The Effect of a School-Based Intervention on Physical Activity and Well-Being: a Non-Randomised Controlled Trial with Children of Low Socio-Economic Status.

Stephen Shannon, Deirdre Brennan, Donncha Hanna, Zoe Younger, Jessica Hassan, Gavin Breslin

Research output: Contribution to journalArticle

Abstract

Background: Self-Determination Theory (SDT) has been used to predict children’s physical activity and well-being. However, few school-based SDT intervention studies have been conducted, and no research exists with children of low socio-economic status (SES). Therefore, SDT-derived needs-supportive teaching techniques informed the design and analyses of the Healthy Choices Programme (HCP). The aim was to determine if the HCP could enhance moderate-to-vigorous physical activity (MVPA) and well-being among children of low SES through increasing autonomy-support, needs satisfaction and intrinsic motivation. Method: A mixed factorial two (group) x two (time) wait-list controlled trial was conducted, and reported using the TREND guidelines. A total of 155 children (56% females; intervention n=84, control n=71) took part and completed measures at baseline (week 0) and post-intervention (week 11). The effect of the intervention on MVPA (Model 1) and well-being (Model 2) was tested through serial mediation models with three mediators (i.e. autonomy-support, needs satisfaction and intrinsic motivation). Results: In comparison to the control group, the intervention was related to increases in MVPA (β=.45) and autonomy-support (β=.17). In Model 1, analyses revealed partial mediation of the MVPA change through autonomy-support (β=.14), intrinsic motivation (β=.51), and all three SDT mediators in sequence (r2=.34). In Model 2, well-being was indirectly enhanced through autonomy-support (β=.38) and autonomy-support and needs satisfaction in sequence (r2=.21). Conclusions: The HCP enhanced MVPA and well-being by engendering a needs-supportive physical activity environment. The scientific and practical contribution of this study was the application of SDT in all aspects of the HCP intervention’s design and analyses. Practitioners may consider integrating SDT principles, as implemented in the HCP, for health promotion.Trial registration: This study is registered on Research Registry (number: researchregistry2852)
LanguageEnglish
JournalBritish Journal of Sports Medicine
Volume4
Issue number16
Publication statusAccepted/In press - 9 Apr 2018

Fingerprint

Personal Autonomy
Economics
Exercise
Motivation
Non-Randomized Controlled Trials
Health Promotion
Research
Teaching
Guidelines
Control Groups

Keywords

  • Health promotion
  • behaviour change
  • needs satisfaction
  • motivation
  • physical education

