The lack of consensus on meaningful and interpretable physical activity outcomes from accelerometer data hampers comparison across studies. Cut-point analyses are simple to apply and easy to interpret but can lead to results that are not comparable. We propose that the optimal accelerometer metrics for data analysis are not the same as the optimal metrics for translation. Ideally, analytical metrics are precise continuous variables that cover the intensity spectrum, while translational metrics facilitate meaningful, public-health messages and can be described in terms of activities (e.g. brisk walking) or intensity (e.g. moderate-to-vigorous physical activity). Two analytical metrics that capture the volume and intensity of the 24-h activity profile are average acceleration (volume) and intensity gradient (intensity distribution). These allow investigation of independent, additive and interactive associations of volume and intensity of activity with health; however, they are not immediately interpretable. The MX metrics, the acceleration above which the most active X minutes are accumulated, are translational metrics that can be interpreted in terms of indicative activities. Using a range of MX metrics illustrates the intensity gradient and average acceleration (i.e. 24-h activity profile). The M120, M60, M30, M15 and M5 illustrate the most active accumulated minutes of the day, the M¹/_3DAY the most active accumulated 8 h of the day. We demonstrate how radar plots of MX metrics can be used to interpret and translate results from between- and within-group comparisons, provide information on meeting guidelines, assess individual activity profiles relative to percentiles and compare activity profiles between domains and/or time periods.

Globally, adolescent girls’ physical activity (PA) levels are low. The ‘Girls Active’ secondary school-based programme, developed by the Youth Sport Trust, aims to increase PA in adolescent girls. This paper explores the effectiveness of the ‘Girls Active’ school-based PA programme. A random sample of girls aged 11–14 from 20 secondary schools (Midlands, UK) participated in a two-arm cluster randomised controlled trial. Ten schools received Girls Active and 10 continued with usual practice. Measurements were taken at baseline, seven- and 14-month follow-up. Primary outcome: wrist-worn accelerometer measured moderate- to vigorous-intensity PA (MVPA). Secondary outcomes: overall PA, light PA, sedentary time, body composition, and psychosocial outcomes. Generalised estimating equations, adjusted for school cluster and potential confounders, were used and A priori subgroup analysis was undertaken. Micro-costing and cost-consequence analyses were conducted using bespoke collection methods on programme delivery information. Outcomes for the cost-consequence analysis were health related quality of life measured by the Child Health Utility-9D and service use. Overall, 1752 pupils participated, 1211 (69.1%) provided valid 14-month accelerometer data. No difference in MVPA (mins/day; 95% confidence intervals) was found at 14 months (1.7; -0.8 to 4.3), there was at seven months (2.4; 0.1 to 4.7). Subgroup analyses showed significant intervention effects on 14-month in larger schools (3.9; 1.39 to 6.09) and in White Europeans (3.1; 0.60 to 6.02) and in early maturers (5.1; 1.69 to 8.48) at seven months. The control group did better in smaller schools at 14-months (-4.38; -7.34 to -1.41). Significant group differences were found in 14-month identified motivation (-0.09; -0.18 to -0.01) and at seven months in: overall PA (1.39 mg/day; 0.1 to 2.2), after-school sedentary time (-4.7; -8.9 to -0.6), whole day (5.7; 1.0 to 10.5) and school day (4.5; 0.25 to 8.75) light PA, self-esteem. Small, statistically significant, differences in some psychosocial variables favoured control schools. Micro-costing demonstrated that delivering the programme resulted in a range of time and financial costs at each school. Cost-consequence analysis demonstrated no effect of the programme for health related quality of life or service use. Compared with usual practice, ‘Girls Active’ did not affect 14-month MVPA. ISRCTN10688342

