The contribution of dance to daily physical activity among adolescent girls

The Cost-Effectiveness of a Dance and Yoga Intervention for Girls with Functional Abdominal Pain Disorders

BACKGROUND

Functional abdominal pain disorders (FAPDs) affect children worldwide, being more prevalent among girls. The individual and societal burdens of the disease are substantial, and evidence-based interventions are needed. Non-pharmacological treatments have generally produced promising results, with dance and yoga specifically having potential as an effective treatment option. Beside efficacy, the cost-effectiveness of interventions is important when prioritizing and allocating public resources.

OBJECTIVE

This study evaluated the cost-effectiveness of an 8-month dance and yoga intervention for girls with functional abdominal pain or irritable bowel syndrome, based on a randomized control trial called 'Just in TIME'.

METHODS

The intervention, performed in Sweden, was studied using a decision analysis tool, i.e., a decision tree within the trial followed by a Markov model with a time horizon of 10 years. The base case considered healthcare costs as well as productivity losses, measuring the effects in gained quality-adjusted life-years (QALYs) and presenting an incremental cost-effectiveness ratio (ICER).

RESULTS

The base case results show that the intervention, compared with current practice, was the dominant strategy from both the 12-month and long-term perspectives. The sensitivity analyses indicated that the long-term, but not the short-term, findings were robust for different assumptions and changes in parameter estimates, resulting in ICERs similar to those of the base case scenario.

CONCLUSIONS

Offering dance and yoga to young girls with FAPDs generates small QALY gains and monetary savings compared with standard healthcare and is likely cost-effective. These findings make a valuable contribution to an area where evidence-based and cost-effective treatment interventions are needed.

CLINICAL TRIALS REGISTRATION NUMBER

ClinicalTrials.gov identifier: NCT02920268; Name: Just in TIME-Intervention With Dance and Yoga for Girls With Recurrent Abdominal Pain.

The Physiological and Psychological Benefits of Dance and its Effects on Children and Adolescents: A Systematic Review

Background: The aim of this review was to examine the physiological and psychological benefits of dance and its effects on children and adolescents. We consider the therapeutic benefits of dance and outline the potential of dance as an alternative therapy for certain pathologies and medical disorders. Secondly, we summarize the types of dances used in physical interventions, and comment on the methodologies used. Finally, we consider the use of dance as a different exercise modality that may have benefits for increased physical activity generally, and for increased physical education provision in schools.

Methods: A structured search strategy was conducted using the databases of PubMed, MEDLINE, Web of science, PsycARTICLES, and Social Science database. This review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for systematic reviews. Studies that were published in the past 20 years were considered for inclusion. All written publications were searched for in English, and all articles included in this review were peer reviewed full papers.

Conclusion: The key findings from this review indicate that dance is a feasible alternative to traditional physical activity. The findings also indicate that dance provides physiological and psychological benefits to healthy and medically compromised populations. Implementation of dance programs in schools and society generally needs serious consideration by policy makers. We hope that the results of this review stimulate debate and provide the necessary evidence to profile dance as a viable alternative medium of physical activity. Comprehensive and integrated changes will be needed including economical and legislative support from politicians and associated governmental agencies. The findings reported here are important and have implications for health policy change, reconfiguration, and implementation.

A Pilot Dance Intervention to Encourage Physical Activity Engagement for Adolescent Girls with Intellectual Disabilities

Adolescent girls with intellectual disabilities (ID) are at risk for low physical activity (PA) participation due to their limited opportunities. Purpose: To evaluate the feasibility and preliminary efficacy of a 12-week dance intervention to promote engagement in moderate-to-vigorous PA (MVPA) and increase cardiorespiratory fitness. Methods: The 12-week intervention included two 75-min weekly dance sessions. Continuous heart-rate (HR) monitoring assessed time spent below/at/above each girl’s target HR zone. Cardiorespiratory fitness was measured by the 6-min walk test (6MWT). Survey items assessed participant enjoyment and participant and parent satisfaction. Results: The mean (SD) age of 18 adolescent girls was 17.3 (2.7) years. Overall, girls attended 88% of sessions and spent 52.3% of each session in MVPA. Mean MVPA was unchanged across the 12 weeks, but the pattern differed across the three sites. We observed a non-significant pre-post increase of 74.6 feet on the 6MWT. Post-intervention surveys indicated that most girls liked the program, perceived improved fitness, and wished to continue dancing. The majority also reported a preference for a girls-only dance program exclusively for those with ID. Conclusion: Our findings suggest that dance is viable for promoting PA for girls with ID. More frequent exercise training is likely needed to improve cardiorespiratory fitness.

