Round 1

Reviewer 1 Report

The work presents an interesting intervention underpinned by SDT. There are clearly multiple elements to the intervention. The current structure of the paper prevents the readers from clearly envisioning the intervention, and, at some points, having to interpret and assume. For example, some elements of section 2.4 Multidisciplinary Program could be inputted into the introduction, allowing more space for a clearer description of the intervention.

I have concerns about the extraordinary amount of measures, and the impact on adolescent wellbeing, specifically related to body dissatisfaction and some anthropometry measures. Limitations or addressing concerns could be covered in the discussion section, or where authors feel is appropriate.

In addition, there are a number of grammatical errors throughout the paper that should be addressed. I have noted some of these at the end of the comments, but it would be worth editing, or seeking support to edit the paper accordingly.

I have included a number of comments below. I hope the authors find these helpful. Throughout the comments, I have referred to a number of key references that should be taken into consideration for inclusion in the paper. Additionally, they may be used to follow the protocol structure for clarity. These include:

Brown et al., (2017). A cluster randomised controlled trial to evaluate the effectiveness and cost-effectiveness of the GoActive intervention to increase physical activity among adolescents aged 13–14 years, BMJ Open, https://bmjopen.bmj.com/content/7/9/e014419

Jago, et al. (2013). Bristol girls dance project (BGDP): protocol for a cluster randomised controlled trial of an after-school dance programme to increase physical activity among 11–12 year old girls. BMC Public Health, https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-13-1003

Demetriou, Y & Bachner, J. (2019). A school-based intervention based on self-determination theory to promote girls' physical activity: study protocol of the CReActivity cluster randomised controlled trial. BMC Public Health, https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-6817-y

Koorts et al (2018). Implementation and scale up of population physical activity interventions for clinical and community settings: the PRACTIS guide. IJBNPA. https://ijbnpa.biomedcentral.com/articles/10.1186/s12966-018-0678-0

Abstract:

• There needs to be a greater link between physical inactivity in line 16/17, to Physical inactivity linking to overweight and obesity
• Provide clarity for an international audience by stating how old students would be at 1^st and 2^nd High School level
• Once the comments below have been addressed, the abstract could be developed to be more impactful and clear.

Introduction:

• In general, the authors have provided some rationale for the study, e.g. Physical activity is important, and declines adolescents are currently inactive. However, there is an unclear link between adolescent physical inactivity and promoting physical activity in schools. A better link informing how schools represent an ideal opportunity for intervention should be established – line 15
• The first paragraph discusses the issues of overweight and obesity linked to sedentary behaviour and physical activity. Paragraph 2 discusses physical inactivity and health issues, and physical activity in adolescents. The third paragraph seems slightly random and basic compared to the former two. It could be excluded.
• Unsure what the addition of line 53 is to the introduction. Line 51 introduces physical activity programs. It could do more to flesh this out, using these previous physical activity programs to situate the need for their research. Instead, it seems to be discussing the effectiveness of one particular program. More work needs to be done to situate the need for the intervention aside from the lack of theoretical support – line 54. For example, consider a discussion of previous physical activity interventions with adolescents. What has been successful? What has not? This will demonstrate how the current research is different and why it is expected to be successful. Additionally, consider looking at other physical activity interventions with adolescents, which have used theory (SDT is quite common). In this way, the introduction is missing key research papers (see references above).
• Link to physical education classes is unclear, line 60
• What is ‘relatedness satisfaction’? line 65
• A clearer explanation is required linking SDT and motivation
• As we have not yet heard about the proposed ‘Multidisciplinary Training Program for the Promotion of Physical 81 Activity and Healthy Lifestyle in Inactive Adolescents’, the final sentence of the introduction should link to the aim of the paper and what the authors wish achieve. Authors should state their research question, their hypothesis and/or their knowledge claim, making sure to place your research within the gap in existing knowledge.

Methods:

• Does the study include a process evaluation or cost-effectiveness evaluation?

Participants:

• Why 2000 students? Will this power the study?
• As the title of the paper suggests, this is a program for ‘inactive adolescents’, however, as most adolescents do not meet the recommended 60 minutes per day, how will the participants be classified? Figure 1 denotes <60 minutes of physical activity per day…is there any other classification?
• Unsure/unclear about how inclusion criteria 5 works
• How are authors ensuring heterogeneity in their sample aside from taking into account PA levels prior to participation? What about demographics? This needs to be clearly stated before making the strong claim on line 408 (discussion)

Procedure:

• Will it be assessed as to why schools were not interested in the study?
• Line 134 - These behaviours will use to – Should it read: These measures will be used to
• Line 125 sedentary screen time should be its own sentence rather than in the brackets together with the physical activity guidelines.
• How will students be invited? Will assent be sought? Will parental consent be sought? How will consent be sought? Who will consent to the study? Will the school be asked to provide consent?
• Same comment as above – most adolescents do not meet 60 minutes of physical activity daily. Are they all considered ‘inactive’? What about someone who completed 50 minutes, compared to someone meeting 10 minutes per day? It is advised that this is revised, specifically when there are only 120 participants.
• 4 Multidisciplinary Program: should be an explicit detailing of the program, instead, most of the information should be situated within the introduction. Please amend so that all elements of the program are clear, succinct and explicit. A further table may facilitate clarity.
• What is the aim of the intervention exactly? It should be moved from the end of the intervention to 2.4
• Where is the logic model of the intervention? See MRC guidelines (https://www.bmj.com/content/350/bmj.h1258, and https://mrc.ukri.org/search-results/?keywords=Developing+and+evaluating+complex+interventions&siteid=mrc)
• 4.1 There does not seem to be any consideration given to the context of each schools when determining duration, volume, frequency, type exercise and load training. Why have the authors excluded this? Do the authors expect to see results if implementation science is not embedded into the implementation of the intervention? (Please see the PRACTIS guide). There seems to be an extraordinary amount of data collection, has consideration been given to time? Has consideration been given to the time that schools will allow? Or the safe spaces that schools will be able to provide researchers (if they can)?
• Very little has been described in relation to ‘socialization’ of the group – why is this important? What evidence is there for it? How will this be developed? Line 239 is the first mention, and it states that ‘the first sessions will have by aim to improve the socialization’. Table 4 depicts high priority throughout.
• It is unclear why 2.3.2 Measure and 2.4.3 A Lifestyle variables are separated. These are all measures in their own right. It is unclear with all measures taken for this study how participants will complete this within 30 minutes.
• Learning that accelerometer data will be included in the measures makes me question the power, or lack thereof from 120 participants only…authors should justify accordingly. Additionally, consideration needs to be given to power and drop out issues. There are an extraordinary amount of measures….what has been put in place to incentivize continued involvement? Line 381 does not describe in enough detail.
• When/how often will these measures be taken?
• What demographic information will be taken?
• The authors make an important observation that SDT should additionally be applied to teachers (line 160). Will the teachers be trained? What will their training include? Will they facilitate the sessions? What measures will teachers complete in the study?
• Limitations and concerns should be noted for the skinfold, and circumference measures taken with adolescents – especially in line with body image. Due consideration should be given to measuring body dissatisfaction, and anthropometric measures.
• It is unclear to the reader when the sessions will take place – is it within the school day? Who will run the sessions? When will they run? In PE class?

Discussion:

• Does the paper require a discussion section aside to highlight key limitations?
• Extremely bold sweeping statements made e.g. 429 - this project will allow creating new guidelines on physical activity. Authors should be mindful and realistic of their research and the constrictions/limitations of their research with 120 participants.
• Has there been a previously publishes pilot study?
• I feel that line 437 onwards is inappropriate for a protocol paper.

 

Some grammatical/punctuation issues needing to be addressed. Some suggestions have been made. Please note that this is not an exhaustive list:

• Line 15 - one important health problems in worldwide. – Issue with plurals. It could read: is ‘an important health problem worldwide’
• Line 16: Only few children have shown the…. – needs rewording – e.g. Only a few have met
• Line 17: In this sense – not used appropriately.
• Sentence line 21 would be better started as ‘The study is a quasi….’
• Line 24: The sessions will length 60 minutes – need to check wording throughout, this could read: The length of the sessions are 60 minutes…
• In-text referencing usually comes at the end of the sentence as to avoid distracting reader, note line 33, and line 36 [3,4]
• Physical Inactivity (PI) introduced line 39, but it is unclear if the authors have swapped it to IP on line 40.
• Missing full stop line 41
• Line 41 requires clarity in communication
• Double and line 43
• Years old adolescents – line 44, check grammar
• Capital missing start of sentence – line 46/7
• Line 60 – ‘In physical education setting’ – missing an ‘a’
• Were reference 26 and 7 specifically linked to adolescents?
• Check sentence from line 80-84 – a full stop may be missing. There is also a repeated ‘physical activity’.
• Check the use of ‘postulates’ line 77, and 85
• Line 86: through the inclusion motivational – missing ‘of’
• Line 102 - 46 school of – I think should read ’46 schools of’
• Line 104 - expected to obtain – I think should read ‘expected to be obtained’
• Line 105 – subdivide - should be subdivided into the control….
• Line 114 - first 23 school – should be schools, same with line 113 and 115
• Line 117 - The research team will inform by e-mail about the interest in participating in the research – The research team informs schools about the study to generate expressions of interest.
• Line 118 Sentence starts with ‘It’ – unsure if it should be ‘If’
• Missing space line 128
• 3.2 Measure – should read ‘measures’ as there are more than one
• Line 154 - shows the developed – should be: shows the development
• Line 156 – despite many research – grammar
• Line 161 - The both, competence and relatedness supports – grammar
• Line 165 – BPN acronym not used
• Line 194 - numerous researches have been developed with the aim – grammar
• Line 375 - The activities of program – grammar
• Line 378 - During the sessions, it could be used music as a – grammar
• Line 389 - This will have performed three months – grammar

Author Response

REVIEWER#1

The work presents an interesting intervention underpinned by SDT. There are clearly multiple elements to the intervention. The current structure of the paper prevents the readers from clearly envisioning the intervention, and, at some points, having to interpret and assume. For example, some elements of section 2.4 Multidisciplinary Program could be inputted into the introduction, allowing more space for a clearer description of the intervention.

I have concerns about the extraordinary amount of measures, and the impact on adolescent wellbeing, specifically related to body dissatisfaction and some anthropometry measures. Limitations or addressing concerns could be covered in the discussion section, or where authors feel is appropriate.

Answer: Thanks you for your contributions. The authors have write a section limitation.