Cite this

@article{e8d0ec3c982042459d809992cb612d11,
title = "The Effect of a School-Based Intervention on Physical Activity and Well-Being: a Non-Randomised Controlled Trial with Children of Low Socio-Economic Status.",
abstract = "Background: Self-Determination Theory (SDT) has been used to predict children’s physical activity and well-being. However, few school-based SDT intervention studies have been conducted, and no research exists with children of low socio-economic status (SES). Therefore, SDT-derived needs-supportive teaching techniques informed the design and analyses of the Healthy Choices Programme (HCP). The aim was to determine if the HCP could enhance moderate-to-vigorous physical activity (MVPA) and well-being among children of low SES through increasing autonomy-support, needs satisfaction and intrinsic motivation. Method: A mixed factorial two (group) x two (time) wait-list controlled trial was conducted, and reported using the TREND guidelines. A total of 155 children (56{\%} females; intervention n=84, control n=71) took part and completed measures at baseline (week 0) and post-intervention (week 11). The effect of the intervention on MVPA (Model 1) and well-being (Model 2) was tested through serial mediation models with three mediators (i.e. autonomy-support, needs satisfaction and intrinsic motivation). Results: In comparison to the control group, the intervention was related to increases in MVPA (β=.45) and autonomy-support (β=.17). In Model 1, analyses revealed partial mediation of the MVPA change through autonomy-support (β=.14), intrinsic motivation (β=.51), and all three SDT mediators in sequence (r2=.34). In Model 2, well-being was indirectly enhanced through autonomy-support (β=.38) and autonomy-support and needs satisfaction in sequence (r2=.21). Conclusions: The HCP enhanced MVPA and well-being by engendering a needs-supportive physical activity environment. The scientific and practical contribution of this study was the application of SDT in all aspects of the HCP intervention’s design and analyses. Practitioners may consider integrating SDT principles, as implemented in the HCP, for health promotion.Trial registration: This study is registered on Research Registry (number: researchregistry2852)",
keywords = "Health promotion, behaviour change, needs satisfaction, motivation, physical education",
author = "Stephen Shannon and Deirdre Brennan and Donncha Hanna and Zoe Younger and Jessica Hassan and Gavin Breslin",
note = "Reference text: 1 Deci EL, Ryan RM. Hedonia, eudaimonia, and well-being: An introduction. Journal of happiness studies 2008;9:1-11. 2 Sallis JF, Bull F, Guthold R, et al. Progress in physical activity over the Olympic quadrennium. The Lancet 2016;388:1325-36. 3 Breslin G, Fitzpatrick B, Brennan D, et al. Physical activity and wellbeing of 8–9 year old children from social disadvantage: An all-Ireland approach to health. Mental Health and Physical Activity 2017. 4 Kj{\o}nniksen L, Torsheim T, Wold B. Tracking of leisure-time physical activity during adolescence and young adulthood: a 10-year longitudinal study. International Journal of Behavioral Nutrition and Physical Activity 2008;5:69. 5 Ball K. Traversing mths and mountains: addressing socioeconomic inequities in the promotion of nutrition and physical activity behaviours. International Journal of Behavioral Nutrition and Physical Activity 2015;12:142. 6 Michie S, Carey R, Johnston M, et al. From theory-inspired to theory-based interventions: linking behaviour change techniques to their mechanisms of action. European Health Psychologist 2016;18:395. 7 Lubans D, Richards J, Hillman C, et al. Physical Activity for Cognitive and Mental Health in Youth: A Systematic Review of Mechanisms. Pediatrics 2016;138:10.1542/peds.2016,1642. Epub 2016 Aug 19 doi:10.1542/peds.2016-1642 [doi]. 