A Novel High-Intensity Short Interval Dance Intervention (THANDAV) to Improve Physical Fitness in Asian Indian Adolescent Girls

Background: There exist several barriers to physical activity (PA) among adolescent girls. We therefore developed a culturally acceptable dance/fitness intervention called THANDAV (Taking High-Intensity Interval Training [HIIT] ANd Dance to Adolescents for Victory over noncommunicable diseases [NCDs]). The main aim of this study was to evaluate the THANDAV protocol among Asian Indian girls aged 10 to 17 years. Materials and Methods: THANDAV consisted of a 10-min routine with high- and low-intensity dance steps that was taught to 23 adolescent girls. Heart rate (HR), energy expenditure, body mass index (BMI), and blood pressure (BP) were recorded. Focused group discussions (FGDs) were conducted after the quantitative measurements were completed. Results: The average age of the girls was 13.9 ± 2.1 years, and the mean BMI and BP were 19.8 ± 3.3 kg/m² and 107/68 (±8/7) mm/Hg, respectively. All participants achieved 80% of their maximum HR during the first dance and managed to sustain this HR throughout the 10-min routine. There was a significant increase in the HR (bpm) [88.7 ± 8.4 to 195.6 ± 11.8, P < 0.001] and VO₂ (L/min) [0.025 ± 0.0 to 0.395 ± 0.1, P < 0.001] postintervention. The average energy cost of the activity (metabolic equivalent) was 6.3. The FGDs revealed that THANDAV was a socially acceptable, fun, and energetic form of PA. Conclusions: The THANDAV intervention meets HIIT norms and is a novel culturally appropriate form of PA that is enjoyable, takes little time, and can be done at home. It has the potential to be a sustainable intervention to improve cardiorespiratory fitness and prevent NCDs in Asian Indian adolescent girls. Clinical Trials Registry of India: CTRI/2020/02/023384.

The Association of Family, Friends, and Teacher Support With Girls' Sport and Physical Activity on the Island of Ireland

BACKGROUND

The current study was the largest physical activity (PA) surveillance assessment of youth undertaken in Ireland in recent years. The purpose of this research was to assess the impact of social support, while controlling for age and screen time, on PA and sport participation, across a representative sample of Irish female youth.

METHODS

A total of 3503 children (mean age: 13.54 [2.05] y) across the island of Ireland participated. Participants completed a previously validated electronic questionnaire while supervised in a classroom setting, which investigated their (1) levels of PA; (2) screen time; (3) community sport participation; and (4) social support (friend, family, and teacher) to be physically active/partake in sport.

RESULTS

There were significant differences, with medium and large effect sizes, for social support from friends and family across types of sports participation. Specifically, girls who participated in the most popular team sports, when compared with the most popular individual sports, reported higher social support scores for friends and family structures.

CONCLUSIONS

Findings from this study confirm the contributing influence of friends and family as sport and PA support networks for girls. Interventions should consider the importance of culturally relevant team sports for PA engagement in female youth.

An Intervention With Dance and Yoga for Girls With Functional Abdominal Pain Disorders (Just in TIME): Protocol for a Randomized Controlled Trial

BACKGROUND

Functional abdominal pain disorders (FAPDs) affect many children worldwide, predominantly girls, and cause considerable long-term negative consequences for individuals and society. Evidence-based and cost-effective treatments are therefore strongly needed. Physical activity has shown promising effects in the practical management of FAPDs. Dance and yoga are both popular activities that have been shown to provide significant psychological and pain-related benefits with minimal risk. The activities complement each other, in that dance involves dynamic, rhythmic physical activity, while yoga enhances relaxation and focus.

