Development and feasibility of an intervention to promote active travel to school

Abstract

Introduction: Active travel to school (ATS) is a source of physical activity for children. Aim: a) Develop an ATS intervention and b) test its feasibility in Year 5 children. Methods: a) Intervention development: Review of ATS and other relevant interventions; review of behaviour change theory; public involvement. Intervention: every ATS day equalled one ticket into a £5 voucher draw. b) Feasibility testing: Cluster-randomised pilot trial in two primary schools with process evaluation. Daily outcome measures: parental ATS reports (optionally by SMS); child ATS reports; accelerometry (moderate-to-vigorous physical activity [MVPA] during journey to school). Results: a) Limited evidence for ATS intervention effectiveness but some evidence for using incentives in health promotion. Twelve theories identified but their utility for ATS intervention development was unclear. Eight families, a head teacher, and a young person’s group supported the development of an ATS incentive scheme. b) Four schools agreed to participate in the study (3.3%) and two were selected, 29 child-parent pairs were recruited (33.0%), and 27 retained for the 9 week study (93.1%). Materials returned on time: accelerometers (81.9%), parental ATS reports (82.1%), and child reports (97.9%). Parent-child agreement on school travel mode was moderate (k=0.53, CI 95% 0.45; 0.60). MVPA differences (minutes) for parent-reported ‘ATS vs non-ATS trips’ were significant, during parent-reported times as corresponding to the school journey (U=390.5, p<0.05; 2.46 (n=99) vs 0.76 (n=13)) and in the pre-classes hour (U=665.5, p<0.05; 4.99 (n=104) vs 2.55 (n=19)). MVPA differences for child-reported ‘ATS vs non-ATS trips’ were also significant, both during parent-reported trip times (U=596.5, p<0.05; 2.40 (n=128) vs 0.81 (n=15)) and the pre-classes hour (U=955.0, p<0.05; 4.99 (n=146) vs 2.59 (n=20)). In a process evaluation, interviewees reported that procedures were generally appropriate. Conclusion: An ATS incentive scheme seems feasible. ATS reports showed validity vis-à-vis accelerometry. Further work is required to improve recruitment.