PASSPORT: A Physical Activity School-Specific PORTfolio intervention evaluated via a stepped wedge design to increase children's physical activity

体育锻炼对儿童的身心健康很重要。随着小学阶段的结束是变化的关键时期，整个童年的体力活动都在减少。新冠肺炎疫情加剧了这些挑战。迫切需要帮助更多的儿童活跃起来，特别是制定普遍的方案，促进儿童的身体活动，而不管他们的社会经济地位如何。这是一个重大挑战，因为目前的体力活动干预措施不起作用，并可能加剧健康不平等。许多“成功的”试点研究在较大规模的试验中都是无效的，因为从一开始就没有考虑实施和外部有效性。作为一个领域，我们一直专注于确保对核心计划的忠诚度，而不是设计与交付这些计划的背景和系统相匹配的计划。目前评估这些项目的集群随机对照试验的主导地位加剧了这些问题，因为它忽视了对成功至关重要的学校环境。在这个项目中，我们将设计一个新的灵活的体育活动计划，在该计划中，学校选择核心和外围组件来创建学校特定的文件夹。这种方法注重外部效度，采用灵活的“组合”干预。我们还将设计一个新的评估框架，基于阶梯式楔形设计，考虑到学校的情况。该项目包括对干预措施组成部分的系统审查、建模设计情景、利益攸关方参与、干预设计、试验新方法，并以对一种全新的组合干预措施进行最先进的阶梯式评估结束。该项目的风险很高(新的干预方法、新方法的模型化、新的评估框架)，但有可能在人口层面上对儿童的身体活动产生可持续的变化，同时也改变以学校为基础的公共卫生干预措施的设计和评估方式。

Physical activity is important for children's physical and mental health. Physical activity declines across childhood with the end of primary school a critical period of change. The COVID-19 pandemic has exacerbated these challenges. There is an urgent need to help more children be active, in particular for universal programs that facilitate physical activity for children regardless of socio-economic position. This presents a major challenge as current physical activity interventions do not work and can exacerbate health inequalities. Numerous "successful" pilot studies have been ineffective in larger trials as implementation and external validity were not considered from the outset. As a field we have focused on ensuring fidelity to a core program rather than designing programs that match the context and system in which they are delivered. The current dominance of the cluster randomised controlled trial to evaluate these programs exacerbates these issues as it ignores the school context that is essential for success. In this project, we will design a new flexible physical activity program in which schools select core and peripheral components to create a school-specific portfolio. This approach focuses on external validity with the flexible "Portfolio" the intervention. We will also design a new evaluation framework based on a stepped-wedge design that accounts for the school context. The project includes systematic reviews of intervention components, modelling design scenarios, stakeholder engagement, intervention design, piloting new methods and ends with a state-of-the-art stepped-wedge evaluation of a completely novel, portfolio intervention. This project is high risk (new intervention approach, modelling of new methods, new evaluation framework) yet has potential to yield sustainable changes in children's physical activity at the population level while also changing how school-based public health interventions are designed and evaluated.