OBJECTIVE

This study aims to evaluate the effects of a dance and yoga intervention among girls aged 9 to 13 years with FAPDs.

METHODS

The study is a prospective randomized controlled trial among girls aged 9 to 13 years with functional abdominal pain, irritable bowel syndrome, or both. The target sample size was 150 girls randomized into 2 arms: an intervention arm that receives dance and yoga sessions twice weekly for 8 months and a control arm that receives standard care. Outcomes will be measured at baseline and after 4, 8, 12, and 24 months, and long-term follow-up will be conducted 5 years from baseline. Questionnaires, interviews, and biomarker measures, such as cortisol in saliva and fecal microbiota, will be used. The primary outcome is the proportion of girls in each group with reduced pain, as measured by the faces pain scale-revised in a pain diary, immediately after the intervention. Secondary outcomes are gastrointestinal symptoms, general health, mental health, stress, and physical activity. The study also includes qualitative evaluations and health economic analyses. This study was approved by the Regional Ethical Review Board in Uppsala (No. 2016/082 1-2).

RESULTS

Data collection began in October 2016. The intervention has been performed in 3 periods from 2016 through 2019. The final 5-year follow-up is anticipated to be completed by fall 2023.

CONCLUSIONS

Cost-effective and easily accessible interventions are warranted to reduce the negative consequences arising from FAPDs in young girls. Physical activity is an effective strategy, but intervention studies are needed to better understand what types of activities facilitate regular participation in this target group. The Just in TIME (Try, Identify, Move, and Enjoy) study will provide insights regarding the effectiveness of dance and yoga and is anticipated to contribute to the challenging work of reducing the burden of FAPDs for young girls.

TRIAL REGISTRATION

ClinicalTrials.gov (NCT02920268); https://clinicaltrials.gov/ct2/show/NCT02920268.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/19748.

Effects of dancing on physical activity levels of children and adolescents: a systematic review

BACKGROUND

Dancing has been suggested to increase the levels of physical activity of the youth. However, it is not clear what are the physiological characteristics of the dance classes for young people, mainly regarding the levels of moderate to vigorous physical activity (MVPA) during classes. It is also unclear if regular engagement in dance practices can contribute with increases in the amounts of daily/weekly MVPA, recommended by health organizations.

OBJECTIVES

To conduct a systematic review verifying the amount of time spent at MVPA (primary outcome), by children and adolescents in the following situations: i) During dance classes, and ii) Before and after dance interventions. Secondary outcomes included: markers of exercise intensity during class, such as oxygen consumption (VO₂) and heart rate (HR); VO₂peak and lipid profile before and after dance interventions.

METHODS

Six data sources were accessed (MEDLINE, EMBASE, Cochrane Wiley, PEDRO and SCOPUS). Study selection included different designs (acute, cohort, randomized controlled trials and others). Participants were from 6 to 19 years old, regularly engaged in dance practices. Methodological quality was assessed using the Downs and Black checklist. Two independent reviewers extracted characteristics and results of each study.

RESULTS

3216 articles were retrieved, and 37 included. Studies indicated that dance classes do not achieve 50% of total class time at MVPA. However, there are peaks of HR and VO₂ during dance classes, which reach moderate and vigorous intensities. MVPA/daily/weekly did not improve before and after dance interventions for most of the studies, also VO₂peak did not. The few results on lipid profile showed improvements only in overweight and obese participants.

LIMITATIONS

Lack of meta-analysis, because there were not enough articles to be analyzed on any given outcome of interest, neither under the same study design.

CONCLUSIONS

Results of individual studies indicated that dance classes did not active 50% of the total time at MVPA levels. This may be related to the absence of improvements in daily/weekly MVPA before and after dance interventions. VO₂ and HR attained peaks of moderateto vigorous intensity during dance classes, suggesting that the structure of the classes may be manipulated to maintain longer periods at MVPA levels. Lack of data on cardiorespiratory fitness and metabolic outcomes limit conclusions on these parameters.