Page 12, line 490 - 493: "Regarding the impact of the project, there are several benefits that can be obtained. The findings of the study "Multidisciplinary Training Program for the Promotion of PA and Healthy Lifestyle in Inactive Adolescents" can help Health Information Systems and politician's makers to identify the target population for primary prevention and health prevention policies with the intention to develop and promote strategies that help promote healthy habits."

In addition, there are a number of grammatical errors throughout the paper that should be addressed. I have noted some of these at the end of the comments, but it would be worth editing, or seeking support to edit the paper accordingly.

Answer: Many thanks for your consideration and comments. We sincerely would like to thank your contributions. According to English language, we have reviewed in depth the whole manuscript, but if it is necessary, we ask for the Journal editing service, in order to improve the quality of the English grammar.

I have included a number of comments below. I hope the authors find these helpful. Throughout the comments, I have referred to a number of key references that should be taken into consideration for inclusion in the paper. Additionally, they may be used to follow the protocol structure for clarity. These include:

Brown et al., (2017). A cluster randomised controlled trial to evaluate the effectiveness and cost-effectiveness of the GoActive intervention to increase physical activity among adolescents aged 13–14 years, BMJ Open, https://bmjopen.bmj.com/content/7/9/e014419

Jago, et al. (2013). Bristol girls dance project (BGDP): protocol for a cluster randomised controlled trial of an after-school dance programme to increase physical activity among 11–12 year old girls. BMC Public Health, https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-13-1003

Demetriou, Y & Bachner, J. (2019). A school-based intervention based on self-determination theory to promote girls' physical activity: study protocol of the CReActivity cluster randomised controlled trial. BMC Public Health, https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-6817-y

Koorts et al (2018). Implementation and scale up of population physical activity interventions for clinical and community settings: the PRACTIS guide. IJBNPA. https://ijbnpa.biomedcentral.com/articles/10.1186/s12966-018-0678-0

ABSTRACT

1. Contributions of reviewer: There needs to be a greater link between physical inactivity in line 16/17, to Physical inactivity linking to overweight and obesity.

Answer: Thank you for your contributions. We have improved the link between physical activity and overweight and obesity as follows:

Page 1, line 15 – 18: "It was showed that physical activity and sedentary behaviour are associated with prevalence of overweight and obesity in youth individuals. However, few children’s and adolescents meet the World Health Organization recommendations about physical activity levels."

2. Contributions of reviewer: Provide clarity for an international audience by stating how old students would be at 1^st and 2^nd High School level.

Answer: Thanks you for your comment. We have included the range age in the abstract.

Page 1, line 24: "... aged between 12-14 years old. "

INTRODUCTION

3. Contributions of reviewer: In general, the authors have provided some rationale for the study, e.g. Physical activity is important, and declines adolescents are currently inactive. However, there is an unclear link between adolescent physical inactivity and promoting physical activity in schools. A better link informing how schools represent an ideal opportunity for intervention should be established – line 15

Answer: We would like to thank reviewer for his/her contributions. The authors agree with him/her, so we have included a new paragraph explaining why schools represent an ideal opportunity for intervention.

Page 2, line 66 - 76: "Intervention programs based on psychological theories have been more successful than those that do not take psychological variables into account. Thus, psychological theories can provide key advances for intervention design as they facilitate the identification of key mediators and factors of behaviour change [17]. School is the best place to promote health-related behaviors, given that young people spend most of the day at school [18]. Furthermore, the Self-Determination Theory (SDT) suggests that s-school provide an opportunity to adopt a global approach to engage the entire school community in developing a health promotion program among adolescents. According to the SDT, there are multiple sources of support that can influence the motivational results of students and, consequently, the initiation and maintenance of health-related behaviors. SDT helps to explain the intention to develop and maintain these health-related behaviors, and therefore, it has been considered as a theory that can predict changes related to healthy habits [19]."

4. Contributions of reviewer: The first paragraph discusses the issues of overweight and obesity linked to sedentary behaviour and physical activity. Paragraph 2 discusses physical inactivity and health issues, and physical activity in adolescents. The third paragraph seems slightly random and basic compared to the former two. It could be excluded.

Answer: The authors would like to thank reviewer`s contributions. We have deleted the paragraph 3 and rewrite this section.

Page 2, line 48 – 64: “Intervention programs based on psychological theories have been more successful than those that do not take psychological variables into account. Thus, psychological theories can provide key advances for intervention design as they facilitate the identification of key mediators and factors of behaviour change [18]. School is the best place to promote health-related behaviors, given that young people spend most of the day at school [19]. Furthermore, the Self-Determination Theory (SDT) suggests that s-school provide an opportunity to adopt a global approach to engage the entire school community in developing a health promotion program among adolescents. According to the SDT, there are multiple sources of support that can influence the motivational results of students and, consequently, the initiation and maintenance of health-related behaviors. SDT helps to explain the intention to develop and maintain these health-related behaviors, and therefore, it has been considered as a theory that can predict changes related to healthy habits [20].”

5. Contributions of reviewer: Unsure what the addition of line 53 is to the introduction. Line 51 introduces physical activity programs. It could do more to flesh this out, using these previous physical activity programs to situate the need for their research. Instead, it seems to be discussing the effectiveness of one particular program. More work needs to be done to situate the need for the intervention aside from the lack of theoretical support – line 54. For example, consider a discussion of previous physical activity interventions with adolescents. What has been successful? What has not? This will demonstrate how the current research is different and why it is expected to be successful. Additionally, consider looking at other physical activity interventions with adolescents, which have used theory (SDT is quite common). In this way, the introduction is missing key research papers (see references above).

Answer: Thanks for this suggestion. We totally agree in including physical activity interventions with adolescents. Following reviewers´ suggestion, we have included the information provided using some information presented below.

Brown et al. (2017). A cluster randomised controlled trial to evaluate the effectiveness and cost-effectiveness of the GoActive intervention to increase physical activity among adolescents aged 13–14 years, BMJ Open, https://bmjopen.bmj.com/content/7/9/e014419

The Get Others Active (GoActive) intervention is an evidence-based and was developed iteratively with adolescents and teachers. This intervention aims to increase physical activity through increased peer support, self-efficacy, group cohesion, self-esteem and friendship quality, and is implemented using a tiered-leadership system.

More specifically, the development of the GoActive was defined by each year 9 class (tutor group or home room class) chooses two activities each week from a selection provided. There are currently 20 activities available, using little or no equipment, and appealing to a wide variety of students (including Ultimate Frisbee, Zumba and Hula Hoop). Materials available on the password-protected GoActive intervention website includes activity instructions (Quick Cards) which offers an overview of each activity, a short explanation, suggestions for adaptations and provide advice, safety tips and ‘factoids’, in addition to a short video introducing each activity. GoActive is implemented using a tiered-leadership system where mentors (older adolescents within the school) and peer leaders (within each year 9 class) encourage students to try these activities each week. The mentors remain paired with each class for the duration of the intervention, whereas the peer leaders (two per class each week, one male and one female) change every week. In addition to the student leaders, a local authority-funded intervention facilitator will support the programme during the first term of delivery and will provide distant support thereafter. Teachers are encouraged to use one tutor time weekly to do one of the chosen activities as a class. However, students gain points for trying these new activities at any time in or out of school. Points are gained every time they try an activity; there is no expectation of time spent doing the activity as points are rewarded for the taking part itself. Individual students keep track of their own points privately on the study website and their points are entered into the between-class competition. Class rankings are available on the website to encourage teacher support and students receive small rewards (such as a sports bag, t-shirt, or hoodie) for reaching individual points thresholds.

Jago et al. (2013). Bristol girls dance project (BGDP): protocol for a cluster randomised controlled trial of an after-school dance programme to increase physical activity among 11–12 year old girls. BMC Public Health, https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-13-1003

Two-arm cluster randomised control trial and economic evaluation conducted in 18 secondary schools across the greater Bristol area. All Year 7 girls in participating schools will receive a 'taster’ dance session and subsequently, they are invited to participate in the project. There is space for up to 33 girls to participate in each school. Schools will be randomly assigned in equal numbers to intervention or control arms after baseline data has been collected. The nine intervention schools will receive a 20 week after-school dance-based intervention, consisting of 40 × 75 minute sessions, delivered by external dance instructors. Control schools will not receive the dance intervention. All measures will be assessed at baseline (time 0), at the end of the intervention period (time 1) and six months after the intervention has ended (time 2). Our primary interest is to determine the effectiveness and cost-effectiveness of the intervention to affect the objectively-assessed (accelerometer) mean weekday minutes of moderate-to-vigorous PA (MVPA) accumulated by Year 7 girls one year after the baseline measurement (time 2).

Demetriou, Y. & Bachner, J. (2019). A school-based intervention based on self-determination theory to promote girls' physical activity: study protocol of the CReActivity cluster randomised controlled trial. BMC Public Health, https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-6817-y

CReActivity is a two-arm cluster randomised controlled trial with a follow-up period of three months after the end of the intervention programme. A total of 600 sixth grade girls in lower secondary schools in Bavaria (Germany) will be proactively recruited. The intervention is carried out by the physical education teachers of the participating classes for five months. Primary outcome is the girls’ physical activity measured by accelerometers and systematic observations.

The first objective of this project is to implement and evaluate an intervention programme designed to promote 6th grade girls’ physical activity levels both during PE and outside of school. Offering modified PE classes to promote girls’ physical activity levels in PE and outside of school will be the centerpiece of the intervention. In order to reach 60 min of moderate-to-vigorous physical activity per day, recommended by the Word Health Organization [1] and Sedentary Behaviour [7], physical activity should be taken place on several occasions during the course of the day. Therefore, the intervention programme is designed to promote girls’ physical activity not only during PE lessons but also during their free time in the afternoon. PE teachers will be trained to carry out the intervention programme. This training will include guidelines and specific materials on how the prepared lesson plans should be put into practice in order to address the constructs of autonomy, competence and relatedness, which are in turn deemed important in terms of increasing physical activity.