8 Van Sluijs EM, Kriemler S. Reflections on physical activity intervention research in young people–dos, don’ts, and critical thoughts. International journal of behavioral nutrition and physical activity 2016;13:25. 9 Ryan RM, Deci EL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol 2000;55:68. 10 Ryan RM, Deci EL. Self-determination theory: Basic psychological needs in motivation, development, and wellness: Guilford Publications 2017. 11 Fortier MS, Duda JL, Guerin E, et al. Promoting physical activity: development and testing of self-determination theory-based interventions. International Journal of Behavioral Nutrition and Physical Activity 2012;9:20. 12 Owen KB, Smith J, Lubans DR, et al. Self-determined motivation and physical activity in children and adolescents: A systematic review and meta-analysis. Prev Med 2014;67:270-9. 13 Standage M, Gillison FB, Ntoumanis N, et al. Predicting students’ physical activity and health-related well-being: A prospective cross-domain investigation of motivation across school physical education and exercise settings. Journal of Sport and Exercise Psychology 2012;34:37-60. 14 Breslin G, Shannon S, Fitzpatrick B, et al. Physical activity, well-being and needs satisfaction in eight and nine-year-old children from areas of socio-economic disadvantage. Child Care in Practice 2017:1-17. 15 Quaresma A, Palmeira A, Martins S, et al. Effect of a school-based intervention on physical activity and quality of life through serial mediation of social support and exercise motivation: the PESSOA program. Health Educ Res 2014;29:906-17. 16 Reeve J, Jang H, Carrell D, et al. Enhancing students' engagement by increasing teachers' autonomy support. Motiv Emotion 2004;28:147-69. 17 Gonz{\'a}lez-Cutre D, Ferriz R, Beltr{\'a}n-Carrillo VJ, et al. Promotion of autonomy for participation in physical activity: A study based on the trans-contextual model of motivation. Educational Psychology 2014;34:367-84. 18 Gonz{\'a}lez-Cutre D, Sierra AC, Beltr{\'a}n-Carrillo VJ, et al. A school-based motivational intervention to promote physical activity from a self-determination theory perspective. The Journal of Educational Research 2016:1-11. 19 Chatzisarantis NL, Hagger MS. Effects of an intervention based on self-determination theory on self-reported leisure-time physical activity participation. Psychology and Health 2009;24:29-48. 20 Tessier D, Sarrazin P, Ntoumanis N. The effect of an intervention to improve newly qualified teachers’ interpersonal style, students motivation and psychological need satisfaction in sport-based physical education. Contemp Educ Psychol 2010;35:242-53. 21 Des Jarlais DC, Lyles C, Crepaz N, et al. Improving the reporting quality of nonrandomized evaluations of behavioral and public health interventions: the TREND statement. Am J Public Health 2004;94:361-6. 22 Hughes JP. Stepped wedge design. Wiley Encyclopedia of Clinical Trials 2008. 23 NISRA NIS. Research Agency, 2012. The Northern Ireland Multiple Deprivation Measure 2010. 24 Duda JL. The conceptual and empirical foundations of Empowering Coaching™: Setting the stage for the PAPA project. International Journal of Sport and Exercise Psychology 2013;11:311-8. 25 Available at: http://ccea.org.uk/curriculum. Accessed 27/04, 2017. 26 Trost SG, Loprinzi PD, Moore R, et al. Comparison of accelerometer cut points for predicting activity intensity in youth. Med Sci Sports Exerc 2011;43:1360-8 doi:10.1249/MSS.0b013e318206476e [doi]. 27 Wells SL, Kipping RR, Jago R, et al. Characteristics associated with requested and required accelerometer wear in children. BMJ Open 2013;3:e003402,2013-003402 doi:10.1136/bmjopen-2013-003402 [doi]. 28 Evenson KR, Catellier DJ, Gill K, et al. Calibration of two objective measures of physical activity for children. J Sports Sci 2008;26:1557-65. 