IMPLICATIONS OF KEYS FINDS

Considering there are peaks of HR and VO₂ during dance classes, we suggest that the structure of a dance class can be manipulate in order to induce cardiorespiratory and metabolic adaptations. Thus, dancing is a potential strategy to contribute with a healthy life style since the earliest ages. Prospero registration: CRD42020144609.

Effects of a Curriculum-Integrated Dance Program on Children's Physical Activity

BACKGROUND

Curriculum-integrated dance programs are a promising but relatively under-researched strategy for increasing children's physical activity (PA). The aim of this study was to determine the impact of a curriculum-integrated dance program on children's PA.

METHODS

A total of 134 primary children aged 7-9 years from 4 New Zealand schools were assigned to either a dance group (n = 78) or a control group (n = 56). The dance group participated in a 6-week curriculum-integrated dance program during school time. Although the dance program focused on curricular learning, fitness and coordination were embedded in the dance sessions. Intensity of PA varied according to the focus of each dance session. PA was measured at baseline and postintervention using a waist-mounted ActiGraph GT3X+ accelerometer for 8 consecutive days.

RESULTS

There were no significant intervention effects on PA levels between the dance and control groups postintervention.

CONCLUSION

Dance-embedded learning did not increase overall levels of PA in this study. Future studies may consider assessing longer term effects of a dance-based intervention, or programs that place more focus on PA promotion.

Dance intervention for adolescent girls: Effects on daytime tiredness, alertness and school satisfaction. A randomized controlled trial

INTRODUCTION

Daytime tiredness is a risk factor for poor health and well-being in the short and long term and is often associated with sleep problems, stress-related mental health complaints and decreased school functioning. This study investigates the effect of an 8 month dance intervention study on daytime tiredness, alertness, sleep duration, sleep quality and school satisfaction.

METHODS

Randomized controlled intervention study that included a total of 112 girls aged 13-18 years old with stress-related somatic and mental health problems. Dance intervention with focus on enjoyment were performed semiweekly for 8 months. Questionnaire-based measurements regarding self-reported daytime tiredness, alertness, school satisfaction, sleep duration and quality were evaluated at baseline and at 8-, 12- and 20- month follow-ups.

RESULTS

Daytime tiredness decreased significantly in the dance group compared to control group at all follow-ups. Alertness increased significant within the dance group, but there were no significant difference compared to the controls. Significant improvements were found in all sleep quality items within the dance group, between groups only one significant result was found. No conclusive changes in sleep duration were observed. School satisfaction increased significantly in the dance intervention group; however, its significance compared to that of the control group faded after adjustment for differences between groups at baseline.

CONCLUSIONS

This study suggests that a dance intervention focusing on enjoyment can be effective in decreasing daytime tiredness. This study also adds to the growing body of evidence for the benefits of using nonpharmacological interventions to decrease stress-related problems among adolescents.

Associations Between Self-Determined Motivation, Team Potency, and Self-Talk in Team Sports

The current study aimed to evaluate the determinant factors of athletes´ internal positive self-talk that might lead to decreased anxiety and increased performance. The sample consisted of 191 male and female athletes ranging in age from 14 to 35 years old. They played soccer, volleyball and basketball and they were cadets (43%), juniors (29.6 %) and adults (27.4%). Results showed that satisfaction of the basic psychological needs was the strongest predictor of positive self-talk or positive thoughts during competition. Specifically, perception of autonomy was the strongest predictor, because it positively predicted concentration, control of anxiety and instructions, followed by perception of competence, which positively predicted confidence. Finally, team sports coaches should promote perception of autonomy and competence in their athletes, with the aim of enhancing more positive self-talk in competition, which may promote a better performance.