Koorts et al. (2018). Implementation and scale up of population physical activity interventions for clinical and community settings: the PRACTIS guide. IJBNPA. https://ijbnpa.biomedcentral.com/articles/10.1186/s12966-018-0678-0

We propose a practical guide for researchers to increase the likelihood of successful implementation and scale up of physical activity interventions in practice contexts. The guide is based on two principles: (i) differences between the research and practice context can be addressed during intervention development and implementation planning by focusing on system, delivery personnel, and intervention characteristics; and (ii) early planning for implementation barriers and facilitators can improve subsequent translation into practice. The PRACTIS (PRACTical planning for Implementation and Scale-up) guide outlines a structure for researchers and stakeholders, with varying levels of implementation experience and expertise, to navigate the complex considerations and decision-making processes involved in translating evidence-based interventions into practice. The purpose is to increase the likelihood that physical activity interventions can be implemented at scale and sustained in practice contexts. The challenges associated with intervention implementation and scale-up are relevant across all areas of public health prevention. For the purposes of this paper, therefore, we refer to physical activity intervention research to discuss these issues and illustrate operationalization of the PRACTIS guide.

6. Contributions of reviewer: Link to physical education classes is unclear, line 60

Answer: We agree with this suggestion. For this reason, we have deleted the first part of the sentence.

7. Contributions of reviewers: What is ‘relatedness satisfaction’? line 65

Answer: We regret the topographic mistake. Corrected.

Page 2, line 86:" relatedness concerns..."

8. Contributions of reviewers: A clearer explanation is required linking SDT and motivation

Answer: Thanks for this recommendation. We have tried to explain in detail the link between the different types of motivation and the basic psychological needs.

9. Contributions of reviewers: As we have not yet heard about the proposed ‘Multidisciplinary Training Program for the Promotion of Physical 81 Activity and Healthy Lifestyle in Inactive Adolescents’, the final sentence of the introduction should link to the aim of the paper and what the authors wish achieve. Authors should state their research question, their hypothesis and/or their knowledge claim, making sure to place your research within the gap in existing knowledge.

Answer: The authors thank the contributions developed by reviewer. We agree with his/her proposals for improvement, so we have decided to rewrite lines 101 - 119.

Page 3, line 101 - 119: " In this sense, the systematic reviews conducted by Vaquero-Solís et al. [27] and Teixeira et al. [28] have shown a good evidence for the value of SDT in understanding and promoting PA. Both reviews showed a greater effectiveness of the interventions that were developed under the SDT perspective, taking into account the individuals´ motivation. Several reasons have been identified for this lack of effectiveness [29]. For example, the excess heterogeneity of the sample (i.e., age, gender, weight or body composition, and fitness status), targeting population subgroups (such as girls [14] or low socioeconomic groups) [30]; with low levels of PA or the short duration of interventions (< 3 months) [27,28]. Moreover, the decrease in PA occurs out of school [9] however, many interventions have been target specific school-based time; for example, school time [31,32] or Physical Education lessons [33] or both in and out of school [15] whereas Multidisciplinary Programme encourages participants to do more activity out of school based on SDT. In addition, SDT suggests that PA interventions programs which developed enjoyable and valued activities and foster perceptions of ownership, competence and belonging, are more likely to achieve sustained behavior change [14].

Therefore, the present Multidisciplinary Program will provide a broad overview of factors associated with PA in adolescents and includes motivational constructs based on SDT such as autonomy, competence and relatedness, which has been found to be reliable and validity in the promotion of PA [34]. The aim of the current research will be to examine the effects of Multidisciplinary Programme based on SDT during out of school through the inclusion motivational strategies aimed at promoting PA adherence in a sample of adolescents."

 

METHODS

10. Contributions of reviewers: Does the study include a process evaluation or cost-effectiveness evaluation?

Answer: Thank you very much for your important contributions. The authors have not included a cost-effectiveness evaluation. Thus, we have included this issue in the limitation section.

Page 12, line 497 – 502: “Firstly, a cost-effectiveness evaluation was not included in the program, which is relevant to know the effects of the intervention developed in order to enhance the positive consequences. Secondly, the logical model for intervention was developed following Patrick and Williams [86] guidelines. The strategies suggested for behavior change in a health behavior intervention context were conducted.”

Participants:

11. Contributions of reviewer: Why 2000 students? Will this power the study?

Answer: Thank you very much for your insightful comments. The important programs provided by the reviewer establish the appropriate sample for your intervention program based on a previous pilot study. According to the number of students in Extremadura (Spain) in the Regional Statistic Bureau (around 15000 individuals ranged in age from 12 to 14 years old), the minimum number of participants was determined through that issue. Taking into account a sampling error of 5% and a confidence level of 95.5%, a total amount of 2000 participants is statistically enough. 

Page 3, line 134 - 140: " Based on the previous investigations [15,35–37], the total number of participants expected to be reached is 2000 students. According to the number of students in Extremadura (Spain) in the Regional Statistic Bureau, the minimum number of participants was determined through that issue. Taking into account a sampling error of 5% and a confidence level of 95.5%. A total amount of 2000 participants is statistically enough. In Cáceres, most of the High School in have a total of four classes (two classes for first grade and two classes for second grade). Since each class have around 22 students, it is necessary 23 schools to be able to recruit close to 2000 participants."

12. Contributions of reviewer: As the title of the paper suggests, this is a program for ‘inactive adolescents’, however, as most adolescents do not meet the recommended 60 minutes per day, how will the participants be classified? Figure 1 denotes <60 minutes of physical activity per day…is there any other classification?

Answer: Thanks for your comment. The authors have corrected this term in the figure and have named physical inactivity individuals those who will not meet with physical activity recommendations (< 150 minutes of moderate physical activity per week). The physical inactivity is defined as an insufficient volume of physical activity in daily life, without reach the recommended PA (< 150 minutes of moderate physical activity per week) (Sedentary Behaviour, 2012). According to definition of physical inactivity, the authors will consider inactive adolescents those that not meet with the recommendations of physical activity.

Reference: Sedentary Behaviour Research Network. Letter to the Editor: Standardized use of the terms “sedentary” and “sedentary behaviours”. Appl Physiol Nutr Metab. 2012; 37: 543–345

13. Contributions of review: Unsure/unclear about how inclusion criteria 5 works

Answer: Thank you for the contribution. The authors have reviewed this criterion and the rest of the manuscript, because it was unclear. Therefore, we have decided to delete it.

14. Contributions of review: How are authors ensuring heterogeneity in their sample aside from taking into account PA levels prior to participation? What about demographics? This needs to be clearly stated before making the strong claim on line 408 (discussion).

Answer: Thanks for your contributions. The authors we have added a description about how we think to have a heterogeneity in our sample.

Page 7, line 262 – 266: “To ensure this heterogeneity, all students who have previously met the inclusion criteria for PA and screen time will be invited to participate in the program. Furthermore, given that a random sampling of the schools is carried out, the socio-demographic characteristics of the participants will also be very diverse.”

Procedure:

15. Contributions of review: Will it be assessed as to why schools were not interested in the study?

Answer: Thanks for your input. We had not thought about this aspect, so we decided to add a sentence about it.

Page 4, line 166 – 167: “In addition, the supervisor team will be asked about the reasons that led them to make that decision.”

16. Contributions of review: Line 134 - These behaviours will use to – Should it read: These measures will be used to

Answer: Done. Page 4, line 6 “These measures will be used to…”

17. Contributions of review: Line 125 sedentary screen time should be its own sentence rather than in the brackets together with the physical activity guidelines.

Answer: Corrected. Page 4, line 177: < 150 minutes of moderate PA per week, > 2 hours of screen time per day"

18. Contributions of review: How will students be invited? Will assent be sought? Will parental consent be sought? How will consent be sought? Who will consent to the study? Will the school be asked to provide consent?

Answer: Thank you for your contributions. We have added a description in page 4, line 151 - 152.

" Regarding to recruitment, once the management team will agree to participate in the research, all participants will be invited. Next, each student will be given a commitment document informing them of the research objectives so that they can give it to their parents or guardians. Therefore, participants who wish to participate in the study must present the commitment form signed by him and by the parents or guardians. This commitment document will be collected by the research team on the first day of measurements. All assessments will take place during the school day, so the teachers will not need to provide consent for the commuting of school time for data collection."

19. Contributions of review: Same comment as above – most adolescents do not meet 60 minutes of physical activity daily. Are they all considered ‘inactive’? What about someone who completed 50 minutes, compared to someone meeting 10 minutes per day? It is advised that this is revised, specifically when there are only 120 participants.

Answer: Thanks you for your contributions. The recommendations for physical activity established by the World Health Organization will be taken into account. Therefore, all those participants who perform a physical activity < 150 minutes per week will be considered physical inactivity (Sedentary Behaviour, 2012). Therefore, they will be invite to participate in the intervention.

Reference: Sedentary Behaviour Research Network. Letter to the Editor: Standardized use of the terms “sedentary” and “sedentary behaviours”. Appl Physiol Nutr Metab. 2012; 37: 543–345

20. Contributions of review: Multidisciplinary Program: should be an explicit detailing of the program, instead, most of the information should be situated within the introduction. Please amend so that all elements of the program are clear, succinct and explicit. A further table may facilitate clarity.

Answer: Thanks you for the comment.  As can be seen in the document, the intervention of the Multidisciplinary Program has been described in detail. Thus, a description of the previous programs based on the SDT to detect weaknesses and set the objectives of the intervention has been included in the introduction section, with the aim to better clarify the aims of our study.

Moreover, and following reviewers´ suggestion, a table has been included in order to make the comprehension clearer.

Table 1. Develop of Multidisciplinary Program

	Initial meeting	Initial measure			Development of the sessions		Final measure	Follow-up post intervention
Control Group		X
Experimental Group
Assessment in both groups
Lifestyle variables
Physical activity (self-reported and Actigraph)			X			X			X
Sedentary behaviour			X			X			X
Body dissatisfaction			X			X			X
Adherence to the Mediterrean diet			X			X			X
Regulation of behaviour in physical exercise			X			X			X
Satisfaction with life			X			X			X
Positive and negative affect			X			X			X
Anthropometric measure
Weight and height			X			X			X
Skinfold			X			X			X
Waist circumference			X			X			X
Neck circumference			X			X			X
Physical fitness
Cardiorespiratory fitness			X			X			X
Handgrip strength			X			X			X
Lower limb strength			X			X			X
Shuttle run test			X			X			X

 

21. Contributions of review: What is the aim of the intervention exactly? It should be moved from the end of the intervention to 2.4

Answer: Thank you for your contributions. Authors have modified that issue.

Page 6, line 244 - 247: " In this sense, the multidisciplinary program aims to respond to some of the limitations found. For this, in relation to the duration, the program will develop over 6 months and will also establish inclusion criteria (mentioned Figure 1), in order to have a more homogeneous sample in relation to the levels of PA and sedentary behaviour."

