Effects of a physical education intervention programme for ninth-graders on physical activity-related health competence: Findings from the GEKOS cluster randomised controlled trial

https://doi.org/10.1016/j.psychsport.2021.101923Get rights and content

Highlights

  • Health- and fitness-related physical education intervention with follow-up analysis.

  • Combining theory and ball games in physical education fosters fitness knowledge.

  • Learning tasks enhance competence to align physical activity to health.

  • Increasing motivation within teaching theory and practice needs further study.

Abstract

The main purpose of this cluster randomised controlled trial was to investigate the effects of a physical education (PE) intervention programme combining theoretical and practical components on students' knowledge, skills, abilities and motivation related to competence for a healthy active lifestyle. The intervention used learning tasks to combine theory on health and physical fitness with either running/jumping activities or small-sided ball games and was compared to regular PE classes. Forty-eight PE classes were randomly assigned to intervention (IG-run, IG-game play; 27 classes) and control (CG-run, CG-game play; 21 classes) groups. Overall, 841 ninth-graders (51.1% girls, Mage = 14.20, SD = 0.51) were tested before and after the six-week intervention and in an eight-to-twelve-week follow-up. Students completed a health-related fitness knowledge test, questionnaires on control competence for physical training, health- and fitness-related interest and attitudes, and physical fitness tests. Regressions in structural equation models revealed positive treatment effects of the game play intervention on students' knowledge (βStdY = 0.33, 99.6% CI [0.12, 0.55]) and control competence for physical training (βStdY = 0.26, 99.6% CI [0.02, 0.50]) at the post-test. No significant effects were found at the follow-up test. Treatment effects were independent of gender. The results indicate the short-term effectiveness of learning tasks combining theory with ball games in order to develop knowledge and control competence for physical training in PE. Further studies have to clarify how to sustain effects over time and address students' physical fitness and health- and fitness-related interest and attitudes in interventions combining theory and practice.

Trial registration

This study was retrospectively registered with the German Clinical Trials Register (DRKS), DRKS-ID: DRKS00016349.

Introduction

Health is a topic in physical education1 (PE) curricula in many countries (e.g. Cale et al., 2020; Ptack & Tittlbach, 2018). In this context, students are supposed to learn to understand the relationship between health and physical activity (PA) or how to design a plan to enhance health-related physical fitness (SHAPE, 2014). One objective of PE regarding health is therefore to ensure that students acquire knowledge, physical skills, abilities and motivation to empower them to be physically active in a health-enhancing way (Cale et al., 2020; Kurz, 2004; Ptack & Tittlbach, 2018). Thus, effective teaching methods are required, which include not only active participation in physical activities (i.e. practice) to develop physical skills and abilities but also the transfer of knowledge (i.e. theory).

Systematic reviews have shown that school-based PA interventions can foster students' knowledge and physical fitness, but they have yielded divergent results regarding motivation (Demetriou et al., 2015; Demetriou & Höner, 2012). On closer examination, intervention studies on health promotion in PE, which include practical and theoretical components (Demetriou et al., 2015; Demetriou & Höner, 2012; Strobl et al., 2020; Wang & Chen, 2020) reveal specific challenges and research gaps.

First, few studies (Demetriou, 2013; Morris et al., 2013; Mott et al., 1991) have been based on a theoretical approach and have simultaneously investigated the effects on knowledge, physical fitness and motivation. However, there are PE-specific theoretical frameworks, such as physical literacy, that encompass these variables and provide a foundation for their simultaneous examination. Physical literacy is the main target of PE in Anglo-Saxon curricula (Roetert & MacDonald, 2015) and is defined as “motivation, confidence, physical competence, knowledge and understanding to value and take responsibility for engagement in physical activities for life” (Tremblay et al., 2018, p. 16). It also comprises variables that can be found in behaviour and motivational theories (e.g. the information-motivation-behavioural skill model; Fisher & Fisher, 2002; the theory of planned behaviour; Ajzen, 1985; self-determination theory; Deci & Ryan, 1985) commonly applied in exercise psychology and used in PE intervention studies to explain and promote PA (Kelly et al., 2012; McEachan et al., 2011; Saugy et al., 2020; Teixeira et al., 2012). Compared to these models, however, physical literacy explicitly considers both psychological elements (e.g. knowledge, motivation towards PA) and physical elements (e.g. physical fitness, motor performance), whose acquisition is equally important in PE (Roetert & MacDonald, 2015).