Same old song and dance: an exploratory study of portrayal of physical activity in television programmes aimed at young adolescents

OBJECTIVE

Exposure to health-related behaviours on television has been shown to influence smoking and drinking in young people, but little research has been conducted on the portrayal physical activity. The aim of the current project was to explore the portrayal of physical activity in television programmes aimed specifically at adolescent females. Content analysis of 120 episodes of four popular adolescent television programmes was performed. Information on the type and context of physical activity, motivating factors and characters involved was recorded.

RESULTS

Physical activity was portrayed 122 times, for a duration of 1 h and 31 min (3.2% of total viewing time). Physical activity was mainly portrayed as part of an informal activity as part of a group activity. Over half (53.2%) of scenes portrayed activity been carried out by teenagers. The types of activities portrayed were mostly of vigorous intensity (76.2%), for recreational purposes (78.7%) such as dancing (54.1%) and running (11.5%), and motivated by enjoyment. This study highlights that physical activity is portrayed infrequently, and often with a skewed representation of type of activity. There may be an opportunity to influence physical activity in young adolescents through the positioning of positive images of an active lifestyle in the media.

Variations in adolescents' motivational characteristics across gender and physical activity patterns: A latent class analysis approach

BACKGROUND

Neglecting to take account of the underlying context or type of physical activity (PA) that underpins overall involvement has resulted in a limited understanding of adolescents' PA participation. The purpose of the present research was to identify male and female adolescents' leisure time PA patterns and examine whether psychological processes derived from self-determination theory differ as a function of the pattern of PA undertaken.

METHODS

Nine hundred ninety-five students (61.2% females, 38.8% males; M age = 13.72 years, SD = 1.25) from eight secondary schools in Dublin, Ireland completed a physical activity recall 7 day diary and measures of intrinsic motivation, competence, relatedness, autonomy and autonomy support. Based on the diary five binary indicators of physical activity were derived reflecting recommended levels of MVPA on a minimum of 3 days, at least three sessions of non-organized physical activity (e.g. jog), team sport, individual sport, and organized non-sport physical activity (e.g. dance). Latent class analysis was used to identify subgroups of adolescents that engaged in similar patterns of physical activity. Profiles of physical activity participation were subsequently compared on motivational characteristics using Kruskal-Wallis tests.

RESULTS

Latent class analysis revealed six distinct classes for girls (Organized Run/Swim & Dance/Gym; Organized Dance; Leisure Active Team Sport; Active Individual Sport; Walk/Run/Outdoor games; Non-Participation) and five for boys (Leisure Active Gym; Leisure Active Individual Sport; Active Team Sport; Active Mixed Type; Non-Participation). Significant differences were found between the classes. Girls characterized by participation in team or individual sport, and boys represented by team sport participation demonstrated significantly higher self-determined motivational characteristics relative to other profiles of physical activity.

CONCLUSION

This research offers a nuanced insight into the underlying type of activities that constitute overall patterns of PA among adolescent boys and girls and further reveals that psychological processes vary dependent on the profile of physical activity undertaken. The findings may be useful for informing interventions aimed at promoting physical activity among young people.

Bristol Girls Dance Project: a cluster randomised controlled trial of an after-school dance programme to increase physical activity among 11- to 12-year-old girls

Background

Many children do not meet UK physical activity (PA) guidelines. Girls are less active than boys, and the age-related decline in activity is steeper for girls. Dance is the favourite form of PA among adolescent girls in the UK. Participation in after-school dance classes could significantly contribute to girls’ PA. Therefore, after-school dance may be effective for increasing PA levels.

Objectives

To determine the effectiveness and cost-effectiveness of a dance-based intervention to increase the objectively assessed mean weekday minutes of moderate- to vigorous-intensity physical activity (MVPA) of Year 7 girls (11- and 12-year olds) 1 year after baseline measurement.

Design

Two-arm cluster randomised controlled trial and economic evaluation. Year 7 girls in participant schools received a ‘taster’ session and were invited to participate. Up to 33 girls per school were able to participate. Schools were randomly assigned (equal numbers) to intervention or control arms.

Setting

A total of 18 mainstream secondary schools across greater Bristol.