22. Contributions of review: Where is the logic model of the intervention? See MRC guidelines (https://www.bmj.com/content/350/bmj.h1258, and https://mrc.ukri.org/search-results/?keywords=Developing+and+evaluating+complex+interventions&siteid=mrc)

Answer: Thank you very much for your important contributions. It has not included a logical intervention model. The authors accepted this limitation, therefore, it has been included in the limitation section. Please, if reviewer consider relevant to include, we will manage the way to include it.

23. Contributions of review: There does not seem to be any consideration given to the context of each schools when determining duration, volume, frequency, type exercise and load training. Why have the authors excluded this? Do the authors expect to see results if implementation science is not embedded into the implementation of the intervention? (Please see the PRACTIS guide). There seems to be an extraordinary amount of data collection, has consideration been given to time? Has consideration been given to the time that schools will allow? Or the safe spaces that schools will be able to provide researchers (if they can)?

Answer: Thank you very much for your insightful comments. The authors have taken the context into account for several reasons. Firstly, the intervention will take place outside of school hours. In addition, to carry out the intervention, the research team will contact those schools that had their facilities free and with fewer logistical problems for the students. Therefore, we think that the time to collect data for the intervention is not a problem, because we plan to dedicate a class of the program to develop these measurements. The only evaluations that are carried out during the school day are the physical activity and screen time questionnaires, with the aim to capture/get the attention to the students who can participate in the intervention.

24. Contributions of review: Very little has been described in relation to ‘socialization’ of the group – why is this important? What evidence is there for it? How will this be developed? Line 239 is the first mention, and it states that ‘the first sessions will have by aim to improve the socialization’. Table 4 depicts high priority throughout.

Answer: Thank you very much for your comments. The authors think that this part is important at the beginning of the intervention, because many of the students will not know each other. Furthermore, one of the postulates of the SDT is relatedness (please, see the strategies followed to enhance relatedness=. Therefore, to promote this postulate and improve the relatedness, we think that the first classes have the aim to improve socialization.

Page 6, line 216 - 240: "Specifically, the strategies used to promote motivation and PA will be based on the satisfaction and support of BPN. In the field of education, autonomy support means nurturing their inner motivational resources by respecting their attitudes and suggestions (adopting the students’ point of view to do an activity), providing rationales to attribute meaningfulness to learning (explaining why a task is important and where/when it could be used), relying on non-controlling language, providing opportunities for choice, displaying patience to allow students the time they need for self-paced learning to occur, and acknowledging and accepting expressions of negative affect [53,55]. In this sense, students will be asked about their interests and their points of view, giving them greater prominence during the sessions. Students will be also allowed to choose those activities that they liked the most or to which they would be permitted to deepen their knowledge of them. Moreover, teachers can use specific autonomy support strategies, referring to the use of cognitive teaching styles, to give responsibility for selecting tasks, as well as allowing the volition and the acknowledgment of the pupils’ perspective. Competence support refers to the way the teacher organizes and delivers the activities in which the objectives of each task were adapted to the capacities of each participant, creating the opportunity for everyone to feel competent while being offered supportive feedback [53]. In this line, students will choose the activity in which he or she could develop with a sense of efficacy. For instance, teachers should propose different options to achieve the objectives of the tasks adjusted to the abilities of each one. Relatedness support (involvement) includes teachers taking time and resources to their students and use a considerate and warm approach to promote an inclusive learning environment, proposing cooperative and interdependent tasks [56]. In relation to this support, for example, teachers could create group work activities and cooperative work strategies will be used. This strategy will be based on creating learning contexts that develop the sense of inclusion, integration, trust and respect among participants. Besides, it is possible that monitor/trainers participate in the activities with the adolescents, in order to create a good sense of relatedness."

25. Contributions of review: It is unclear why 2.3.2 Measure and 2.4.3 A Lifestyle variables are separated. These are all measures in their own right. It is unclear with all measures taken for this study how participants will complete this within 30 minutes.

Answer: Thank you very much for your contributions. These sections are separated because 2.3.2 Measurements are to be carried out during the school day. Only physical activity and screen time will be evaluated, with the aim to identify the adolescents who meet the inclusion criteria. Those who have met these criteria will then be contacted to invite them to participate in the intervention. While lifestyle measures will be carried out at the beginning of the intervention, developed in the afternoon and outside of school hours.

26. Contributions of review: Learning that accelerometer data will be included in the measures makes me question the power, or lack thereof from 120 participants only…authors should justify accordingly. Additionally, consideration needs to be given to power and drop out issues. There are an extraordinary amount of measures…. what has been put in place to incentivize continued involvement? Line 381 does not describe in enough detail.

Answer: The authors agree with the reviewer contributions. However, two reasons made us conduct this decision about sample. Firstly, practical reasons: we just have 60 accelerometers and we have to organize our investigation according to the number of accelerometers. Secondly, scientific reasons: Taking into account the great number of variables to assess, most of the studies have included that number of participants. Moreover, 60 individuals represent a sampling error of 5% and a confidence level of 95% in our context.

Finally, with the aim to incentivize the adherence to the program, the following information has been included:

Page 11, line 446 – 457: "However, the risk that the students drop out of the intervention does not depend on us. In this regard, the issue that depends on us is to develop strategies to avoid drop out, as well as increase the adherence of students who are against the possibility of leaving the intervention. In this sense, based on previous investigation [84], strategies will be developed to promote the autonomy support such as to foster pupils’ active participation or activities that increase the pressure to win will be avoided to reduce the competitiveness. In order to promote the competence, support the activities will be adapted to the levels of the participants to avoid frustration, as well as to carry out activities where success is evaluated through intrapersonal instead of interpersonal indicators, in addition to providing positive feedback so that students feel safer when carrying out the tasks. Regarding to relatedness support, socialization will be promoted among all members, in addition to promoting the mixed-gender groups. In addition, stereotypical activities and sports with excessive competition will be avoided. "

25. Contributions of review: When/how often will these measures be taken?

Answer: Thanks for your contributions. As can be seen in Table 4, the measurements will be taken in the first class, (week 1), in the last class (week 23), a post-intervention follow-up will be carried out (3 months later).

26. Contributions of review: What demographic information will be taken?

Answer: Thank you very much for your contributions. These features have been added in the manuscript.

Page 5, line 191: "Sociodemographic measures. Students’ self-reported age, grade and gender."

Page 8, line 308 – 311: "Sociodemographic measures. Students’ self-reported age, gender and socioeconomic status. Socioeconomic status was reported by the Family Affluence Scale II (Currie et al., 2008). A socioeconomic indicator (0 – 9 range) was calculated as a continuous variable by summing the four possible responses."

27. Contributions of review: The authors make an important observation that SDT should additionally be applied to teachers (line 160). Will the teachers be trained? What will their training include? Will they facilitate the sessions? What measures will teachers complete in the study?

Answer: Thanks you for your suggestions. Thus, the authors have added a description about teacher training.

Page 11, line 437 – 442: “The monitors/trainers who will conduct the  program will be graduates in PA and sports sciences. These monitors/trainers will receive 15 hours of specific training on the SDT. In addition, the research team (who are experts in the development of motivational strategies in the PA and physical education context) supervised the program. This issue is relevant because supervisors will train the coaches during 15 hours, divided into three – five hours’ classes (similar to other studies carried out with SDT programs [54,85]”

García-Calvo, T., Sánchez-Oliva, D., Leo, F. M., Amado, D., & Pulido, J. J. (2016). Effects of an intervention programme with teachers on the development of positive behaviours in Spanish physical education classes. Physical Education and Sport Pedagogy, 21(6), 572-588.

Sanchez-Oliva, D., Sanchez-Miguel, P. A., Leo, F. M., Kinnafick, F. E., & García-Calvo, T. (2014). Physical education lessons and physical activity intentions within Spanish secondary schools: A self-determination perspective. Journal of Teaching in Physical Education, 33(2), 232-249.

28. Contributions of review: Limitations and concerns should be noted for the skinfold, and circumference measures taken with adolescents – especially in line with body image. Due consideration should be given to measuring body dissatisfaction, and anthropometric measures.

Answer: Thanks you for your contributions. These limitations have been considered, therefore, anthropometric measurements will performance in a designated private location to ensure discretion and comfort of the participants.

Page 9, line 374 - 375: "Anthropometric measurements will performance in a designated private location to ensure discretion and comfort of the participants".

29. Contributions of review: It is unclear to the reader when the sessions will take place – is it within the school day? Who will run the sessions? When will they run? In PE class?

Answer: Thanks you for your contributions. The authors agree with the reviewer contributions so we have added an information about develop of sessions.

Page 11, line 436 - 437: "The development of sessions will take place in the afternoon, outside of school hours. They will be led by a qualified monitor. "

Discussion:

30. Contributions of review: Does the paper require a discussion section aside to highlight key limitations?

Answer: Thanks you for your contribution. The authors agree with the reviewer, therefore, we have added a limitation section.

Page 13, line 497 – 503: “However, despite the important contributions expected, this project is not without limitations. Firstly, a cost-effectiveness evaluation was not included in the program, which is relevant to know the effects of the intervention developed in order to enhance the positive consequences. Secondly, the logical model for intervention was developed following Patrick and Williams [86] guidelines. The strategies suggested for behavior change in a health behavior intervention context were conducted. Regarding to cost-effectiveness evaluation, it would be important for future interventions to carry out a cost-effectiveness evaluation”

31. Contributions of review: Extremely bold sweeping statements made e.g. 429 - this project will allow creating new guidelines on physical activity. Authors should be mindful and realistic of their research and the constrictions/limitations of their research with 120 participants. Has there been a previously publishes pilot study?

Answer: Thanks you for your contributions. No previous pilot study has been carried out.

33. Contributions of review: I feel that line 437 onwards is inappropriate for a protocol paper.

Answer: Thanks you for your contributions. The authors agree with the reviewer comments, therefore, we have deleted this information.

Some grammatical/punctuation issues needing to be addressed. Some suggestions have been made. Please note that this is not an exhaustive list:

Line 15 - one important health problems in worldwide. – Issue with plurals. It could read: is ‘an important health problem worldwide’

Answer: corrected.

Line 16: Only few children have shown the…. – needs rewording – e.g. only a few have met.

Answer: deleted.

Line 17: In this sense – not used appropriately.

Answer: deleted.

Sentence line 21 would be better started as ‘The study is a quasi….’

Answer: done.

Line 24: The sessions will length 60 minutes – need to check wording throughout, this could read: The length of the sessions are 60 minutes…

Answer: done.