Second, there is limited empirical evidence on how most effectively to include theory and practice in PE to address knowledge, physical fitness and motivation altogether. Intervention studies on health and physical fitness in PE differed in their delivery of theoretical components (e.g. separated from PA in a classroom, at the beginning/end of the PE lesson or combination of theory and practice through PA; Demetriou, 2013; Stock et al., 2007). The delivery of knowledge, skills and abilities through participation in different physical activities in PE is assumed to be appropriate and most effective for the school subject (Cale et al., 2020; Ennis, 2007). Some studies on health and physical fitness in PE have explicitly reported a combination of practical and theoretical components as part of their intervention programme to foster knowledge and/or motivation (Strobl et al., 2020; Sun et al., 2012; Wang & Chen, 2020). However, the sustainability of learning effects related to intervention programmes that explicitly combine theoretical and practical components has rarely been investigated (e.g. Wang & Chen, 2020). This lack of follow-up analysis has generally been met with criticism in PE intervention studies that include theory and practice independent of the type of delivery.

Third, theory-based studies that include theoretical and practical intervention components on health and physical fitness to concurrently address knowledge, physical fitness and motivation have typically investigated fitness activities (e.g. circuit training, rope jumping, jogging; Demetriou, 2013; Mott et al., 1991). Therefore, it remains unclear whether intervention-related effects differ depending on the type of PA. Meanwhile, several intervention studies in PE have shown that small-sided ball games (e.g. 3 vs 3 football games) can be effective for improving students' physical fitness and health knowledge (Fuller et al., 2017; Krustrup et al., 2016). As students differ in their PA preferences (Hill & Hannon, 2008), the type of PA might influence the effectiveness of health-related interventions in PE that incorporate theoretical and practical components. Additionally, studies have demonstrated inconsistent results regarding gender-specific effectiveness, either in favour of girls or reported no difference between gender (Demetriou, 2013; Höner & Demetriou, 2014; Mott et al., 1991). However, evidence about the extent to which gender influences intervention effectiveness is important for the development and cross-gender application of intervention programmes.

Against this background, the GEKOS (abbreviation of the project title in German: Förderung bewegungsbezogener Gesundheitskompetenz im Sportunterricht [Promotion of PA-related health competence in PE]) intervention programme was developed. GEKOS is a theory-based health- and fitness-related intervention programme combining theoretical and practical components through learning tasks (Leisen, 2010) and the principle of reflective practice (Schön, 2006; Serwe-Pandrick, 2013). It incorporates either running/jumping activities (“run intervention”) or small-sided ball games (“game play intervention”) while the learning objectives, contents and methods remain constant regardless of the type of PA. The PA-related health competence model (Sudeck & Pfeifer, 2016) was chosen as the theoretical framework for the GEKOS study and its learning objectives. This model shares some features with physical literacy (Tremblay et al., 2018), as it incorporates knowledge, motivation, physical skills and abilities, suggesting their simultaneous promotion. Therefore, the present study evaluated whether the GEKOS intervention programme in PE can sustainably foster knowledge, skills, abilities and motivation associated with competence for a healthy active lifestyle. The following sections explain the theoretical framework of the study and the specific approaches for combining the theoretical and practical elements through learning tasks and the principle of reflective practice.

The PA-related health competence model (Sudeck & Pfeifer, 2016) describes domain-specific competencies thought to be required to meet the complex demands of health-enhancing PA. The model is thus based on a functional-pragmatic understanding of competence (Klieme et al., 2008; Weinert, 2001). According to this model, each of the domain-specific competencies is composed of a specific linkage between knowledge, physical (e.g. physical skills and abilities) and motivational (e.g. attitudes) elements. The model shares some features with the concepts of physical literacy and health literacy. Compared to the concept of physical literacy, however, elements and competencies of the model focus explicitly on the connection with health (Cairney et al., 2019; Carl et al., 2020). In accordance with health literacy concepts, it considers skills and abilities that enable the individual to take decisions and actions that have positive effects on health and well-being (Carl et al., 2020; Sudeck & Pfeifer, 2016).

The relationship between physical literacy and health literacy in this model of PA-related health competence is echoed in the sub-competence of control competence for physical training, which describes an individual's ability to adjust PA to gain physical health effects (Sudeck & Pfeifer, 2016). Individuals with high control competence for physical training can apply their health-related fitness knowledge (HRFK) – defined as the understanding of exercise and training principles for the promotion of health-related fitness as well as knowledge of the effects of PA on health (Volk et al., 2020; Zhu & Haegele, 2019) – to gear PA to individual health. These individuals are aware of their body signals and use them to control physical load (Sudeck & Pfeifer, 2016). Health- and fitness-related attitudes and interest also have been shown to be positively correlated with individuals' control competence for physical training (Carl et al., 2020; Haible et al., 2020). This aligns with both physical literacy approaches (Chen, 2015) and expectancy-value theory (Eccles & Wigfield, 2002; Wigfield & Cambria, 2010), which suggest that students' interest (intrinsic value) and attitudes (utility value) are especially beneficial for their engagement in learning. Additionally, control competence for physical training has been empirically shown to be related to physical fitness (Haible et al., 2020; Sudeck & Pfeifer, 2016). Bearing in mind the specific objectives concerning health as a PE topic, control competence for physical training along with its related elements is considered a valuable and domain-specific theoretical basis for investigating effective teaching methods that concurrently address knowledge, physical skills, abilities and motivation.

