Effectiveness of the intervention Alle Leerlingen Actief! to motivate inactive students to become physically active.

Alle Leerlingen Actief! (ALA), developed by the Dutch Institute for Sport and Physical Activity (NISB), is a
school-based intervention to motivate inactive students to become physically active, with motivational
interviewing combined with efforts to create a supportive school environment as most important features.
Up till now, most school-based interventions focus on entire classes or specific age groups. ALA
consists of a unique combination of motivational interviewing and an environmental approach. As such it
targets high-risk individuals rather than groups, as well as promoting the sport- and activity-friendliness
of the school environment. The intervention consists of a series of motivational interviews between
individual students of secondary schools and trained teachers. Based on the promising pilot results from
3 secondary schools, in which ALA’s effectiveness was preliminary assessed, NISB considers
nationwide implementation of ALA. Therefore, sound evidence on its effectiveness as well as indications
on the costs (in terms of time and funds invested) associated with the intervention is needed.

The research design to study the effectiveness of ALA is a randomized waiting-list-controlled design,
with randomization at school level (i.e. intervention schools and control schools). Outcomes will be
assessed in students, trained teachers and schools. The main utcomes that will be assessed among the
students include: physical activity behaviour (i.e., number of days per week engaged in 60 minutes of at
least moderate intensity physical activity) and the intrinsic motivation towards sports and physical
activity. Outcomes that will be assessed among the teachers include: the frequency, duration and setting
of the counselling sessions with the students and the students’ stage of change toward sports and
physical activity as noted by the teacher in each counselling session. Outcomes that will be assessed at
the school level include: the school policy on physical activity and sports, and the social and physical
environment in and around school.
The outcomes of intervention schools will be compared with the outcomes of control schools using
multilevel analyses. Questionnaires measuring these outcomes will be completed at the beginning,
middle and end of the school year.
This project will be conducted by TNO Quality of Life in close collaboration with NISB, Maastricht
University and The Hague University.

Alle Leerlingen Actief! (ALA) works both on the intrinsic motivation of inactive students to become more
physically active, as it promotes the activity-friendly environment in and around schools. Motivational
interviewing techniques will be used to achieve a sustained behavioural change toward sports and
physical activity, and attitude towards this topic.

1. To verify the effectiveness of the intervention ALA, the
first objective of this study is to investigate if ALA achieves an increase in physical activity in daily life in the inactive or semi-inactive group of students, as determined by the four stages (active, semi-active,
semi-inactive, inactive) of the national guideline of physical activity, the Dutch Exercise Health Standard
(NNGB).

Corresponding research question: Does ALA lead to a significant improvement of the physical activity pattern in the participating inactive
students?


2. The second objective of this study is to achieve, together with the actual behavioural change, a positive
change in intrinsic motivation to increase physical activity.

Corresponding research question:
Does ALA lead to a significant improvement of the intrinsic motivation in the participating inactive
students to increase physical activity.


3. Besides the suggested intrinsic motivational and behavioural effect on an individual level, ALA tries to
positively influence the social and physical environment. The sports minded nature at the administrative
level should be embedded in the local school policy. Therefore, the third objective of this study is to
assess if and to what extent ALA affects the school environment and thus creates a safe and supportive
setting to start physical activity for the inactive.
Corresponding research question:
Does ALA lead to a significant positive change of the social and physical environment in and around
school?


4. The last objective of this study deals with indications on the costs (in terms of time and funds invested)
for schools when implementing the intervention ALA.

The decision regarding funding of the current proposal is expected in June 2009. Project activities will
subsequently start in October/November 2009 (recruitment of schools, training of participating teachers,
preparation and pre-testing of measurements, etc). The intervention is scheduled to take place in the
school year 2010/2011; as a result the data from the follow-up measure of the intervention are expected
to be available for analyses in September 2011. Data analyses and presentation (e.g., in draft articles
and oral presentations for the (inter)national scientific community) will be completed in March 2012.
Evidently, the effectiveness data will be provided to NISB and the rest of the community as soon as they
are complete.

Alle Leerlingen Actief! (ALA), developed by the Dutch Institute for Sport and Physical Activity (NISB), is a
school-based intervention to motivate inactive students to become physically active, with motivational
interviewing combined with efforts to create a supportive school environment as most important features.
Up till now, most school-based interventions focus on entire classes or specific age groups. ALA
consists of a unique combination of motivational interviewing and an environmental approach. As such it
targets high-risk individuals rather than groups, as well as promoting the sport- and activity-friendliness
of the school environment. The intervention consists of a series of motivational interviews between
individual students of secondary schools and trained teachers. During these motivational interviews students are motivated to participate in sports or other forms of exercise. Therefore, teachers or supervisors will contact single individual students by performing motivational interviews. The duration of the intervention is one school year with 10 to approximately 15 motivational interview meetings between teacher and the individual student. Parents will also be contacted.

The effectiveness of ALA will be studied using a randomized waiting-list controlled design.
The intervention is proposed to affect participating individual students as well as their school environment. To avoid contamination of study groups, randomization will therefore take place at the school level. The intervention will be tested for a period of one school year; after this period the waiting-list-control schools will be allowed to start with the intervention. Twenty schools will be recruited from the total sample of secondary schools in The Netherlands. The control schools will receive care as usual.