Physical activity is a fundamental therapeutic aid in the management of type 2 diabetes (T2D). Regular engagement elicits a plethora of adaptations which leads to improvements in clinical outcomes, such as HbA_1c, lipids and blood pressure as well as whole body health and physical function benefits. Those with T2D are encouraged to engage in a minimum of 150 minutes/week of moderate‐intensity physical activity (or 75 minutes/week of vigorous activity). Current recommendations also suggest that this should be supplemented with two‐to‐three resistance, flexibility and/or balance training sessions/week. The latter is particularly encouraged for older individuals or those with limited mobility/poor physical function. Those with T2D are also encouraged to break up prolonged bouts of sitting.However, a large proportion of the general population do not meet current physical activity guidelines, with the figure even lower in those with T2D. Getting started and sustaining a physically active lifestyle is challenging. Therefore, this article aims to provide health care professionals with the information required to tailor guidance to individuals with T2D by: presenting an overview of current guidelines, terminology and benefits; discussing the risk of adverse events; precautions when exercising with complications; practical options for getting started and how to tailor advice in primary care.Where appropriate, individual preferences and motivations should inform decision making regarding exercise modality in order to maximise compliance. That said, the overarching message is that any physical activity is better that none, but more is better especially when combined with a reduction in sitting. Copyright © 2021 John Wiley & Sons.

Despite the health benefits of physical activity, data from the UK suggest that a large proportion of adolescents do not meet the recommended levels of moderate-to-vigorous physical activity (MVPA). This is particularly evident in girls, who are less active than boys across all ages and may display a faster rate of decline in physical activity throughout adolescence. The ‘Girls Active’ intervention has been designed by the Youth Sport Trust to target the lower participation rates observed in adolescent girls. ‘Girls Active’ uses peer leadership and marketing to empower girls to influence decision making in their school, develop as role models and promote physical activity to other girls. Schools are provided with training and resources to review their physical activity, sport and PE provision, culture and practices to ensure they are relevant and attractive to adolescent girls. This study is a two-arm cluster randomised controlled trial (RCT) aiming to recruit 20 secondary schools. Clusters will be randomised at the school level (stratified by school size and proportion of Black and Minority Ethnic (BME) pupils) to receive either the ‘Girls Active’ intervention or carry on with usual practice (1:1). The 20 secondary schools will be recruited from state secondary schools within the Midlands area. We aim to recruit 80 girls aged 11–14 years in each school. Data will be collected at three time points; baseline and seven and 14 months after baseline. Our primary aim is to investigate whether ‘Girls Active’ leads to higher objectively measured (GENEActiv) moderate-to-vigorous physical activity in adolescent girls at 14 months after baseline assessment compared to the control group. Secondary outcomes include other objectively measured physical activity variables, adiposity, physical activity-related psychological factors and the cost-effectiveness of the ‘Girls Active’ intervention. A thorough process evaluation will be conducted during the course of the intervention delivery. The findings of this study will provide valuable information on whether this type of school-based approach to increasing physical activity in adolescent girls is both effective and cost-effective in the UK. ISRCTN10688342 . Registered 12 January 2015.

Of interest across the domains of sport, education and health in the UK and internationally is the challenge of engaging girls in physical activity. There has been increasing support for novel approaches that take seriously the notion of ‘co-design’: i.e. involving girls in decision-making processes that directly and indirectly affect their engagement with physical activity. Given this approach is still in its infancy, this study set out to explore pupils’ experiences of a co-designed school-based physical activity programme – the UK Youth Sport Trust’s Girls Active programme – and offers suggestions for enhancing future co-design interventions. We report analysis of 22 focus groups conducted with 143 pupils from eight of the ten schools that engaged in the Girls Active programme. Seeking to explore how co-design can be optimised, the analysis arrived at a conceptualisation grounded in comfort theory, articulated here across three sources of comfort and discomfort: material, social and practical. We discuss how orienting future co-design interventions around these sources of discomfort may be a useful way of avoiding several significant reasons why girls might disengage from physical activity in schools. Crucially, we suggest that pupils are uniquely placed to offer insight and foresight about experiences of discomfort, making a co-design approach a potentially powerful way to help navigate what can be a complex, changing and context-sensitive issue. Finally, important distinctions between co-design and co-production are discussed to encourage researchers in the field to carefully consider which of these approaches are most appropriate for their own work.