Process evaluation of an intervention developed using a participatory approach targeting school-related sedentary behaviour among adolescents

Adolescents’ high levels of school-related sedentary behaviour pose health risks, yet existing interventions have shown limited effectiveness. Participatory research, which engages adolescents and other partners in intervention development, holds promise by tailoring interventions to their needs and context, which may improve intervention implementation and effectiveness. This study conducted an evaluation of a participatory process aimed at developing and implementing an intervention addressing adolescents’ school-related sedentary behaviour and the implementation process of this intervention.

Intervention Mapping guided the participatory process with 12 pupils from Grade 7 and three teachers from a secondary school in Flanders, Belgium. To develop the intervention, ten sessions with pupils and five with teachers were organised. Next, the intervention was implemented over six weeks. Experiences were captured from reflection forms completed by pupils (n = 34) and researchers (n = 28), four group interviews with pupils (n = 15) and two with teachers (n = 5), as well as questionnaires completed by 31 pupils and 8 teachers. Qualitative data were analysed using reflexive thematic analysis. Descriptive statistics were calculated from questionnaire data.

Pupils appreciated being engaged, however, integrating the participatory sessions with pupils within regular lessons challenged participation due to for instance time constraints. Teachers preferred a more efficient, less time-intensive engagement that still made them feel heard. Moreover, pupils and teachers mentioned in group interviews that the early engagement of a large group of pupils and teachers was necessary in participatory research to build support for the intervention. As only a small group of teachers was engaged in the participatory process, not all teachers supported and implemented the intervention. Nevertheless, questionnaire data showed that most pupils were exposed to the intervention.

Broader engagement from pupils and teachers was suggested to improve support for the intervention and enhance the implementation of the intervention. A future study will determine the effectiveness of the intervention.

This study was retrospectively registered at the Open Science Framework (DOI: https://doi.org/10.17605/OSF.IO/Y8GEJ; registered on July 1, 2024).