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.
Evaluate the data from the DESKCohort study about lifestyle behaviours of the
adolescent population in Central Catalonia to contextualize the situation and needs
of this population and incorporate them in the eHealth platform.
Conduct a pilot testing of the ePro-Schools eHealth platform.
Conduct a randomized controlled trial (RCT) to test the effectiveness,
cost-effectiveness and implementation parameters of the eHealth platform in regard
to the physical activity, sedentary behaviour and dietary habits of the 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 and 2nd of secondary
school and in total around 1000 adolescents will be involved. Moreover, physical activity
teachers from the selected secondary schools will participate in the study as well
(co-creation process and by answering some questionnaires).
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 2): 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 3): 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 4 & 5): 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 6): 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.
In the same line, we propose de following analysis. First, an implementation analysis
will be carried out. These 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 implementation will also be explored, and all
qualitative data will be recorded, transcribed, and analyzed.
Moreover, an effectiveness and cost-effectiveness analysis will be carried out. First, a
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 sex, sociodemographic status, and baseline outcomes. Effect
size will be calculated using Cohen's coefficient and the Reliable Change Index (RCI)
will measure reliable results. Second, 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. Data will be used in a Health Technology Assessment (HTA) to evaluate
economic, organizational, and ethical aspects of the intervention.