Participants

Year 7 girls in participating schools who could participate in physical education.

Intervention

Nine intervention schools received an after-school dance intervention (40 × 75-minute sessions) underpinned by self-determination theory, which attempts to improve intrinsic motivation for being active, and delivered by external dance instructors. Control schools continued as normal.

Main outcome measures

The main outcome was accelerometer-assessed mean minutes of MVPA at T2. Measures were assessed at baseline (T0), the end of the intervention (T1) and at T0 + 52 weeks (T2).

Results

Baseline MVPA levels were high. A total of 508 girls were included in the primary analysis, which found no difference in weekday MVPA between trial arms. There was no effect on secondary accelerometer outcomes. Data were subjected to a per-protocol analysis and no effect was found. However, at T1, girls who attended dance classes had 4.61 minutes more of MVPA and 14.27 minutes more of light-intensity activity between 15.00 and 17.00 on the days on which they attended intervention sessions. The intervention was inexpensive at £73 per participant (£63 when excluding dance instructor travel) but was not cost-effective owing to the ineffectiveness of the intervention. The European Quality of Life-5 Dimensions Youth survey data were unresponsive to changes in the sample. The process evaluation reported that girls in attendance enjoyed the sessions, that exertion levels were low during sessions and that attendance was low and declined. Fidelity to the session-plan manual was low but theoretical fidelity (to self-determination theory) was good. Qualitative information provides information for improving future interventions.

Conclusions

The intervention was enjoyed by participants. However, there was no difference in the MVPA levels (which were high at baseline) of girls allocated to receive dance compared with girls receiving the control. High baseline MVPA levels indicate that the study appealed to an already active cohort and, therefore, may not have targeted those most in need of an intervention. Dance is an enjoyable activity for adolescent girls and could be further trialled as a means by which to increase PA. Research might consider the impact of dividing the intervention period into smaller blocks.

Trial Registration

Current Controlled Trials ISRCTN52882523.

Funding

The National Institute for Health Research Public Health Research programme. The work was also undertaken with the support of the Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), a UK Clinical Research Collaboration (UKCRC) PHR Centre of Excellence. Joint funding (MR/KO232331/1) from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, the Welsh Government and the Wellcome Trust, under the auspices of the UKCRC, is gratefully acknowledged. This study was designed and delivered in collaboration with the Bristol Randomised Trials Collaboration, a UKCRC Registered Clinical Trials Unit in receipt of NIHR Clinical Trials Unit support funding. All intervention costs were funded by the respective councils to which the participant schools were affiliated, namely North Somerset Council, Bristol City Council, and Bath and North East Somerset Council.

Process evaluation of the Bristol girls dance project

Background

The Bristol Girls Dance Project was a cluster randomised controlled trial that aimed to increase objectively measured moderate-to-vigorous physical activity (MVPA) levels of Year 7 (age 11–12) girls through a dance-based after-school intervention. The intervention was delivered in nine schools and consisted of up to forty after-school dance sessions. This paper reports on the main findings from the detailed process evaluation that was conducted.

Methods

Quantitative and qualitative data were collected from intervention schools. Dose and fidelity were reported by dance instructors at every session. Intervention dose was defined as attending two thirds of sessions and was measured by attendance registers. Fidelity to the intervention manual was reported by dance instructors. On four randomly-selected occasions, participants reported their perceived level of exertion and enjoyment. Reasons for non-attendance were self-reported at the end of the intervention. Semi-structured interviews were conducted with all dance instructors who delivered the intervention (n = 10) and school contacts (n = 9) in intervention schools. A focus group was conducted with girls who participated in each intervention school (n = 9).

Results

The study did not affect girls’ MVPA. An average of 31.7 girls participated in each school, with 9.1 per school receiving the intervention dose. Mean attendance and instructors’ fidelity to the intervention manual decreased over time. The decline in attendance was largely attributed to extraneous factors common to after-school activities. Qualitative data suggest that the training and intervention manual were helpful to most instructors. Participant ratings of session enjoyment were high but perceived exertion was low, however, girls found parts of the intervention challenging.

