There is limited high-quality information regarding physical activity, sedentary
behaviour and dietary habits focusing on adolescents from socially disadvantaged
settings. Therefore, there is a limited number of public health and educational policies
specifically designed for this population group. The ePro-Schools project will address
both knowledge gaps in the state-of the-art by co-designing and testing the effectiveness
of an intervention, which includes an eHealth platform (website), for promoting healthy
habits among adolescents from socially disadvantaged settings in the area of Central
Catalonia. For this reason, the main aim of the ePro-Schools project is to co-design and
test the effectiveness of an eHealth platform for promoting healthy habits among
adolescents from socially disadvantaged settings. The specific objectives of the project
are to:
Co-design with adolescents and teachers from secondary schools and policymakers in
socially disadvantaged settings a modular and digital eHealth platform for promoting
healthy habits among adolescents.
Pilot test with adolescents and teachers from secondary schools the ePro-Schools
platform
Conduct a randomized controlled trial (RCT) in a group of schools located in
socially disadvantaged settings in Catalonia to evaluate the effectiveness,
cost-effectiveness and implementation parameters of the ePro-Schools program in
regard to physical activity, sedentary behaviour and dietary habits of adolescents
in socially disadvantaged settings.
Evaluate to which extend changes in lifestyle behaviours (physical activity,
sedentary behaviour and dietary habits) are associated with physical and mental
health in adolescents from socially disadvantaged settings.
Co-design with adolescents, teachers and policymakers transferable evidence-based
practices, methodologies and guidance for upscaling of the ePro-Schools platform as
a public mental health policy for youth, and present it to EU, national and regional
policymaker.
The study will be conducted in the area of Central Catalonia, particularly in six
secondary schools from socially disadvantaged settings (intervention group vs control
group size ratio 1:1). We will focus on students attending 1st, 2nd and 3rd year of
secondary school, and in total, around 1000 adolescents will be involved. Moreover,
physical activity teachers and school staff from the selected secondary schools will
participate in the study as well. The families of the adolescents will also be involved
in the study.
To achieve all the objectives, the project has several phases:
Co-design (Objective 1): The platform will be co-created with input from various
stakeholders-adolescents, teachers, school administrators, and policymakers. Focus
group sessions with teachers and school directors will shape the content and
features of the platform, while policymakers will provide feedback on potential
barriers and strategies for large-scale implementation.
Project Survey (Objective 1): A survey will be conducted with teachers and students
to gather feedback on the platform's content, particularly regarding physical
activity and nutrition.
Pilot Testing (Objective 2): After the co-creation phase, alpha and beta testing of
the platform will occur, including feedback from stakeholders and experts. A pilot
test will assess usability, functionality, and integration of feedback to refine the
platform before the main trial.
Randomized Controlled Trial and Evaluation (Objectives 3 & 4): In a randomized
controlled trial, control group will receive basic health-related information, while
the intervention group will use the ePro-Schools platform. Participants will be
evaluated at multiple time points to assess the impact on lifestyle behaviors,
physical health, and mental well-being.
Co-design of Transferable Practices (Objective 5): A concluding workshop with
stakeholders will consolidate findings and generate actionable recommendations for
scaling the platform, resulting in a policy translation report to guide broader
implementation.
The RCT will be evaluated regarding its effectiveness, cost-effectiveness and process
implementation.
Regarding the effectiveness of the program, statistical analyses will assess the impact
of the program using Mixed Methods with Repeated Measurements (MMRM) for continuous data
and Generalized Estimating Equations (GEE) for categorical data. The analyses will
measure outcomes at both post-intervention and follow-up, adjusting for potential
confounders (e.g., sex, sociodemographic status, and baseline outcomes). For the
cost-effectiveness, a comparison of costs between the new intervention and regular care
will be made, calculating the incremental cost-effectiveness ratio (ICER). The
cost-effectiveness will be expressed as cost per Quality-Adjusted Life Year (QALY)
gained. The implementation evaluation will focus on evaluating the adoption,
acceptability, appropriateness, and feasibility of the program. Adoption will be assessed
through multiple indicators, such as questionnaire completion and content interaction,
instead of just logins or time spent on the platform. Acceptability and feasibility will
be evaluated using questionnaires, interviews, and focus groups during the co-creation
phase. Barriers and facilitators to intervention implementation will also be explored.