In-text referencing usually comes at the end of the sentence as to avoid distracting reader, note line 33, and line 36 [3,4]

Answer: corrected.

Physical Inactivity (PI) introduced line 39, but it is unclear if the authors have swapped it to IP on line 40.

Answer: corrected.

Missing full stop line 41

Answer: done.

Line 41 requires clarity in communication

Answer: corrected

Double and line 43

Answer: done

Years old adolescents – line 44, check grammar

Answer: corrected.

Capital missing start of sentence – line 46/7

Answer: this paragraph has been modified.

Line 60 – ‘In physical education setting’ – missing an ‘a’

Answer: corrected.

Were reference 26 and 7 specifically linked to adolescents?

Answer: Thank you very much for your contributions. Reference 7 was removed. While reference 7 (actually 25) does take into account the interventions of adolescents and we think that it supports our contextualization.

Check sentence from line 80-84 – a full stop may be missing. There is also a repeated ‘physical activity’.

Answer: This paragraph has been modified.

Check the use of ‘postulates’ line 77, and 85

Answer: done.

Line 86: through the inclusion motivational – missing ‘of’

Answer: done.

Line 102 - 46 school of – I think should read ’46 schools of’

Answer: done.

Line 104 - expected to obtain – I think should read ‘expected to be obtained’

Answer: corrected

Line 105 – subdivide - should be subdivided into the control….

Answer: corrected.

Line 114 - first 23 school – should be schools, same with line 113 and 115

Answer: done.

Line 117 - The research team will inform by e-mail about the interest in participating in the research – The research team informs schools about the study to generate expressions of interest.

Answer: corrected.

Line 118 Sentence starts with ‘It’ – unsure if it should be ‘If’

Answer: done.

Missing space line 128

Answer: done.

3.2 Measure – should read ‘measures’ as there are more than one

Answer: corrected.

Line 154 - shows the developed – should be: shows the development

Answer: done.

Line 156 – despite many research – grammar

Answer: corrected.

Line 161 - The both, competence and relatedness supports – grammar

Answer: corrected.

Line 165 – BPN acronym not used

Answer: corrected.

Line 194 - numerous researches have been developed with the aim – grammar

Answer: corrected.

Line 375 - The activities of program – grammar

Answer: corrected

Line 378 - During the sessions, it could be used music as a – grammar

Answer: As was found in previous researches, music is a resource for maintain the motivation towards physical activity. Please see the following articles:

Karageorghis, C. I., & Priest, D. L. (2012). Music in the exercise domain: a review and synthesis (Part I). International review of sport and exercise psychology, 5(1), 44-66. Karageorghis, C. I., & Priest, D. L. (2012). Music in the exercise domain: a review and synthesis (Part I). International review of sport and exercise psychology, 5(1), 44-66.

Karageorghis, C., & Priest, D. L. (2008). Music in sport and exercise: An update on research and application. The Sport Journal, 11(3).

Line 389 - This will have performed three months – grammar

Answer: corrected.

Author Response File: Author Response.pdf

Reviewer 2 Report

Thank you for your work which is very valuable and helps the scientific community. The subject indicated in the paper is not new since there are many works on this subject, however, none of them took into account the individuals´ heterogeneity and that's why this work deserves attention.

There are several benefits that can be achieved in the program "Multidisciplinary Training Program for the Promotion of Physical Activity and Healthy Lifestyle in Inactive Adolescents". It can help health information systems and politicians to develop and promote healthy habits in target populations.

The description of the protocol methodology in the article is well thought out, planned in the smallest details. It is a very good example of research planning in social sciences.

 

Author Response

Thank you very much to the reviewer for his comments. The authors greatly appreciate the time spent reviewing our article. So we are very grateful for your positive comments on our work.

Reviewer 3 Report

The text of the paper itself is difficult to understand, it contains a number of syntactic and grammatical errors and typos, it is often inconsistent, which hinders its proper understanding.

The authors used a rather unconventional abbreviation PI (Physical inactivity), while the term does not frequently appear in the text (only 3 times in the Introduction and 2 times in the Discussion). For this reason, using such abbreviation is needless. In addition, in lines 40 and 432, the abbreviation is changed to "IP", obviously a typo. And in line 53, the term "inactivity" is used again, without abbreviation.

On the other hand, the commonly used abbreviation of the term physical activity is not used, despite the fact that the term occurs  in the text much more frequently (only in the Introduction section 14 times and frequently occurs in other parts as well). Paradoxically, the abbreviation PA is used for the first time, without explanation, in the Discussion, line 442.

Overall:

The way of carrying out the research is not entirely clear to me assuming that 60 students to be included in the experimental group will come from 23 schools. Who exactly will implement the program? How will the program be supervised? And how is it expected to promote social relations between the participants if they are students from different schools?

Author Response

REVIEWER#3

1. Contributions of reviewer: The text of the paper itself is difficult to understand, it contains a number of syntactic and grammatical errors and typos, it is often inconsistent, which hinders its proper understanding.

Answer: The authors understand that this may be a weakness of the work. Despite having previously reviewed the manuscript, neither my co-authors nor I are native English, so we understand that there may be certain grammatical errors. Nevertheless, we have reviewed the English grammar in depth, but it is necessary, the authors would not have any problem accepting the English review by Sustainability Journal.

2. Contributions of reviewer: The authors used a rather unconventional abbreviation PI (Physical inactivity), while the term does not frequently appear in the text (only 3 times in the Introduction and 2 times in the Discussion). For this reason, using such abbreviation is needless. In addition, in lines 40 and 432, the abbreviation is changed to "IP", obviously a typo. And in line 53, the term "inactivity" is used again, without abbreviation.

Answer: Thanks you for your insightful comment. The authors agree with reviewer contributions; therefore, we have decided to delete the abbreviation PI (Physical inactivity) in all manuscript.

3. Contributions of reviewer: On the other hand, the commonly used abbreviation of the term physical activity is not used, despite the fact that the term occurs in the text much more frequently (only in the Introduction section 14 times and frequently occurs in other parts as well). Paradoxically, the abbreviation PA is used for the first time, without explanation, in the Discussion, line 442.

Answer: The authors agree with the reviewer's comments. Thus, we have used the abbreviation PA for physical activity in the whole document.

For example:

Page 2, line 47 "... years old practice PA"

Page 3, line 79: "... promotion of PA [21,22]"

Page 6, line 216: "... and PA will be based ..."

3. Contributions of reviewer: The way of carrying out the research is not entirely clear to me assuming that 60 students to be included in the experimental group will come from 23 schools. Who exactly will implement the program? How will the program be supervised? And how is it expected to promote social relations between the participants if they are students from different schools?

Answer: Many thanks for the suggestion. The program will be conducted by two experts in physical activity and trained in SDT, and supervised by the main researcher (who got the granted and funding by the Regional Government). Relatedness is developed by the different strategies used in the program. Moreover, with the aim to incentivize the maintain in the program, the following information has been included:

Page 11, line 446 – 457: “However, the risk that the students drop out of the intervention does not depend on us. In this regard, the issue that depends on us is to develop strategies to avoid drop out, as well as increase the adherence of students who are against the possibility of leaving the intervention. In this sense, based on previous investigation [84], strategies will be developed to promote the autonomy support such as to foster pupils’ active participation or activities that increase the pressure to win will be avoided to reduce the competitiveness. In order to promote the competence, support the activities will be adapted to the levels of the participants to avoid frustration, as well as to carry out activities where success is evaluated through intrapersonal instead of interpersonal indicators, in addition to providing positive feedback so that students feel safer when carrying out the tasks. Regarding to relatedness support, socialization will be promoted among all members, in addition to promoting the mixed-gender groups. In addition, stereotypical activities and sports with excessive competition will be avoided."

Author Response File: Author Response.pdf

Reviewer 4 Report

This manuscript describes a protocol for a study to be conducted in adolescents. The protocol itself is very detailed and overall, the manuscript would benefit tremendously from edits that improve the readability of the paper. I have made some additional comments that may assist the authors with their edits:

1. The introduction should focus on research in adolescents, or at least be specific about when research in adults in cited.

2. There needs to be more consistency of terms used in the manuscript, e.g. PA vs. exercise.

3. Regarding recruitment: How will adolescents at each school be recruited? Will parents be contacted by the schoolteachers or the researchers? Following that, do both parents and adolescents provide consent? Will the teachers need to provide consent for the displacement of school time for data collection?

4. Regarding randomisation: Contamination is a real risk when participants from the same class or school are in different groups. Is it feasible to randomise schools as opposed to participants to reduce that risk (acknowledging that there may even be contamination when schools are randomised, especially if schools have children from the same residential area)?

5. Will the screening take 30 minutes per adolescent? Lines 122-124 are not clear. 

6. Have any of the questionnaires been validated for use in Spanish adolescents? – If no, this project may be a way to assess validity and this could be incorporated in the manuscript.

7. The paper would benefit greatly from another figure or perhaps a flow diagram or table that outlines the ‘lifestyle variables’ and ‘Anthropometric measure and physical fitness’. The numbering and heading styles used for this whole section (between lines 251 and 368) is quite confusing difficult to follow.

 

Author Response

REVIEWER#4

This manuscript describes a protocol for a study to be conducted in adolescents. The protocol itself is very detailed and overall, the manuscript would benefit tremendously from edits that improve the readability of the paper. I have made some additional comments that may assist the authors with their edits:

1. Contributions of reviewer: The introduction should focus on research in adolescents, or at least be specific about when research in adults in cited.

Answer: Thanks you for your insightful comment. The bibliographic of the introduction has been review and the adults cites have been deleted.

2. Contributions of reviewer: There needs to be more consistency of terms used in the manuscript, e.g. PA vs. exercise.

Answer: Thank you very much for your important contributions. The authors have unified the term of physical activity in the overall document.

3. Contributions of reviewer: Regarding recruitment: How will adolescents at each school be recruited? Will parents be contacted by the schoolteachers or the researchers? Following that, do both parents and adolescents provide consent? Will the teachers need to provide consent for the displacement of school time for data collection?

Answer: Thanks you for your contributions. The authors added a paragraph in the procedure and measure section to clarify this information.

Page 4, line 151 - 157: "Regarding to recruitment, once the management team will agree to participate in the research, all participants will be invited. Next, each student will be given a commitment document informing them of the research objectives so that they can give it to their parents or guardians. Therefore, participants who wish to participate in the study must present the commitment form signed by him and by the parents or guardians. This commitment document will be collected by the research team on the first day of measurements. All assessments will take place during the school day, so the teachers will not need to provide consent for the commuting of school time for data collection."

