The reimagination of school-based physical activity research in the COVID-19 era

Deirdre Harrington and Michelle O'Reilly discuss the article "Effectiveness and cost-effectiveness of the GoActive intervention to increase physical activity among UK adolescents: A cluster randomised controlled trial" by Kirsten Corder and colleagues.

been produced from these trials. It is clear that doing more of the same will not lead to the creation of new knowledge relevant to stakeholders. This is particularly pertinent because the Corder publication coincides with the crest of the COVID-19 pandemic-a global issue that means researchers and funders are likely to be forced to reassess their priorities and approach.
Will schools be seen as the solution to the post-COVID-19 'problems'?
The general area of 'health, sport and physical education' in schools is commonly used as a vehicle to address public health or societal 'problems' [8]. UK Prime Minister Boris Johnson is said to be primed 'to launch a war on fat' [9], and we expect schools to remain an attractive location for any efforts. Schools may not be able to devote 'time and energy' into solving whatever the latest crisis is as 'they are neither expert nor likely to have an impact' [10], but teachers do have a desire for expertise [8]. However, after 10 years of austerity, teachers are at their limit for what they can deliver outside of the curriculum. Corder and colleagues highlight issues with teacher burden ('time pressures') and future sustainability of the GoActive delivery model. The team trained peer mentors and had local authority-funded health trainers facilitate half of the delivery that ultimately negatively affected fidelity [6].

What are the implications of social distancing for data collection in schools?
The research world has quickly mobilised and repurposed studies to tackle the COVID-19 pandemic including research on how health behaviours and outcomes, such as physical activity, have changed. School-based physical activity research too will likely change. The need for social distancing and enhanced personal hygiene practices would pose practical challenges if we imagine planning the GoActive study methods in the COVID-19 era.
The Corder trial employed a cluster RCT design that required large amounts of data collected during a narrow time frame to fit in with the academic calendar (because intervention delivery is usually anchored to term times). This is done by teams of research staff travelling together, sharing equipment, and co-operating in settings the researchers often have little control over. Collection of outcome data such as waist circumference requires close proximity between research staff and participants. The rapid deployment, use, and collection of bodyworn physical activity measurement devices would require careful hygiene procedures. Research staff would facilitate large groups of pupil participants completing extensive questionnaire booklets in packed classrooms. The willingness to engage in these data collection methods will largely be down to the researchers' own personal assessments of risk and that of the school.

The 'new normal' is not clear for researchers or schools
As the world still reels from the effect of the COVID-19 pandemic, there is an impending threat of triple inertia: that funders may stop funding school-based physical activity research, that academics may flounder under the weight of evidence lacking effectiveness, and that stakeholders will have new priorities resulting in limited physical activity research opportunities with schools.
The stark and transparent light of COVID-19 provides the UK government a real chance to tackle health inequality and to reinstate local government public health and education funding that schools rely on. This would provide schools with adequate financial and human resources to develop bespoke physical activity programmes. These practice-driven programmes are more likely to suit the needs and preferences of the school's own pupils and account for and listen to adolescents' perspectives as well as other key stakeholders. This would open up the opportunity for pragmatic and flexible evaluation of these practice-led programmes in schools allowing researchers to move away from RCTs and towards more realist [11] methodologies. Now more than ever researchers need to be more innovative and interdisciplinary in research endeavours as we start to chart the 'new normal' for school-based physical activity research.