Physical activity promotion strategies for adolescent girls: exploring experiences, co-design and intervention development

Abstract

Globally, over 80% of adolescent girls aged 11-17 fail to reach the recommended physical activity (PA) guidelines (Sallis et al. 2016). Interventions aiming to increase girls’ PA levels have only demonstrated modest effects (Pearson et al. 2015). This thesis aimed to: (i) conduct a qualitative synthesis of adolescent girls’ perceptions of PA, (ii) assess the feasibility of involving girls in the design of a PA programme, (iii) explore maternal correlates of adolescent girls’ PA and (iv) assess the feasibility of a 6-week mother-daughter multi-component PA programme. Four papers are contained within this thesis. Paper one involved a literature review (n=24 included studies) examining adolescent girls’ perceptions of PA. Findings indicated that girls from the included studies disliked the gendered nature of PA, had issues with low perceived competence levels and experienced competing priorities and expectations during adolescence. This paper informed the development of two behaviour change interventions and a cross-sectional study. Paper two was a feasibility study in a co-educational post-primary school with adolescent girls aged 15-17 years (n=31). The study assessed the feasibility of involving girls in the design of a PA programme, guided by the Behaviour Change Wheel (BCW) (Michie et al. 2011). Successful recruitment, retention, adherence and acceptability rates demonstrated the feasibility of the school-based PA programme. Qualitative data indicated participants enjoyed experiencing “novel” activities (e.g. aerobics) during PE, and providing autonomy led to increased levels of accountability for participation. While schools are frequently used locations for PA promotion, recent evidence has recognised the potential of family-based approaches, but there is a paucity of research investigating this approach with adolescents (Barnes et al. 2018). Therefore, paper three investigated maternal correlates of PA in mothers and adolescent daughters (n=84). Significant correlations were found for daughters’ PA including mothers’ PA, PA parenting practices and mothers’ reports of daughters’ physical well-being (p <0.05). These findings support the involvement of mothers in PA promotion for adolescent girls. Finally, paper four assessed the feasibility of a PA programme for mothers and daughters (n=58). This study followed Orsmond and Cohn’s (2015) objectives for feasibility studies, examining recruitment, data collection, acceptability, resources and participant responses. Positive feasibility metrics and a change in the primary outcome of daily steps indicate the likelihood of intervention success with the intended population. This thesis demonstrates that PA promotion strategies, guided by the BCW, are feasible for adolescent girls. Papers one and two highlight the importance of providing alternative PA opportunities to girls aside from competitive sports. Papers three and four illustrate the potential of family-based PA promotion strategies. The effectiveness of an inter-generational PA programme should be evaluated in a randomised controlled trial (RCT).