Promoting Physical Activity in Girls by a Theory-Based Intervention In
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Technische Universität München Fakultät für Sport- und Gesundheitswissenschaften Professur für Sport- und Gesundheitspädagogik Promoting Physical Activity in Girls by a Theory-Based Intervention in Physical Education: Evaluation of the CReActivity Study David Joseph Sturm Vollständiger Abdruck der von der Fakultät für Sport- und Gesundheitswissenschaften der Technischen Universität München zur Erlangung des akademischen Grades eines Doktors der Philosophie (Dr. phil.) genehmigten Dissertation. Vorsitzender: Prof. Dr. Joachim Hermsdörfer Prüfer der Dissertation: 1. Prof. Dr. Yolanda Demetriou 2. Prof. Jo Salmon, Ph.D. Die Dissertation wurde am 01.03.2021 bei der Technischen Universität München eingereicht und durch die Fakultät für Sport- und Gesundheitswissenschaften am 13.07.2021 angenommen. „Das habe ich noch nie vorher versucht, also bin ich völli g sicher, dass ich es schaffe.“ Pippi Langstrumpf Acknowledgements Before I started my dissertation project, my first supervisor Prof. Dr. Yolanda Demetriou pointed out that the next three years are going to be a challenging time with many ups and downs. In retrospective, the time was characterized by an unexpectedly long lockdown and I am deeply grateful to her because she always motivated, inspired, and supported my research. I further want to thank my second supervisor Prof. Ph.D. Jo Salmon. Unfortunately, my visit in 2020 at the Deakin University was cancelled due to the Covid-19 crisis. Hence, I am delighted that she immediately responded to my request to serve as supervisor for this work. Besides that, I wish to thank Dr. Joachim Werner for his mentoring and constructive ideas whenever requested as well as Dr. Stephan Haug for his comprehensive support. I further would like to thank all co-authors and colleagues for lending research material and sharing expertise. A special thanks goes to the students, teachers and schools who participated in the study. I am thankful that they provided the opportunity to carry out this intervention. I personally want to thank all student assistants who did an excellent job and thereby contributed essentially to the success of this project. Besides, I want to thank my colleagues and friends from the second floor. Sharing inspiring ideas, knowledge, and several cups of coffee solved my project-related challenges and formed friendships which I deeply appreciate. Thank you. Finally, I want to thank my family, partner, and friends, who have always showed great interest in my studies and have supported me from the very beginning. Their life experience and expertise as teachers in particular inspired my studies. Table of Contents List of Figures ....................................................................................................................VI List of Abbreviations....................................................................................................... VII Summary .............................................................................................................................. 8 1 Introduction.............................................................................................................. 10 1.1 Physical Activity as Part of a Healthy Lifestyle ..................................................... 11 1.2 Measurement of Physical Activity .......................................................................... 13 1.3 Recommendations and Physical Activity Levels.................................................... 14 1.4 The School Environment as an Activity Setting ..................................................... 17 1.5 The Pedagogical Role of Physical Education ......................................................... 19 1.6 Theoretical Framework of the CReActivity Study ................................................. 22 1.6.1 Ecological Model of Health Behavior........................................................... 23 1.6.2 Self-Determination Theory............................................................................ 24 1.6.3 Synthesis to Youth Physical Activity Promotion Model............................... 26 1.7 Efficacy of Physical Education Interventions ......................................................... 29 1.8 Critique of Current Research................................................................................... 32 2 Aims of the Studies................................................................................................... 34 3 Methodology ............................................................................................................. 35 3.1 Accelerometry ......................................................................................................... 35 3.2 Multilevel Validation .............................................................................................. 36 3.3 Mixed Method Evaluation....................................................................................... 37 3.4 Intervention Components ........................................................................................ 39 4 Publications............................................................................................................... 42 4.1 Publication 1............................................................................................................ 42 4.2 Publication 2............................................................................................................ 52 IV 4.3 Publication 3............................................................................................................ 66 5 General Discussion................................................................................................... 84 5.1 The Self-Determination Approach in Physical Education ...................................... 87 5.2 Limitations .............................................................................................................. 90 5.3 Future Research Perspective ................................................................................... 91 6 Conclusion................................................................................................................. 95 7 References................................................................................................................. 96 8 Appendix ................................................................................................................. 120 8.1 List of Publications................................................................................................ 120 8.2 Reprint Permissions............................................................................................... 120 V List of Figures Figure 1 The Internalization Continuum: Types of Motivation According to Self- Determination Theory (Illustration from Legault, 2017). ............................... 24 Figure 2 Youth Physical Activity Promotion Model (Welk, 1999). ................................ 27 VI List of Abbreviations RCT Randomized Controlled Trial cpm Counts per Minute e.g. exempli gratia: “for example” et al. et alii: “and others” HBSC Health Behavior in School-Aged Children i.e. id est: “that is” KiGGS Kinder- und Jugendgesundheitssurvey PE Physical Education (M)CFA (Multilevel) Confirmatory Factor Analysis p. Page MET Metabolic Equivalent of Task MVPA Moderate-to-Vigorous Physical Activity SOFIT System of Observing Fitness Instruction Time WHO World Health Organization YPAPM Youth Physical Activity Promotion Model VII Summary Already in adolescence, physical inactivity is associated with the risk factors of non- communicable diseases and mental health issues. Girls, especially those with low socioeconomic status, represent a high-risk group for inactivity. How the rapidly changing environment and intrapersonal factors contribute to the low and further decreasing physical activity levels is of critical interest. Understanding the behavioral changes in physical activity allows researchers to develop effective strategies promoting physical activity in health-related risk groups. Literature indicates that theory-based school interventions increase students’ motivation to engage in physical activity . A self-determination theory- based teaching style in physical education might be fruitful to motivate those who not already adhere to an active lifestyle in their leisure time to engage in sports and exercises. The CReActivity study aimed to promote the girls’ physical activity behavior through a tailored PE intervention in Bavarian secondary schools (Realschulen). This doctoral thesis comprises three peer-reviewed publications that describe the sample’s physical activity levels, validate methodologies, as well as evaluate the CReActivity intervention. The description of the girls’ physical activity levels, which were assessed using accelerometry, contributes to fill the fragmentary physical activity observations in Germany. By using an innovative multilevel confirmatory factor analysis, the study validated a measurement tool which helps to identify students’ perceptions of their basic psychological needs in physical education. Finally, the mixed method evaluation of the cluster randomized control trial represents the core element of this dissertation thesis. This work provides an insight in an intervention that is among the first studies, which addresses the girls’ needs through a tailored and theory-based physical education program. Based on the integration of results from qualitative and quantitative methodologies, girls