Young 2006.

Study characteristics
Methods	Study design: RCT
Participants	Student inclusion criteria: Grade 9 girls enrolled in an all‐girl public magnet high school and also enrolled in 2 consecutive semesters of required PE  Student exclusion criteria: excused from meeting Maryland state PE requirements, pregnant or breastfeeding, planning to leave the geographic area, having a sister enrolled in the trial Setting: school, urban Age group: adolescents Gender distribution: females Country/Countries where trial was performed: USA
Interventions	Intervention: the intervention was taught by a teacher hired by the project. Intervention content included information to make an informed decision about personal benefits of a physically active lifestyle, develop problem‐solving skills, and obtain support from others. Specific strategies that were taught and reinforced included goal‐setting, problem‐solving barriers, communication skills, reinforcement of goal achievement through internal and external rewards, and learning from relevant role models. Skills were taught using class lectures and discussions, small‐group discussions, and homework activities. PA self‐monitoring was given a strong focus. Students were encouraged to keep weekly exercise logs from which the teacher provided feedback on progress toward goal attainment and reward strategies. All students in class received the intervention, irrespective of whether they were trial participants. The intervention was also designed to maximise PA during PE class. The format was congruent with the school’s PE curriculum ‐ 1 semester of individual sports and 1 semester of team sports ‐ taught 5 days/week. Classes were optimised for PA by teaching units that were active in nature (e.g. soccer instead of softball (personal fitness unit), breaking skills training into small‐group activities, and playing games in small groups (e.g. 3‐on‐3 basketball). Skills training was limited to that needed for competency rather than proficiency. Written tests focused on health‐related PA and fitness concepts and behavioural skills. The family support component consisted of a family workshop, monthly newsletters, and adult‐child homework assignments. A 2‐hour family workshop, scheduled shortly after randomisation, featured tips on how parents could provide support to their daughters. As an in‐class activity, students worked on skits illustrating support strategies that were videotaped and viewed at the workshop. Families who did not attend were mailed copies. Families also received a 2‐page family support newsletter each month that contained an article on ways families can support PA with their daughter Comparator: standard PE class was a curriculum in which students were taught skills in individual and team sports. For example, during the basketball unit, students were taught how to dribble, shoot, and pass, and were tested on concepts such as game rules and defence strategies. Similar to the intervention structure, 1 semester focused on individual sports and the other on team sports. Classes were taught by certified PE teachers employed by the school. Parents of participants in the standard PE class also received monthly newsletters. Topics were of general health interest and an article about PE class content that month was included Duration of intervention: 1 school year Duration of follow‐up: 1 school year Number of schools: 1 Theoretical framework: social action theory
Outcomes	BMI
Study registration	—
Publication details	Language of publication: English Funding: non‐commercial funding (National Institutes of Health) Publication status: peer‐reviewed journal
Stated aim for study	"This trial tests the effectiveness of a life skills–oriented PA intervention, conducted in PE class by a teacher hired by the project, for increasing PA and fitness in ninth‐grade girls"
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Comment: coin flip [author communication]
Allocation concealment (selection bias)	Low risk	Comment: all participants were allocated at a single point in time following recruitment, so at time of recruitment, allocation was not known
Blinding of participants and personnel (performance bias) All outcomes	High risk	Comment: no blinding of personnel or participants [author communication]
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Comment: outcome assessors were blinded for primary outcome assessment [author communication]
Incomplete outcome data (attrition bias) Anthropometrics, Fitness	Low risk	Comment: less than 10% dropout rate; reasons given
Selective reporting (reporting bias)	Unclear risk	Comment: no protocol published or trial registry; cannot assess