4. Contributions of reviewer: Regarding randomisation: Contamination is a real risk when participants from the same class or school are in different groups. Is it feasible to randomise schools as opposed to participants to reduce that risk (acknowledging that there may even be contamination when schools are randomised, especially if schools have children from the same residential area)?

Answer: Thank you very much for your insightful comment. We totally agree with reviewer, but according to cultural reasons in order to access to public schools in our region (proximity of the parents` job, family, family incomes, new areas of development…), we decide to randomize the participants with the aim to maintain the heterogeneity of our study, which is one of the potential aspect of our study. In fact,  authors think about the possibility that the reviewer suggests. Nevertheless, we think that it is more feasible to randomize the participants because it allows knowing the effect of the program regardless of the sociodemographic characteristics of the participants. Surely the students of each school have similar environments such as, for example, socioeconomic status, facilities, level of practice of physical activity, parents' educational level... If we did the randomization by school, we would lose part of the heterogeneity of our study, as we have previously indicated. That is why we have decided that a simple randomization.

Moreover, it is important to note the characteristics of our region, which is a huge region with not a lot of population (80000 people in one city and just 40000 people in another city) has not enough participants/individuals who aim to participate in researches. Therefore, we decide to randomize by participants.

5. Contributions of reviewer: Will the screening take 30 minutes per adolescent? Lines 122-124 are not clear.

Answer: Thanks you for your contributions. The authors have rewrite this section.

Page 4, line 172- 179: " The research team will travel to participating schools to collect the research data. The commitment sheet signed by the student and the parent or guardian will be collected. Next, each student will be given a questionnaire packet in order to measure PA levels and screen time. It is expected that 30 minutes will be enough to develop the measurements. It is expected that 30 minutes will be enough to develop the measurements. These measures will be used to identify the sample that not meet with the daily guidelines for adolescents [38]; < 150 minutes of moderate PA per week, > 2 hours of screen time per day. Students who meet inclusion criteria (see Figure 1), will be invited to participle in the Multidisciplinary Program.”

6. Contributions of reviewer: Have any of the questionnaires been validated for use in Spanish adolescents? – If no, this project may be a way to assess validity and this could be incorporated in the manuscript.

Answer: Thank you for your comments. Consider this contributions, the authors have thought about validating the Body Image Dimensional Assessment questionnaire for Spanish adolescents. However, we made the mistake to not include it in the manuscript, so we have added the following publications.

Page 13, line 513 – 515: “Study 3: The reliability and validity of the BIDA instrument in adults has been demonstrated [69]. Given the importance of this instrument to assess body dissatisfaction, we intend to validate this instrument for Spanish adolescents.”

7. Contributions of reviewer: The paper would benefit greatly from another figure or perhaps a flow diagram or table that outlines the ‘lifestyle variables’ and ‘Anthropometric measure and physical fitness’. The numbering and heading styles used for this whole section (between lines 251 and 368) is quite confusing difficult to follow.

Answer: Thanks for your contributions. The authors agree with the contributions made by reviewer, so we have modified table 1. Regarding to numbering and heading styles, the modifications have been modified as well.

Table 1. Develop of Multidisciplinary Program

	Initial meeting	Initial measure			Development of the sessions		Final measure	Follow-up post intervention
Control Group		X
Experimental Group
Assessment in both groups
Lifestyle variables
Physical activity (self-reported and Actigraph)			X			X			X
Sedentary behaviour			X			X			X
Body dissatisfaction			X			X			X
Adherence to the Mediterrean diet			X			X			X
Regulation of behaviour in physical exercise			X			X			X
Satisfaction with life			X			X			X
Positive and negative affect			X			X			X
Anthropometric measure
Weight and height			X			X			X
Skinfold			X			X			X
Waist circumference			X			X			X
Neck circumference			X			X			X
Physical fitness
Cardiorespiratory fitness			X			X			X
Handgrip strength			X			X			X
Lower limb strength			X			X			X
Shuttle run test			X			X			X

 

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

Dear authors,

It is evident that a significant amount of work has gone into updating the paper. Unfortunately, there are still sections which raise questions, and are difficult to understand. Please find further comments below:

Introduction:

• Fantastic incorporation of more evidence throughout.
• GoActive and CReActivity are both founded on SDT. The line 62 does not necessitate a gap in the literature. You do not need to describe the interventions in-depth as authors have done e.g. line 52-62. These papers should add to your case for using SDT. I reiterate previous comments: consider what has been successful? What has not? This will demonstrate how the current research is different and why it is expected to be successful. The authors draw on reference 27 and 28 to form late conclusions and basis for their research. This should be presented earlier, alongside references 15, 17 etc. It would be worth reviewing the introduction of the referenced papers to ascertain the structure of their introductions.
• Comment: In general, the authors have provided some rationale for the study, e.g. Physical activity is important, and declines adolescents are currently inactive. However, there is an unclear link between adolescent physical inactivity and promoting physical activity in schools. A better link informing how schools represent an ideal opportunity for intervention should be established – referred to creating a better link between current line 47 and the paragraph commencing line 49. There is one sentence (line 47) that states there is a need to stat promoting regular PA at schools – what is the evidence behind this? Read through citation 15 and 17 to note how they discussed this in their various papers.
• Clarity in writing will allow the clarification of the aim, line 117.

Methods:

• It is unclear why ‘the logical model for intervention was developed following Patrick and Williams [86] guidelines’ is a limitation of the study (line 499). Keep it clear, reference the logic model in-text, where the logic model is, and keep the limitation to the exclusion of a cost-effectiveness. Is there a reason why this was excluded? It would be good to look at how other papers have worded this. – I have now read the response to comment 22. I would suggest excluding the logic model comment. This is not published in all protocols, but it is suggested that researchers utilise this in intervention development and evaluation.
• Physical inactivity: please look at the following paper: Global trends in insufficient physical activity among adolescents...The Lancet (https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(19)30323-2/fulltext#seccestitle70), it states inactivity is classified as doing less than 60 min of daily MVPA, or being active for less than 60 min on 5 days a week as inactive. This is more recent than the 2012 reference used by authors. If authors are going to call it ‘physical inactivity’ they will need to use this definition. If authors are going to call it ‘sedentary activity’ they will need to reference something like ‘Objectively measured sedentary behaviour and health and development in children and adolescents’ (2016) (https://onlinelibrary.wiley.com/doi/abs/10.1111/obr.12371)
• Comment 14 response: are the schools sampled from socio-demographically diverse areas?
• Line 155– inclusive language required e.g. ‘them’ or ‘him/her’
• Line 152 – ‘all participants will be invited’ – they are not yet participants
• Comment response 23 – do authors expect students to stay after school hours to complete the measurements? Is this appropriate?
• Comment response 24 – the comment still remains. The way that the section is currently written, it is still unclear how socialization of the group is important. This needs to be evident to the reader. Additionally, this is still the first mention. If it is important, then this should be introduced earlier, potentially linked to motivation in the introduction.
• Comment 25: Ensure that it is clear as to why they are separated in text.
• Comment 26: It is completely understandable that you have 60 accelerometers only. It would be good to make note in text the scientific reasons and references. Is this the reason that from 2000 students there will only be 120 in the intervention? (line 144). This should be made clear; it seems like a lot of effort to recruit 2000 to narrow to 120.
• Comment 27: Will teachers facilitate the sessions? What measures will teachers complete in the study?
• Comment 29: Who is a qualified monitor? Are they from the school or study team? Ensure this is clear in-text. It is still quite difficult to understand who will implement the program, how will the program be supervised, and how it will promote social relations between the participants if they are students from different schools.

Comments:

• Grammatical errors, plurals, errors with tense, and random capitalisation still remain throughout the paper. These should be addressed. I suggest seeking support to edit the paper accordingly.

Author Response

Pedro Antonio Sánchez Miguel

University of Extremadura

Faculty of Teaching Training

Av/ de la Universidad s/n

Cáceres, (Spain)

+34 927 25 70 49

 

 

July, 10^th 2020

Dear academic editor,

We would like to thank reviewers for their comments and suggestions (ref. 838660) which have improved the quality of the manuscript.

Moreover, we would like to thank Reviewer#1 for his/her suggestions towards our article. They are constructive and make our manuscript better.

We hope to have responded correctly all reviewers’ comments.

Dr. Pedro Antonio Sánchez-Miguel

Teacher Training College

University of Extremadura

On behalf of all authors.

 

 

REVIEWER#1

First of all, the authors would like to thank the reviewer's effort to review our article. The authors have to acknowledge that all the revisions made by the reviewer have been very important for our manuscript, because we really consider that they have improved the final quality of it.

Secondly, we would also like to thank reviewer for the important knowledge that he/she has given us about the intervention programs prior to our study. Thanks to his/her contributions, we have learnt very important interventions based on the SDT that have given us some ideas and proposals for the future. Some of these ideas have been highlighted in the manuscript (i.e., interviews with teachers).

Finally, we thank the reviewer for recognizing our hard work to improve the quality of the article. As can be seen in the following responses, the authors have tried at all times to attend to their contributions, because we truly believe that they have helped us improve our final work. Therefore, we hope that all modifications made have been adequately addressed and are considered positively.

1. Contribution of reviewer: GoActive and CReActivity are both founded on SDT. The line 62 does not necessitate a gap in the literature. You do not need to describe the interventions in-depth as authors have done e.g. line 52-62. These papers should add to your case for using SDT. I reiterate previous comments: consider what has been successful? What has not? This will demonstrate how the current research is different and why it is expected to be successful. The authors draw on reference 27 and 28 to form late conclusions and basis for their research. This should be presented earlier, alongside references 15, 17 etc. It would be worth reviewing the introduction of the referenced papers to ascertain the structure of their introductions.

Answer: Thanks you for your insightful contributions. The authors have made an important review effort to consider what has been successful, as well as the limitations showed in previous programs. We have mainly focused in Brown et al. (2017) and Demetriou and Bachner (2019) studies.

Page 2, 75 – 86: “Grounded in SDT, intervention as the Get Others Active (GoActive) [21], that was developed iteratively with adolescents and teachers with strategies based on peer support, self-efficacy, group cohesion, self-esteem and friendship quality, and was implemented using a tiered-leadership system. The highlighted of the GoActive study was the cluster randomised controlled trial design, objective measurement of PA in a large sample, the long-term follow-up post intervention, the assessment cost-effectiveness of the intervention and qualitative interviews with adolescents to know how may encourage them to participate in the intervention. Moreover, the CReActivity [11] intervention program was designed to promote girls PA levels in Physical Education lessons. CReActivity highlighted the importance of implementing these interventions within physical education classes, adapting didactic contents and teaching methods to promote an active life in adolescents. In addition, it also took into account relevant issues such as socioeconomic status, environmental factors, characteristics of adolescents and body mass index.”

