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Introducing physically active lessons in UK secondary schools: feasibility study and pilot cluster-randomised controlled trial
  1. Catherine Gammon1,
  2. Katie Morton1,
  3. Andrew Atkin1,2,
  4. Kirsten Corder1,
  5. Andy Daly-Smith3,
  6. Thomas Quarmby3,
  7. Marc Suhrcke4,5,
  8. David Turner6,
  9. Esther van Sluijs1
  1. 1 MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
  2. 2 Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
  3. 3 Carnegie School of Sport, Leeds Beckett University, Leeds, UK
  4. 4 Centre for Health Economics, University of York, York, UK
  5. 5 Luxembourg Institute of Socio-Economic Research, (LISER), Esch-sur-Alzette/Belval, Luxembourg
  6. 6 Norwich Medical School, University of East Anglia, Norwich, UK
  1. Correspondence to Dr Esther van Sluijs; ev234{at}


Objectives Assess feasibility, acceptability and costs of delivering a physically active lessons (PAL) training programme to secondary school teachers and explore preliminary effectiveness for reducing pupils’ sedentary time.

Design and setting Secondary schools in East England; one school participated in a pre-post feasibility study, two in a pilot cluster-randomised controlled trial. In the pilot trial, blinding to group assignment was not possible.

Participants Across studies, 321 randomly selected students (51% male; mean age: 12.9 years), 78 teachers (35% male) and 2 assistant head teachers enrolled; 296 (92%) students, 69 (88%) teachers and 2 assistant head teachers completed the studies.

Intervention PAL training was delivered to teachers over two after-school sessions. Teachers were made aware of how to integrate movement into lessons; strategies included students collecting data from the environment for class activities and completing activities posted on classroom walls, instead of sitting at desks.

Primary and secondary outcomes Quantitative and qualitative data were collected to assess feasibility and acceptability of PAL training and delivery. Outcomes were assessed at baseline and ~8 weeks post-training; measures included accelerometer-assessed activity, self-reported well-being and observations of time-on-task. Process evaluation was conducted at follow-up.

Results In the feasibility study, teachers reported good acceptability of PAL training and mixed experiences of delivering PAL. In the pilot study, teachers’ acceptability of training was lower and teachers identified aspects of the training in need of review, including the outdoor PAL training and learning challenge of PAL strategies. In both studies, students and assistant head teachers reported good acceptability of the intervention. Preliminary effectiveness for reducing students’ sedentary time was not demonstrated in either study.

Conclusions No evidence of preliminary effectiveness on the primary outcome and mixed reports of teachers’ acceptability of PAL training suggest the need to review the training. The results do not support continuation of research with the current intervention.

Trial registration number ISRCTN38409550.

  • active lessons
  • movement integration
  • physical activity
  • sedentary time
  • school health

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  • Contributors All authors (CG, KM, AA, KC, AD-S, TQ, MS, DT and ES) contributed to the conceptualisation and design of the work, and reviewed and approved the final manuscript. CG, DT and ES contributed to the acquisition, analysis and interpretation of data. CG drafted the manuscript.

  • Funding The Creating Active School Environments project is a 3-year programme of research funded by the Department of Health Policy Research Programme (PR-R5-0213-25001). This report is based on independent research commissioned and funded by the NIHR Policy Research Programme (opportunities within the school environment to shift the distribution of activity intensity in adolescents; PR-R5-0213-25001). EvS is supported by the Medical Research Council [MC_UU_12015/7].

  • Disclaimer The views expressed in the publication are those of the author(s) and not necessarily those of the NHS, the NIHR, the Department of Health, ‘arms’ length bodies or other government departments.

  • Competing interests None declared.

  • Ethics approval Ethical approval for both studies was granted by the University of Cambridge’s School of the Humanities and Social Sciences.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The datasets are not available for download. The study’s participant information sheets and ethics applications stipulated that the data would not be shared outside of the research team. The data are held at the MRC Epidemiology Unit at the University of Cambridge.

  • Patient consent for publication Not required.

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