Conclusions

The intervention was enjoyed by participants. Attendance at the intervention sessions was low but typical of after-school activities. Participants reported that the intervention brought about numerous health and social benefits and improved their dance-based knowledge and skills. The intervention could be improved by reducing the number of girls allowed to participate in each school and providing longer and more in-depth training to those delivering the intervention.

Trial registration

ISRCTN52882523 Registered 25th April 2013.

Effect and cost of an after-school dance programme on the physical activity of 11-12 year old girls: The Bristol Girls Dance Project, a school-based cluster randomised controlled trial

Background

The aim of this study was to examine the effectiveness and cost of an after-school dance intervention at increasing the physical activity levels of Year 7 girls (age 11–12).

Methods

A cluster randomised controlled trial was conducted in 18 secondary schools. Participants were Year 7 girls attending a study school. The Bristol Girls Dance Project (BGDP) intervention consisted of up to forty, 75-minute dance sessions delivered in the period immediately after school by experienced dance instructors over 20-weeks. The pre-specified primary outcome was accelerometer assessed mean minutes of weekday moderate to vigorous physical activity (MVPA) at time 2 (52 weeks are T0 baseline assessments). Secondary outcomes included accelerometer assessed mean minutes of weekday MVPA at time 1 (while the intervention was still running) and psychosocial outcomes. Intervention costs were assessed.

Results

571 girls participated. Valid accelerometer data were collected from 549 girls at baseline with 508 girls providing valid accelerometer data at baseline and time 2. There were no differences between the intervention and control group for accelerometer assessed physical activity at either time 1 or time 2. Only one third of the girls in the intervention arm met the pre-set adherence criteria of attending two thirds of the dance sessions that were available to them. Instrumental variable regression analyses using complier average causal effects provided no evidence of a difference between girls who attended the sessions and the control group. The average cost of the intervention was £73 per girl, which was reduced to £63 when dance instructor travel expenses were excluded.

Conclusion

This trial showed no evidence that an after-school dance programme can increase the physical activity of Year 7 girls. The trial highlighted the difficulty encountered in maintaining attendance in physical activity programmes delivered in secondary schools. There is a need to find new ways to help adolescent girls to be physically active via identifying ways to support and encourage sustained engagement in physical activity over the life course.

Trial registration

ISRCTN52882523

Electronic supplementary material

The online version of this article (doi:10.1186/s12966-015-0289-y) contains supplementary material, which is available to authorized users.

Physical activity in youth dance classes

BACKGROUND AND OBJECTIVES

The majority of youth are not meeting the US Department of Health and Human Services physical activity guidelines. Dance is a popular activity, particularly for girls, and has the potential to increase physical activity for many youth. This study investigated physical activity of children and adolescents in 7 dance types: ballet, hip-hop, jazz, Latin-flamenco, Latin-salsa/ballet folklorico, partnered, and tap.

METHODS

Data were collected in 17 private studios and 4 community centers in San Diego, California. A total of 264 girls from 66 classes participated (n =154 children; n = 110 adolescents). Physical activity was measured with accelerometers, and activity levels during class were calculated.

RESULTS

Participants recorded an average of 17.2 ± 8.9 minutes of moderate-to-vigorous physical activity (36% of class), but this varied by age and dance type. For children, dance type differences were observed with percent of class in moderate-to-vigorous physical activity ranging from 13.6% (Latin-flamenco) to 57% (hip-hop). For adolescents, there were no differences across dance types. Children were more active than adolescents in all types except ballet. Children and adolescents were more active in private compared with community center classes.

CONCLUSIONS

Overall, physical activity in youth dance classes was low; 8% of children and 6% of adolescents met the Centers for Disease Control and Prevention 30-minute guideline for after-school physical activity during dance. To increase physical activity in dance classes, teaching methods could be employed to increase activity in all types, or emphasis could be placed on greater participation in more active dance types.