29 Ravens‐Sieberer U, Erhart M, Gosch A, et al. Mental health of children and adolescents in 12 European countries—results from the European KIDSCREEN study. Clinical psychology & psychotherapy 2008;15:154-63. 30 Shannon S, Breslin G, Fitzpatrick B, et al. Testing the psychometric properties of Kidscreen-27 with Irish children of low socio-economic status. Quality of Life Research 2016:1-9. 31 Standage M, Duda JL, Ntoumanis N. A test of self‐determination theory in school physical education. Br J Educ Psychol 2005;75:411-33. 32 Sebire SJ, Jago R, Fox KR, et al. Testing a self-determination theory model of children’s physical activity motivation: a cross-sectional study. International Journal of Behavioral Nutrition and Physical Activity 2013;10:111. 33 Breslin G, Brennan D, Rafferty R, et al. The effect of a healthy lifestyle programme on 8-9 year olds from social disadvantage. Arch Dis Child 2012;97:618-24 doi:10.1136/archdischild-2011-301108 [doi]. 34 Field A. Discovering statistics using IBM SPSS statistics: Sage 2013. 35 Hayes AF. Beyond Baron and Kenny: Statistical mediation analysis in the new millennium. Communication monographs 2009;76:408-20. 36 Hayes AF. Introduction to mediation, moderation, and conditional process analysis: A regression-based approach: Guilford Press 2013. 37 Hayes AF. The PROCESS macro for SPSS and SAS. Retrieved 2015;12:2015. 38 Tessier D, Sarrazin P, Ntoumanis N. The effect of an intervention to improve newly qualified teachers’ interpersonal style, students motivation and psychological need satisfaction in sport-based physical education. Contemp Educ Psychol 2010;35:242-53. 39 Wallhead TL, Hagger M, Smith DT. Sport education and extracurricular sport participation: An examination using the trans-contextual model of motivation. Res Q Exerc Sport 2010;81:442-55. 40 Hagger MS, Chatzisarantis NL. An integrated behavior change model for physical activity. Exerc Sport Sci Rev 2014;42:62-9 doi:10.1249/JES.0000000000000008 [doi]. 41 Rafferty R, Breslin G, Brennan D, et al. A systematic review of school-based physical activity interventions on children’s wellbeing. International review of sport and exercise psychology 2016;9:215-30. 42 Tymms PB, Curtis SE, Routen AC, et al. Clustered randomised controlled trial of two education interventions designed to increase physical activity and well-being of secondary school students: the MOVE Project. BMJ Open 2016;6:e009318,2015-009318 doi:10.1136/bmjopen-2015-009318 [doi]. 43 Lubans DR, Smith JJ, Morgan PJ, et al. Mediators of psychological well-being in adolescent boys. Journal of Adolescent Health 2016;58:230-6. 44 Reeve J. Understanding motivation and emotion: John Wiley & Sons 2014. 45 Muros JJ, P{\'e}rez FS, Ortega FZ, et al. The association between healthy lifestyle behaviors and health-related quality of life among adolescents. J Pediatr 2017. 46 Ntoumanis N, Quested E, Reeve J, et al. Need supportive communication: Implications for motivation in sport, exercise, and physical activity. Persuasion and communication in sport, exercise, and physical activity.Abingdon, UK: Routledge 2017. 47 Kelly, M. P., & Barker, M. (2016). Why is changing health-related behaviour so difficult?. Public Health, 3 (136), 109-116. 48 Brand, R., & Ekkekakis, P. (2017). Affective–Reflective Theory of physical inactivity and exercise. German Journal of Exercise and Sport Research, 1-11. 49 Sebire, S. J., Kesten, J. M., Edwards, M. J., May, T., Banfield, K., Tomkinson, K., et al. (2016). Using self-determination theory to promote adolescent girls' physical activity: Exploring the theoretical fidelity of the bristol girls dance project. Psychology of Sport and Exercise, 24(4), 100-110.",
year = "2018",
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language = "English",
volume = "4",
journal = "British Journal of Sports Medicine",
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TY - JOUR