On the other hand, according to include the main contributions of the study, authors think that it may be more adequate to include them in the discussion section, in order to show contributions and so, some prospective of future.

Page 13, line 529 – 536: “Finally, it was not evaluated whether participation in the Multidisciplinary program increased their involvement and motivation during Physical Education lessons. This limitation could be an important aspect to consider for future interventions to develop outside of school hours. It would be interesting to carry out interviews with the Physical Education teachers to follow up on the participants of the program during the Physical Education lessons, for example, to know if the participants get involved during the Physical Education lessons, if they have a greater interest in PA, if the teachers see the students of the program more motivated in their lessons.”

2. Contribution of reviewer: In general, the authors have provided some rationale for the study, e.g. Physical activity is important, and declines adolescents are currently inactive. However, there is an unclear link between adolescent physical inactivity and promoting physical activity in schools. A better link informing how schools represent an ideal opportunity for intervention should be established – referred to creating a better link between current line 47 and the paragraph commencing line 49. There is one sentence (line 47) that states there is a need to stat promoting regular PA at schools – what is the evidence behind this? Read through citation 15 and 17 to note how they discussed this in their various papers.

Answer: Thank you for your important contributions. The authors agree with the reviewer, therefore we have included a new paragraph to improve link about promoting physical activity in schools, according to studies of Brown et al. (2017) and Demetriou and Bachner (2019).

Page 2, line 48 – 56: “In this sense, the PA Promotion Model [10] suggest that the combination of individual-level factors (e.g., age, gender or socioeconomic status) and environmental/policy-level factors (e.g., family, school, peers...) can directly and indirectly influence in PA promotion and health-related behaviours. Thus, previous investigations [11,12] have appointed that more interventions promoting PA are needed for the creation of active schools. However, the previous reviews have appointed a limited efficacy of existing adolescent PA promotion interventions. Several reason have been identified, for instance, socioeconomic status [13] or gender [5,14]. To overcome this limitation, the present study intends of promoting of health-related behaviours in adolescents, in depend on socioeconomic status and gender.”

3. Contribution of reviewer: Clarity in writing will allow the clarification of the aim, line 117.

Answer: Thanks you for your contributions. The description objective has been improved.

Page 3, line 125 – 127: “Finally, the aim of this study will be to assess the 5-month effectiveness of the Multidisciplinary Programme to increase PA and to promote health-related behaviours in adolescents.”

Methods

4. Contribution of reviewer: It is unclear why ‘the logical model for intervention was developed following Patrick and Williams [86] guidelines’ is a limitation of the study (line 499). Keep it clear, reference the logic model in-text, where the logic model is, and keep the limitation to the exclusion of a cost-effectiveness. Is there a reason why this was excluded? It would be good to look at how other papers have worded this. – I have now read the response to comment 22. I would suggest excluding the logic model comment. This is not published in all protocols, but it is suggested that researchers utilise this in intervention development and evaluation.

Authors: Thank you for your important contributions. The authors have accepted the proposal of reviewer and we excluded the logic model comment. As was indicated by the reviewer, this is not published in all protocols, and honestly, we have not thought in it. Nevertheless, we will include it for sure in the following studies. We would like to thank reviewer for this comment, because it might be an issue to add in our researches.

5. Contribution of reviewer: Physical inactivity: please look at the following paper: Global trends in insufficient physical activity among adolescents...The Lancet (https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(19)30323-2/fulltext#seccestitle70), it states inactivity is classified as doing less than 60 min of daily MVPA, or being active for less than 60 min on 5 days a week as inactive. This is more recent than the 2012 reference used by authors. If authors are going to call it ‘physical inactivity’ they will need to use this definition. If authors are going to call it ‘sedentary activity’ they will need to reference something like ‘Objectively measured sedentary behaviour and health and development in children and adolescents’ (2016) (https://onlinelibrary.wiley.com/doi/abs/10.1111/obr.12371)

Answer: The authors would like to thank reviewer for his/her contributions. We agree with propose of reviewer, therefore we have included a new physical inactivity description, according to Guthold et al. (2020) study.

Page 1, line 41 - 42: " Based on [8], the physical inactivity is considered doing less than 60 minutes of daily moderate-vigorous PA, or being active for less than 60 minutes on 5 days a week "

Page 4, line 184 - 185: "...< 60 minutes of daily MVPA, or being active for less than 60 minutes on 5 days a week"

6. Contribution of reviewer: Comment 14 response: are the schools sampled from socio-demographically diverse areas?

Answer: Thanks you for your comment. The redaction of sample schools has been improved.

Page 7, line 274 - 276: "Furthermore, given that a random sampling of the schools is carried out, the sample schools will choose from socio-demographically diverse areas."

7. Contribution of reviewer: Line 155– inclusive language required e.g. ‘them’ or ‘him/her’

Answer: Corrected. Page 4, line 161: “…form signed by them”

8. Contribution of reviewer: Line 152 – ‘all participants will be invited’ – they are not yet participants.

Answer: Thank you for your comments. We have substitute participants by students.

Page 5, line 159: “… all students will be invited”

9. Contribution of reviewer: Comment response 23 – do authors expect students to stay after school hours to complete the measurements? Is this appropriate?

Answer: Thank you very much for your comments. We do not intend that students stay after the school day to take measurements. In the school environment, we only intend to carry out the measurement of sociodemographic measurements, physical activity and screen time. Therefore, the school will be asked to provide us a 30-minute period of the school day to carry out these measurements. These variables will help us to know the potential students for our Multidisciplinary Program. Once we identify the students, they will be invited to participate in the Multidisciplinary program that will take place in the afternoons after school hours. During the program we will carry out the specific measurements of lifestyle, anthropometric measure and physical fitness. Therefore, we do not think (and the program does not show that idea) that students will have to stay after school hours to complete the measurements.

10. Contribution of reviewer: Comment response 24 – the comment still remains. The way that the section is currently written, it is still unclear how socialization of the group is important. This needs to be evident to the reader. Additionally, this is still the first mention. If it is important, then this should be introduced earlier, potentially linked to motivation in the introduction.

Answer: Many thanks for the contribution. According to the suggestion, we have included some information and strategies to adopt and follow in order to promote socialization in groups based on SDT. Thus, the following information has been included:

Page 11, line 472 – 479: “Give free time during the development of the sessions/classes (with the aim that individuals promote their relatedness and speak about different things of the session; a greater confidence and lack of inhibition is promoted); develop heterogeneous ways of grouping (i.e. promoting integration and cohesion); teach individuals in social skills (i.e. teach them to show empathy through peers and teacher/coach; diary dedication by teacher/trainer); plan cooperative and group dynamics activities (i.e. Help continue work in a common purpose, enjoyment in the session/class to improve motivation)".

11. Contribution of reviewer: Comment 25: Ensure that it is clear as to why they are separated in text.

Answer: Thank you for your contributions. Regarding section 2.3.2, the measurements that are intended to be carried out are those that are related to the inclusion criteria. On the other hand, the measurements that we will carry out in section 2.4.3 refer to the measures that will be taken in the Multidisciplinary program once the program participants have been selected. Therefore, to facilitate the reader's understanding, the authors have decided to replace the title “2.3.2 Measures by” “2.3.2 Sociodemographic measures, physical activity and screen time”

Page 5, line 200: “2.3.2 Sociodemographic measures, PA and screen time”

12. Contribution of reviewer: Comment 26: It is completely understandable that you have 60 accelerometers only. It would be good to make note in text the scientific reasons and references. Is this the reason that from 2000 students there will only be 120 in the intervention? (line 144). This should be made clear; it seems like a lot of effort to recruit 2000 to narrow to 120.

Answer: Thank you very much for your contributions. According to the characteristics of our region, as well as practical reasons (number of accelerometers), we think enough to develop the intervention program with that total amount of sample. Honestly, we can increase that number, but in our experience we think it is logical and according to the representative number in our region. In Spain, there are many programs that have been developed with a similar sample. For example:

1. Sevil, J., García-González, L., Abós, Á., Generelo, E., & Aibar, A. (2019). Can high schools be an effective setting to promote healthy lifestyles? Effects of a multiple behavior change intervention in adolescents. Journal of Adolescent Health, 64(4), 478-486.
2. González-Cutre, D., Sierra, A. C., Beltrán-Carrillo, V. J., Peláez-Pérez, M., & Cervelló, E. (2018). A school-based motivational intervention to promote physical activity from a self-determination theory perspective. The Journal of Educational Research, 111(3), 320-330.

Therefore, we think that it is a normal sample to develop the program successfully.

13. Contribution of reviewer: Comment 27: Will teachers facilitate the sessions? What measures will teachers complete in the study?

Answer: Thank you very much for your comment. As was previously indicated, we will ask for permission to the school, supervisors and teachers. They have to give permission to facilitate the sessions but they do not have to complete any measurement in the study. For our program, the involvement of teachers is not necessary, since it is intended to develop the program outside of school hours. During the school day, only the sociodemographic questionnaire, of physical activity and sedentary time will be carried out. However, the contributions of the reviewer have suggested a new idea to consider for future interventions. The authors think that it would have been interesting to include in the design quantitative interviews with the Physical Education teachers to have a follow-up of the participants of the program during the Physical Education classes. For example, to know if the participants get involved during Physical Education classes, if they have a greater interest in physical activity, if the teachers see the students of the program more motivated in their classes ... Therefore, the authors have decided to include this comment in the discussion section.

Page 13, line 529 – 536: “Finally, it was not evaluated whether participation in the Multidisciplinary program increased their involvement and motivation during Physical Education lessons. This limitation could be an important aspect to consider for future interventions to develop outside of school hours. It would be interesting to carry out interviews with the Physical Education teachers to follow up on the participants of the program during the Physical Education lessons, for example, to know if the participants get involved during the Physical Education lessons, if they have a greater interest in PA, if the teachers see the students of the program more motivated in their lessons.”

14. Contribution of reviewer: Comment 29: Who is a qualified monitor? Are they from the school or study team? Ensure this is clear in-text. It is still quite difficult to understand who will implement the program, how will the program be supervised, and how it will promote social relations between the participants if they are students from different schools.

