BCTs were 'Instruction on how to perform the behaviour' (identified in 98.1% of programmes) and 'Social support (unspecified)' (50.9%). We found moderate/high fidelity studies were significantly more likely to include shorter (≤6 months) and theory-informed programmes than low fidelity studies, and 19 BCTs were independently associated with moderate/high fidelity outcomes. Programmes that used more BCTs (estimated increase per additional BCT, d: 0.18; 95% CI: 0.05, 0.31) and BCTs 'Action planning' (1.40; 0.70, 2.10) and 'Feedback on the behaviour' (1.19; 0.36, 2.02) were independently associated with positive physical activity outcomes (N = 15). No training features associated with sedentary behaviour were identified (N = 11).
Few evidence-based BCTs have been used to promote sustained behaviour change amongst teachers in school-based activity behaviour interventions. Our findings provide insights into why interventions may be failing to effect student outcomes.
PROSPERO registration number: CRD42020180624.
The majority of children and adolescents worldwide are not physically active enough to maintain good health. Schools have the potential to effect large-scale positive change. Accordingly, they have been the focus of the majority of government policies and research-led intervention programmes aiming to increase young people’s physical activity. However, the best available evidence suggests that these policies and programmes have largely failed to achieve their desired outcomes and reasons for this are poorly understood.
We know that the success of these programmes is often dependent on behaviour change by key actors in students’ lives, including teachers. For example, teachers may be asked to implement a new sports programme or ‘active’ lesson, which aims to increase students’ physical activity. To facilitate this process, teachers are frequently provided with training, the broad aim of which is to change their practice. Little is known about the training they receive, and if and how this effects their professional practice and student programme outcomes.
To investigate this, we reviewed evidence from 51 randomised controlled trials to determine what staff training has been provided within school-based programmes aiming to increase students’ physical activity and explored if specific training features are associated with professional change and desired student outcomes. We included studies conducted in 19 countries; each study included an average of 14 schools and 779 students.
Overall, we found that the majority of training provided to school staff within these programmes was not based on relevant literature about teacher professional development. These findings provide insights into why these programmes may be failing to change professional practice and student outcomes. We were also able to identify specific training features associated with programme success. For example, we found that teachers enrolled onto training where they had an opportunity to practice the new teaching technique or lesson and were provided with evaluative feedback, were more likely to deliver the programme to students as intended.
This study advances our understanding of how programmes have been implemented in practice to date, and provides detailed guidance to support the success of future school-based programmes aiming to promote physical activity.