T1 - The Effect of a School-Based Intervention on Physical Activity and Well-Being: a Non-Randomised Controlled Trial with Children of Low Socio-Economic Status.

AU - Shannon, Stephen

AU - Brennan, Deirdre

AU - Hanna, Donncha

AU - Younger, Zoe

AU - Hassan, Jessica

AU - Breslin, Gavin

N1 - Reference text: 1 Deci EL, Ryan RM. Hedonia, eudaimonia, and well-being: An introduction. Journal of happiness studies 2008;9:1-11. 2 Sallis JF, Bull F, Guthold R, et al. Progress in physical activity over the Olympic quadrennium. The Lancet 2016;388:1325-36. 3 Breslin G, Fitzpatrick B, Brennan D, et al. Physical activity and wellbeing of 8–9 year old children from social disadvantage: An all-Ireland approach to health. Mental Health and Physical Activity 2017. 4 Kjønniksen L, Torsheim T, Wold B. Tracking of leisure-time physical activity during adolescence and young adulthood: a 10-year longitudinal study. International Journal of Behavioral Nutrition and Physical Activity 2008;5:69. 5 Ball K. Traversing mths and mountains: addressing socioeconomic inequities in the promotion of nutrition and physical activity behaviours. International Journal of Behavioral Nutrition and Physical Activity 2015;12:142. 6 Michie S, Carey R, Johnston M, et al. From theory-inspired to theory-based interventions: linking behaviour change techniques to their mechanisms of action. European Health Psychologist 2016;18:395. 7 Lubans D, Richards J, Hillman C, et al. Physical Activity for Cognitive and Mental Health in Youth: A Systematic Review of Mechanisms. Pediatrics 2016;138:10.1542/peds.2016,1642. Epub 2016 Aug 19 doi:10.1542/peds.2016-1642 [doi]. 8 Van Sluijs EM, Kriemler S. Reflections on physical activity intervention research in young people–dos, don’ts, and critical thoughts. International journal of behavioral nutrition and physical activity 2016;13:25. 9 Ryan RM, Deci EL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol 2000;55:68. 10 Ryan RM, Deci EL. Self-determination theory: Basic psychological needs in motivation, development, and wellness: Guilford Publications 2017. 11 Fortier MS, Duda JL, Guerin E, et al. Promoting physical activity: development and testing of self-determination theory-based interventions. International Journal of Behavioral Nutrition and Physical Activity 2012;9:20. 12 Owen KB, Smith J, Lubans DR, et al. Self-determined motivation and physical activity in children and adolescents: A systematic review and meta-analysis. Prev Med 2014;67:270-9. 13 Standage M, Gillison FB, Ntoumanis N, et al. Predicting students’ physical activity and health-related well-being: A prospective cross-domain investigation of motivation across school physical education and exercise settings. Journal of Sport and Exercise Psychology 2012;34:37-60. 14 Breslin G, Shannon S, Fitzpatrick B, et al. Physical activity, well-being and needs satisfaction in eight and nine-year-old children from areas of socio-economic disadvantage. Child Care in Practice 2017:1-17. 15 Quaresma A, Palmeira A, Martins S, et al. Effect of a school-based intervention on physical activity and quality of life through serial mediation of social support and exercise motivation: the PESSOA program. Health Educ Res 2014;29:906-17. 16 Reeve J, Jang H, Carrell D, et al. Enhancing students' engagement by increasing teachers' autonomy support. Motiv Emotion 2004;28:147-69. 17 González-Cutre D, Ferriz R, Beltrán-Carrillo VJ, et al. Promotion of autonomy for participation in physical activity: A study based on the trans-contextual model of motivation. Educational Psychology 2014;34:367-84. 18 González-Cutre D, Sierra AC, Beltrán-Carrillo VJ, et al. A school-based motivational intervention to promote physical activity from a self-determination theory perspective. The Journal of Educational Research 2016:1-11. 19 Chatzisarantis NL, Hagger MS. Effects of an intervention based on self-determination theory on self-reported leisure-time physical activity participation. Psychology and Health 2009;24:29-48. 20 Tessier D, Sarrazin P, Ntoumanis N. The effect of an intervention to improve newly qualified teachers’ interpersonal style, students motivation and psychological need satisfaction in sport-based physical education. Contemp Educ Psychol 2010;35:242-53. 21 Des Jarlais DC, Lyles C, Crepaz N, et al. Improving the reporting quality of nonrandomized evaluations of behavioral and public health interventions: the TREND statement. Am J Public Health 2004;94:361-6. 22 Hughes JP. Stepped wedge design. Wiley Encyclopedia of Clinical Trials 2008. 