The promotion of control competence for physical training and related HRFK, health- and fitness-related motivation (interest, attitudes) and physical fitness is assumed to require not only the isolated transfer of theoretical or practical components in PE but their combination (Carl et al., 2020). The instructional principle of reflective practice – that is, reflection in and on action – describes a method for combining practical and theoretical components in PE (Schön, 2006; Serwe-Pandrick, 2013). For example, students could be asked in PE to explicitly perceive the changes of their body signals during PA or to reflect on their perceived body signals during previous PA.

Furthermore, learning tasks (Leisen, 2010) are regarded as beneficial for developing competence in education in general (Pfitzner et al., 2012) and are based on a constructivist understanding of learning (Ennis, 2015; Rovegno & Dolly, 2006). A learning task includes different subtasks on a topic or problem (e.g. perception and use of acute physiological responses to PA) that students have to solve consecutively. These tasks are characterized by cognitive activation (i.e. the student must actively think about the tasks' solutions) and student orientation (i.e. students are actively involved in the learning process), and they permit social interaction (Pfitzner et al., 2012; Ptack & Tittlbach, 2018). Still, there is a need for detailed research into whether learning tasks and the principle of reflective practice are suitable for the promotion of control competence for physical training, HRFK, health- and fitness-related motivation and physical fitness.

Within the research on interventions related to health and physical fitness in PE, there is a scarcity of theory-based studies investigating the sustainable acquisition of knowledge, physical fitness and motivational elements through a combination of theory and different types of physical activities in learning tasks. Therefore, the aim of this study was to investigate whether the two types of the GEKOS intervention programme (run intervention, game play intervention) would affect student's HRFK, control competence for physical training, physical fitness, health- and fitness-related interest and attitudes in the short- and mid-terms compared to regular PE classes. Furthermore, this study aimed to investigate differences between the effects of the run and game play interventions in order to examine whether treatment effects vary with the selected type of PA. Finally, owing to a lack of consistent findings on the gender-specific effectiveness of health and physical fitness intervention programmes with theoretical and practical components, this study analysed whether the GEKOS intervention effects differ depending on gender.

Section snippets

Study design and procedure

The published study protocol presents a detailed description of the study design, sample size calculation, sample recruitment and randomisation process (Haible et al., 2019).

A cluster randomised controlled trial with ninth-graders was conducted to examine the effects of the two types of the GEKOS intervention programme. Two intervention groups (IG-run, IG-game play) were compared to two waiting list control groups (CG-run, CG-game play) attending regular PE classes. A power analysis

Sample

Of the 48 PE classes randomly allocated to the two intervention (IG-run or IG-game play) and two control (CG-run or CG-game play) groups, one class discontinued the intervention programme after the first PE lesson due to the PE teacher's illness. Consequently, this class was excluded from the final analyses, resulting in a total sample of 841 students (Mage = 14.20, SD = 0.51; 21 PE control classes, 26 PE intervention classes). Of this sample, 405 students belonged to the run groups (10 PE

Discussion

In this cluster randomised controlled trial, the game play intervention had significant positive effects on students' control competence for physical training and HRFK in the short term. For cardiovascular fitness, muscular fitness and health- and fitness-related motivation, it was not possible to determine effects of the run intervention or the game play intervention. Furthermore, intervention effects did not differ regarding students' gender.

Conclusion

This cluster randomised controlled trial provides an initial indication of the short-term effectiveness of a game play intervention on ninth-graders’ HRFK and control competence for physical training. However, similar effects were not found for the run intervention. Therefore, it is necessary to clarify how to increase and sustain the effects of the GEKOS intervention programme. As competence refers to the integration of knowledge, skills, abilities and motivation (Klieme et al., 2008; Weinert,

CRediT authorship contribution statement

Carmen Volk: Conceptualization, Methodology, Validation, Formal analysis, Investigation, Data curation, Writing – original draft, Writing – review & editing, Visualization, Project administration. Stephanie Rosenstiel: Conceptualization, Methodology, Investigation, Data curation, Writing – review & editing, Project administration. Yolanda Demetriou: Conceptualization, Methodology, Resources, Writing – review & editing, Funding acquisition. Peter Krustrup: Conceptualization, Writing – review &

Declaration of competing interest

We have no conflicts of interest to disclose.

Acknowledgements

This work was supported by the German Research Foundation (Deusche Forschungsgemeinschaft [DFG], Germany; grant number 397847999).

We would like to thank all the schools, teachers and students who participated in our study. We would also like to thank our research assistants and the regional council of Tübingen (Department 7, Sport) for their support.

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