Belton 2019.

Study characteristics
Methods	Study design: cluster‐RCT
Participants	School inclusion criteria: (a) schools have a qualified PE teacher on staff, (b) first year students attending the school were time tabled for a minimum of 70 minutes of PE weekly, (c) schools were mixed gender and were situated in the greater area of a large Irish city School exclusion criteria: — Student inclusion criteria: first year post primary students (12 to 13 years old) attending post primary education within a particular Irish geographical region Student exclusion criteria: — Setting: school Age group: adolescent Gender distribution: females and males Country/Countries where trial was performed: Ireland
Interventions	Intervention: a whole‐school multi‐component intervention programme, aimed at reducing the age‐related decline of MVPA among adolescents. Key features include 1. PE component: PE teachers received 4 hours of Y‐PATH professional development including 6 targeted lesson plans focusing heavily on motivational climate, integrating health‐related activity core knowledge through fun and engaging practical lessons, with an emphasis on functional movement skill proficiency. Resource cards were used to prompt teachers to enable them to integrate a health‐related activity and fundamental movement skill focus within other core PE content areas. Students were given a PA journal to learn to track PA behaviours and identify ways to increase PA levels, and a PA directory containing information and contact details for local youth sport and PA clubs 2. Whole‐school teacher component: PA promotion workshops for teachers, and development and implementation of a school 'charter' for PA. Teachers were encouraged to be 'active role models' 3. Parent component: information evening for parents and information leaflets distributed through the school newsletter to highlight key strategies for promoting PA beyond the school environment Comparator: usual care, consisting of regular delivery of the Irish Junior Cycle PE curriculum, and the broader school curricula Duration of intervention: 2 years Duration of follow‐up: 2 years Number of schools: 20 Theoretical framework: social‐ecological framework, self‐determination theory
Outcomes	PA duration
Study registration	ISRCTN20495704
Publication details	Language of publication: English Funding: Dublin Local Sports Partnerships, Dublin City University Career Start grant Publication status: peer‐reviewed journal
Stated aim for study	"to investigate the effect of participation in the Y‐PATH intervention over a two‐year period on objectively measured MVPA levels of young people"
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	High risk	Quote from publication: "one school from each pair was then randomly allocated by the study principal investigator to the control group (and the other to the intervention group) using a manual number generator in blocks of 1:1, prior to the commencement of baseline testing"
Allocation concealment (selection bias)	High risk	Quote from publication: "one school from each pair was then randomly allocated by the study principal investigator to the control group (and the other to the intervention group) using a manual number generator in blocks of 1:1, prior to the commencement of baseline testing"
Blinding of participants and personnel (performance bias) All outcomes	High risk	Quote from publication: "not possible given the nature of the intervention"
Blinding of outcome assessment (detection bias) All outcomes	High risk	Quote from publication: "not possible given the nature of the intervention"
Incomplete outcome data (attrition bias) Anthropometrics, Fitness	High risk	Comment: BMI data missing > 10%
Incomplete outcome data (attrition bias) Physical activity and sedentary time	High risk	Comment: Large % missing data
Selective reporting (reporting bias)	High risk	Comment: BMI data not reported, stated in methods; secondary outcomes listed in clinical trials registry not reported
Cluster RCT ‐ Recruitment bias	High risk	Comment: baseline data collected after randomisation of schools
Cluster RCT ‐ Baseline imbalance	Low risk	Comment: groups balanced at baseline [author communication]
Cluster RCT ‐ Loss of clusters	High risk	Comment: 50% of clusters lost at 24 months
Cluster RCT ‐ Incorrect analysis	Low risk	Quote from publication: "a three level multilevel structure was proposed with random intercepts, where time (Level one), pupils (Level two) and schools (Level three) served as the grouping variables, where time was treated as a fixed effect in the model but was also incorporated as a random slope effect (repeated measure) in the residual component"