23 NISRA NIS. Research Agency, 2012. The Northern Ireland Multiple Deprivation Measure 2010. 24 Duda JL. The conceptual and empirical foundations of Empowering Coaching™: Setting the stage for the PAPA project. International Journal of Sport and Exercise Psychology 2013;11:311-8. 25 Available at: http://ccea.org.uk/curriculum. Accessed 27/04, 2017. 26 Trost SG, Loprinzi PD, Moore R, et al. Comparison of accelerometer cut points for predicting activity intensity in youth. Med Sci Sports Exerc 2011;43:1360-8 doi:10.1249/MSS.0b013e318206476e [doi]. 27 Wells SL, Kipping RR, Jago R, et al. Characteristics associated with requested and required accelerometer wear in children. BMJ Open 2013;3:e003402,2013-003402 doi:10.1136/bmjopen-2013-003402 [doi]. 28 Evenson KR, Catellier DJ, Gill K, et al. Calibration of two objective measures of physical activity for children. J Sports Sci 2008;26:1557-65. 29 Ravens‐Sieberer U, Erhart M, Gosch A, et al. Mental health of children and adolescents in 12 European countries—results from the European KIDSCREEN study. Clinical psychology & psychotherapy 2008;15:154-63. 30 Shannon S, Breslin G, Fitzpatrick B, et al. Testing the psychometric properties of Kidscreen-27 with Irish children of low socio-economic status. Quality of Life Research 2016:1-9. 31 Standage M, Duda JL, Ntoumanis N. A test of self‐determination theory in school physical education. Br J Educ Psychol 2005;75:411-33. 32 Sebire SJ, Jago R, Fox KR, et al. Testing a self-determination theory model of children’s physical activity motivation: a cross-sectional study. International Journal of Behavioral Nutrition and Physical Activity 2013;10:111. 33 Breslin G, Brennan D, Rafferty R, et al. The effect of a healthy lifestyle programme on 8-9 year olds from social disadvantage. Arch Dis Child 2012;97:618-24 doi:10.1136/archdischild-2011-301108 [doi]. 34 Field A. Discovering statistics using IBM SPSS statistics: Sage 2013. 35 Hayes AF. Beyond Baron and Kenny: Statistical mediation analysis in the new millennium. Communication monographs 2009;76:408-20. 36 Hayes AF. Introduction to mediation, moderation, and conditional process analysis: A regression-based approach: Guilford Press 2013. 37 Hayes AF. The PROCESS macro for SPSS and SAS. Retrieved 2015;12:2015. 38 Tessier D, Sarrazin P, Ntoumanis N. The effect of an intervention to improve newly qualified teachers’ interpersonal style, students motivation and psychological need satisfaction in sport-based physical education. Contemp Educ Psychol 2010;35:242-53. 39 Wallhead TL, Hagger M, Smith DT. Sport education and extracurricular sport participation: An examination using the trans-contextual model of motivation. Res Q Exerc Sport 2010;81:442-55. 40 Hagger MS, Chatzisarantis NL. An integrated behavior change model for physical activity. Exerc Sport Sci Rev 2014;42:62-9 doi:10.1249/JES.0000000000000008 [doi]. 41 Rafferty R, Breslin G, Brennan D, et al. A systematic review of school-based physical activity interventions on children’s wellbeing. International review of sport and exercise psychology 2016;9:215-30. 42 Tymms PB, Curtis SE, Routen AC, et al. Clustered randomised controlled trial of two education interventions designed to increase physical activity and well-being of secondary school students: the MOVE Project. BMJ Open 2016;6:e009318,2015-009318 doi:10.1136/bmjopen-2015-009318 [doi]. 43 Lubans DR, Smith JJ, Morgan PJ, et al. Mediators of psychological well-being in adolescent boys. Journal of Adolescent Health 2016;58:230-6. 44 Reeve J. Understanding motivation and emotion: John Wiley & Sons 2014. 45 Muros JJ, Pérez FS, Ortega FZ, et al. The association between healthy lifestyle behaviors and health-related quality of life among adolescents. J Pediatr 2017. 46 Ntoumanis N, Quested E, Reeve J, et al. Need supportive communication: Implications for motivation in sport, exercise, and physical activity. Persuasion and communication in sport, exercise, and physical activity.Abingdon, UK: Routledge 2017. 47 Kelly, M. P., & Barker, M. (2016). Why is changing health-related behaviour so difficult?. Public Health, 3 (136), 109-116. 48 Brand, R., & Ekkekakis, P. (2017). Affective–Reflective Theory of physical inactivity and exercise. German Journal of Exercise and Sport Research, 1-11. 49 Sebire, S. J., Kesten, J. M., Edwards, M. J., May, T., Banfield, K., Tomkinson, K., et al. (2016). Using self-determination theory to promote adolescent girls' physical activity: Exploring the theoretical fidelity of the bristol girls dance project. Psychology of Sport and Exercise, 24(4), 100-110.

