Smith 2014.

Study characteristics
Methods	Study name: Active teen leaders avoiding screen‐time (ATLAS) Study design: cluster‐RCT Intervention period: 8 months Follow‐up period (post‐intervention): 10 months Differences in baseline characteristics: reported Reliable outcomes: reported Protection against contamination: NR Unit of allocation: school Unit of analysis: individual accounting for clustering
Participants	N (control baseline) = 284 N (control follow‐up) = 195 N (intervention baseline) = 283 N (intervention follow‐up) = 191 Setting (and number by study group): 14 co‐educational public secondary schools in areas with a socioeconomic index (SEI) value of ≤ 5 (lowest 50%): 7 schools in each group Recruitment: NR Geographic region: Newcastle, Hunter, and Central Coast regions of New South Wales, Australia Percentage of eligible population enrolled: 70% schools, 42% participants Mean age: intervention: 12.7 ± 0.5; control: 12.7 ± 0.5 Sex: intervention: 0% female; control: 0% female
Interventions	To evaluate the effects of a multicomponent, school‐based obesity prevention intervention incorporating smartphone technology on weight and health behaviours of male adolescents, teacher professional development, provision of fitness equipment to schools, face‐to‐face PA sessions, lunchtime student mentoring sessions, researcher‐led seminars, a smartphone application and website, and parental strategies for reducing screen‐time 'ATLAS' is a multicomponent intervention designed to prevent unhealthy weight gain by increasing PA, reducing screen‐time, and lowering SSB consumption among adolescent boys attending schools in low‐income areas: For teachers Teacher professional development: two 6‐h workshops (pre‐programme and mid‐programme to provide a rationale for the programme and outline the intervention strategies (ie, programme components, behavioural messages)) 1 fitness instructor session (each school received 1 visit during their regularly scheduled sport session from a practicing fitness instructor (i.e. personal trainer) while the teacher observed) For parents 4 parent newsletters For students 3 x 20‐min researcher‐led seminars (seminars provide key information surrounding the programme’s components and behavioural messages, including current recommendations regarding youth PA, screen‐time, and RT) 20 x 90‐min enhanced school sport sessions (sport sessions delivered by teachers at the study schools, behavioural messages reinforced during cool down times) Lunchtime PA–mentoring sessions (6 x 20 min sessions, recruiting and instructing grade 7 boys in elastic tubing RT) Constant pedometer and ATLAS smartphone app access (15‐17 weeks, smartphone app and website are used for PA monitoring, recording of fitness challenge results, tailored motivational messaging, peer assessment of RT skills, and goal‐setting for PA and screen time) The control group participated in usual practice (i.e. regularly scheduled school sports and PE lessons) for the duration of the intervention but received an equipment pack and a condensed version of the programme after the 18‐month follow‐up assessments. PA intervention vs control
Outcomes	Outcome measures Primary outcome: BMI, waist circumference Secondary outcomes: % body fat, PA, screen time, SSB intake, muscular fitness, RT skill competency Process evaluation: reported (implementation)
Implementation‐related factors	Theoretical basis: Self‐determination theory and SCT Resources for intervention implementation: reported Who delivered the intervention: reported PROGRESS categories assessed at baseline: race/ethnicity, SES PROGRESS categories analysed at outcome: NR Outcomes relating to harms/unintended effects: reported Intervention included strategies to address diversity or disadvantage: targeted boys at risk of obesity: failing to meet international PA or screen‐time guidelines Economic evaluation: NR
Notes	ACTRN 12612000978864 Funding: this study was funded by an Australian Research Council Discovery Project grant (DP120100611). The sponsor had no involvement in the design or implementation of the study, in analyses of data, or in the drafting of the manuscript. An equipment pack valued at approximately AUD 1000 (including pedometers, elastic tubing devices, boxing gloves, focus pads and hanging gym handles) was provided to each school if needed. On average, schools conducted 79% of intended school sports sessions and 64% of intended lunchtime sessions. Sixty‐five percent of boys attended $70% of the sport sessions but only 44% of boys attended at least two‐3rds of lunchtime sessions. Participant satisfaction with the ATLAS intervention was high, but satisfaction with the lunchtime sessions was somewhat lower. Smartphone (or similar device) ownership was reported by 70% of boys, and 63% reported using either the iPhone or Android version of the ATLAS app. Almost one‐half of the group agreed or strongly agreed that the “push prompt” messages reminded them to be more active, reduce their screen‐time, and drink fewer sugary drinks, and 44% of participants agreed or strongly agreed that the ATLAS app was enjoyable to use. Teacher satisfaction with the intervention was high.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Randomisation was performed by an independent researcher with the use of a computer‐based random number–producing algorithm.
Allocation concealment (selection bias)	Low risk	Randomisation was performed by an independent researcher with the use of a computer‐based random number–producing algorithm. Also assessors were blinded to treatment allocation at baseline but not at follow‐up.
Blinding (performance bias and detection bias) All outcomes	High risk	Assessors were blinded to treatment allocation at baseline but not at follow‐up.
Incomplete outcome data (attrition bias) All outcomes	Low risk	Retention 85.6% at 8 months and 76.8% at 18 months; ITT done
Selective reporting (reporting bias)	Low risk	Protocol not sought; all outcomes specified in methods have been reported
Other bias	Low risk	No additional threats to validity
Other bias‐ timing of recruitment of clusters	Low risk	Figure shows recruitment happened prior to randomisation