Dance Class Structure Affects Youth Physical Activity and Sedentary Behavior: A Study of Seven Dance Types

PURPOSE

The study aims were to determine: (a) how class structure varies by dance type, (b) how moderate-to-vigorous physical activity (MVPA) and sedentary behavior vary by dance class segments, and (c) how class structure relates to total MVPA in dance classes.

METHOD

Participants were 291 boys and girls ages 5 to 18 years old enrolled in 58 dance classes at 21 dance studios in Southern California. MVPA and sedentary behavior were assessed with accelerometry, with data aggregated to 15-s epochs. Percent and minutes of MVPA and sedentary behavior during dance class segments and percent of class time and minutes spent in each segment were calculated using Freedson age-specific cut points. Differences in MVPA (Freedson 3 Metabolic Equivalents of Tasks age-specific cut points) and sedentary behavior ( < 100 counts/min) were examined using mixed-effects linear regression.

RESULTS

The length of each class segment was fairly consistent across dance types, with the exception that in ballet, more time was spent in technique as compared with private jazz/hip-hop classes and Latin-flamenco and less time was spent in routine/practice as compared with Latin-salsa/ballet folklorico. Segment type accounted for 17% of the variance in the proportion of the segment spent in MVPA. The proportion of the segment in MVPA was higher for routine/practice (44.2%) than for technique (34.7%). The proportion of the segment in sedentary behavior was lowest for routine/practice (22.8%).

CONCLUSION

The structure of dance lessons can impact youths' physical activity. Working with instructors to increase time in routine/practice during dance classes could contribute to physical activity promotion in youth.

Bristol girls dance project feasibility study: using a pilot economic evaluation to inform design of a full trial

BACKGROUND

There is currently little guidance for pilot trial economic evaluation where health outcomes and costs are influenced by a range of wider determinants and factors.

OBJECTIVES

This article presents the findings of a pilot economic evaluation study running alongside the Bristol Girls Dance Project (BGDP) feasibility study.

DESIGN

3-arm, cluster randomised, controlled pilot trial and economic evaluation. 7 schools (n=210) from the Bristol and greater Bristol area, UK were randomly allocated to the intervention arm 3 schools (n=90) and the control arm 4 schools (n=120).

INTERVENTION

Girls aged 11-12 years with parental consent were provided with two, 90 min dance sessions per week for 9 weeks at school facilities.

ECONOMIC OUTCOME MEASURES

Programme costs and girls' preferences for attributes of dance and preferences for competing leisure time activities were measured.

RESULTS

The mainstream average cost of the BGDP programme (not including research, control and dance teacher training costs) per school was $2126.40, £1329 and €1555 and per participant was $70.90, £44.31 and €51.84 in 2010-2011 prices. Discrete choice experiment (DCE) methods are acceptable to girls of this age indicating time available for other leisure activities on dance class days is the attribute girls valued most and 2 h leisure time remaining preferred to 3 h.

CONCLUSIONS

This pilot study indicates that providing full cost data for a future trial of the BGDP programme is feasible and practical. There is no evidence from preference data to support adjustment to intervention design. A future economic evaluation is likely to be successful utilising the resource use checklist developed. The importance of categorising separately resources used to develop, prepare, deliver and maintain the programme to estimate mainstream costs accurately is demonstrated.

Lessons learned from the HEALTHY primary prevention trial of risk factors for type 2 diabetes in middle school youth

The HEALTHY trial was designed to take a primary prevention approach to risk factors for type 2 diabetes in youth, primarily obesity. The study involved over 6,000 students at 42 middle schools across the U.S. Half received an integrated intervention program of components addressing the school food environment, physical education, lifestyle behaviors, and promotional messaging. The intervention was designed to be more comprehensive than previous efforts, and the research was amply funded. Although the primary objective of reducing the percentage of overweight and obesity in schools that received the intervention program, as compared with control schools, was not obtained, key secondary outcomes indicated an intervention effect. In retrospect, senior investigators involved in the study's design, conduct, and analysis discuss weaknesses and strengths and offer recommendations for future research efforts that address prevention of childhood obesity from a public health perspective.