PY - 2018/4/9

Y1 - 2018/4/9

N2 - Background: Self-Determination Theory (SDT) has been used to predict children’s physical activity and well-being. However, few school-based SDT intervention studies have been conducted, and no research exists with children of low socio-economic status (SES). Therefore, SDT-derived needs-supportive teaching techniques informed the design and analyses of the Healthy Choices Programme (HCP). The aim was to determine if the HCP could enhance moderate-to-vigorous physical activity (MVPA) and well-being among children of low SES through increasing autonomy-support, needs satisfaction and intrinsic motivation. Method: A mixed factorial two (group) x two (time) wait-list controlled trial was conducted, and reported using the TREND guidelines. A total of 155 children (56% females; intervention n=84, control n=71) took part and completed measures at baseline (week 0) and post-intervention (week 11). The effect of the intervention on MVPA (Model 1) and well-being (Model 2) was tested through serial mediation models with three mediators (i.e. autonomy-support, needs satisfaction and intrinsic motivation). Results: In comparison to the control group, the intervention was related to increases in MVPA (β=.45) and autonomy-support (β=.17). In Model 1, analyses revealed partial mediation of the MVPA change through autonomy-support (β=.14), intrinsic motivation (β=.51), and all three SDT mediators in sequence (r2=.34). In Model 2, well-being was indirectly enhanced through autonomy-support (β=.38) and autonomy-support and needs satisfaction in sequence (r2=.21). Conclusions: The HCP enhanced MVPA and well-being by engendering a needs-supportive physical activity environment. The scientific and practical contribution of this study was the application of SDT in all aspects of the HCP intervention’s design and analyses. Practitioners may consider integrating SDT principles, as implemented in the HCP, for health promotion.Trial registration: This study is registered on Research Registry (number: researchregistry2852)

AB - Background: Self-Determination Theory (SDT) has been used to predict children’s physical activity and well-being. However, few school-based SDT intervention studies have been conducted, and no research exists with children of low socio-economic status (SES). Therefore, SDT-derived needs-supportive teaching techniques informed the design and analyses of the Healthy Choices Programme (HCP). The aim was to determine if the HCP could enhance moderate-to-vigorous physical activity (MVPA) and well-being among children of low SES through increasing autonomy-support, needs satisfaction and intrinsic motivation. Method: A mixed factorial two (group) x two (time) wait-list controlled trial was conducted, and reported using the TREND guidelines. A total of 155 children (56% females; intervention n=84, control n=71) took part and completed measures at baseline (week 0) and post-intervention (week 11). The effect of the intervention on MVPA (Model 1) and well-being (Model 2) was tested through serial mediation models with three mediators (i.e. autonomy-support, needs satisfaction and intrinsic motivation). Results: In comparison to the control group, the intervention was related to increases in MVPA (β=.45) and autonomy-support (β=.17). In Model 1, analyses revealed partial mediation of the MVPA change through autonomy-support (β=.14), intrinsic motivation (β=.51), and all three SDT mediators in sequence (r2=.34). In Model 2, well-being was indirectly enhanced through autonomy-support (β=.38) and autonomy-support and needs satisfaction in sequence (r2=.21). Conclusions: The HCP enhanced MVPA and well-being by engendering a needs-supportive physical activity environment. The scientific and practical contribution of this study was the application of SDT in all aspects of the HCP intervention’s design and analyses. Practitioners may consider integrating SDT principles, as implemented in the HCP, for health promotion.Trial registration: This study is registered on Research Registry (number: researchregistry2852)

KW - Health promotion

KW - behaviour change

KW - needs satisfaction

KW - motivation

KW - physical education

M3 - Article

VL - 4

JO - British Journal of Sports Medicine

T2 - British Journal of Sports Medicine

JF - British Journal of Sports Medicine

SN - 0306-3674

IS - 16

ER -