Answer: Thank you very much for your comments. The authors have expanded the information about monitor and promote social relationship.

Page 10, line 446 - 458: " The development of sessions will take place in the afternoon, outside of school hours. They will be led by a qualified monitor. The monitors/trainers qualified will be graduates in sports sciences and will not be part of the research team. Moreover, these monitors/trainers will receive 15 hours of specific training on the SDT by research team, divided into three – five hours’ classes (similar to other studies carried out with SDT programs) [57,88]. In addition, to supervise the program, a member of the research team (who are experts in the development of motivational strategies in the PA and Physical Education context) will be randomly present during some sessions. The monitor/trainers will not be previously informed to avoid influencing the development of the session. Regarding to promote social relationship, several strategies will be developed. Firstly, a WhatsApp group will be created in which information related to BP and healthy habits will be shared, with the aim of promoting interaction between the participants. In addition, there will also be two coexistence sessions, in which there will be two bicycle routes to the natural environment, with all the participants of the experimental group."

15. Contributions of reviewer: Grammatical errors, plurals, errors with tense, and random capitalisation still remain throughout the paper. These should be addressed. I suggest seeking support to edit the paper accordingly.

Answer: Many thanks for your comments. We have revised the whole manuscript, but if further revisions are needed we will ask for editing support of the Journal in order to improve grammar errors, mistakes…

Author Response File: Author Response.pdf

Reviewer 3 Report

Prijímam opravy autora. Rukopis bol vylepšený a teraz si vyžaduje publikáciu v publikácii Sustainability

Author Response

Thank you very much to the reviewer for his comments. The authors greatly appreciate the time spent reviewing our article. So we are very grateful for your positive comments on our work.

Reviewer 4 Report

The authors have addressed my comments adequately although I think the manuscript would benefit greatly from further extensive editing of English - this would improve the readability. 

Author Response

Thank you very much to the reviewer for his comments. The authors greatly appreciate the time spent reviewing our article. So we are very grateful for your positive comments on our work.

Regarding English, the authors commit to sending it to the sustainability editing process once the review process is complete.

Round 3

Reviewer 1 Report

Thank you to the authors for making considerable changes to the article. This article has developed immensely since its initial submission. Some elements remain unclear, and I feel this comes down to the structure, mainly of the introduction, and where the intervention description is placed. If possible and normally structured this way within the journal, it may be beneficial to move the discussion of the intervention earlier in the paper. Please find some comments to the new sections below.

 

Answer 1: Introduction:

• Need to check wording of sentences 40 – should not start with ‘The’
• Referencing needs work e.g. reference 8, line 41
• Line 55 should be specifically related to schools
• Chunk together when you talk about your intervention, it shouldn’t be scattered through the introduction e.g. line 57 – should come later, maybe in final paragraph (line 153).
• Need to check pluralisation throughout
• Sentence starting like 67 needs a reference – this is a bold sweeping statement
• Topic sentence commencing line 138 is confusing e.g. ‘based on or not’
• Unclear what lack of effectiveness there is (line 143) – this argument needs to be created. Authors have mentioned SDT, effectiveness of PA interventions using SDT, mentioned GoActive and Creative (still seems at random, need to provide context here), discussed SDT as an appropriate framework, and then paragraph commencing line 138 notes lack of effectiveness. Structure needs work to lead up to this point. Are you saying GoActive and Creative have all of these limitations? I do not feel the authors of these research studies would be happy with this insinuation.

Answer 9:

• Authors should make it clear in-text that the school will be asked to provide us a 30-minute period of the school day to carry measurements of sociodemographic, physical activity and screen time.

Answer 15:

• Grammatical errors, plurals, errors with tense still remain throughout the paper. As you have suggested, please ask for editing support of the Journal

Further comments:

• Is there any way that the intervention description e.g. what it is and what it entails, can come before participants (2.4, line 251)? The reader is left questioning what the intervention entails. This would answer these questions early. This structure may be set up as the journal recommends, so it is understandable if this is not changeable.
• Line 175 – the group will not yet be participants at this time.
• Line 177 – through what issue?
• Line 219 – be specific, they are PA guidelines
• Screening – how will you create a cut-off point and randomise if you have too many students who meet the inclusion criteria? We know from the literature you have mentioned that many adolescents will be considered inactive with your definition.
• Seems to be issue with Figure one – looks like it has been duplicated, difficult to read. Will randomisation need to occur at the selection of participants’ stage? Consider screening question above.
• Discussion – first line – ensure the aim is clear e.g. ‘to show…’ – ensure you clearly articulate what you mean.

Author Response

Firstly, we would like to thank reviewer for his/her important contributions. The authors appreciate the enormous work of the reviewer, since he/she is helping us to improve the quality of our manuscript. As was indicated in previous reviews, we are delighted with his/her comments and suggestions.

1. Contributions to review: Need to check wording of sentences 40 – should not start with ‘The’

Authors: Corrected. Page 1, line 40: "Physical inactivity has been..."

2. Contributions to review: Referencing needs work e.g. reference 8, line 41

Authors: Corrected. Page 1, line 41: "Based on Guthold et al. [8],"

3. Contributions to review: Line 55 should be specifically related to schools

Authors: Many thanks for your contributions. The authors agree with the revision and therefore, we have modified the redaction.

Page 2, line 53 - 54: "However, the previous reviews have appointed that the school interventions to promote the PA in adolescents have a limited efficacy."

4. Contributions to review: Chunk together when you talk about your intervention, it shouldn’t be scattered through the introduction e.g. line 57 – should come later, maybe in final paragraph (line 153).

Authors: Thank you for your important contributions. The authors agree with your comments, therefore, we have added in the line 153:

Page 4, line 153 – 155: "Finally, the present study intends of promoting of health-related behaviours in adolescents, independently on socioeconomic status and gender."

5. Contributions to review: Need to check pluralisation throughout

Authors: Thank you very much for your contributions. The authors have thoroughly revised the manuscript as well and have corrected the pluralization errors. Furthermore, if the mistakes continue in the document, we ask for the Journal editing service in order to avoid these mistakes. We apologize for the inconvenient.

6. Contributions to review: Sentence starting like 67 needs a reference – this is a bold sweeping statement

Authors: Thanks you for your contributions. The authors agree with the contributions, therefore, we have added a reference in line 67

Sentence starting like 67 needs a reference – this is a bold sweeping statement.

Page 2, line 67 - 68: "According to the SDT, there are multiple sources of support that can influence the motivational results of students and, consequently, the initiation and maintenance of health-related behaviours [24]"

Reference:

Ryan, R.M.; Deci, E.L. Intrinsic and Extrinsic Motivations: Classic Definitions and New Directions. Contemp. Educ. Psychol. 2000, 25, 54–67.

7. Contributions to review: Topic sentence commencing line 138 is confusing e.g. ‘based on or not’

Answer: Corrected.

Page 3, line 112: “…based on SDT”

8. Contributions to review: Unclear what lack of effectiveness there is (line 143) – this argument needs to be created. Authors have mentioned SDT, effectiveness of PA interventions using SDT, mentioned GoActive and Creative (still seems at random, need to provide context here), discussed SDT as an appropriate framework, and then paragraph commencing line 138 notes lack of effectiveness. Structure needs work to lead up to this point. Are you saying GoActive and Creative have all of these limitations? I do not feel the authors of these research studies would be happy with this insinuation.

Answer: Thanks for your comments. The authors apologize for the mistake in the description. At no time is our intention to offend the authors of the GoActive and Creative works. It is evident that the design of these works has a high quality and at no time we intend to point out such weaknesses. The authors apologize because we acknowledge that we have used too crude language for our statement, so we have corrected the wording of this sentence. Again, sorry for the inconveniences. We hope and respect authors of those researches.

Page 3, line 112 - 113: “Regarding interventions based on SDT, some prospects have been pointed out to take into account for the future [34]”

9. Contributions to review: Answer 9: Authors should make it clear in-text that the school will be asked to provide us a 30-minute period of the school day to carry measurements of sociodemographic, physical activity and screen time.

Authors: Thank you for your comment. The author added this information.

Page 4, line 183 - 185: "The research team will ask the supervisor team to provide us a 30-minute period of the school day to carry measurements of sociodemographic, physical activity and screen time."

10. Contributions to review: Answer 15: Grammatical errors, plurals, errors with tense still remain throughout the paper. As you have suggested, please ask for editing support of the Journal.

Authors: If the reviewer considers it appropriate, the authors will request the sustainability editing service to improve the quality of the manuscript. However, in this review we were unable to send the manuscript to the editing service because we have only been given 5 days to address the comments. We hope the reviewer understands this situation and language is not an obstacle to our article being finally accepted. Once again, we thank you for all your contributions, and if the reviewer still considers it appropriate, we will pass the article on to the sustainability edition service.

11. Contributions to review: Further comments: Is there any way that the intervention description e.g. what it is and what it entails, can come before participants (2.4, line 251)? The reader is left questioning what the intervention entails. This would answer these questions early. This structure may be set up as the journal recommends, so it is understandable if this is not changeable.

Authors: Many thanks for the comments and suggestions. The authors agree with the contributions of the reviewer. We think that including the description of the Multidisciplinary Program could improve the comprehension of the manuscript for the reader. However, as the reviewer points out, the norms of the Journal suggest us to adapting this structure. Thus, these important contributions cannot be conducted (as was suggested by reviewer).

12. Contributions to review: Line 175 – the group will not yet be participants at this time.

Authors: Line 169 and 191: We have changed “participants” for "students"

13. Contributions to review: Line 177 – through what issue?

Authors: The problem to which we intend to refer is that in the Extremadura Region (Spain) there is a large depopulation. The sample that we can reach is very low compared to other urban places. In addition, our region is very geographically dispersed and children are widely dispersed. As was found in previous researches by the Research team, authors are going to find many logistical problems in order to reach the sample we are looking for. Therefore, we have indicated that issue in order to give further information about the study.

14. Contributions to review: Line 219 – be specific, they are PA guidelines

Authors: Thanks you for your contributions. The authors we have been more specific with the PA guidelines.

Page 4, line 188: "the PA daily guidelines for adolescents"

Page 7, line 281 - 282: "The goal will be to meet with the PA recommendations [1] and guidelines sedentary screen time based on 24-hour movement for adolescents [41].”

15. Contributions to review: Screening – how will you create a cut-off point and randomise if you have too many students who meet the inclusion criteria? We know from the literature you have mentioned that many adolescents will be considered inactive with your definition.

Authors: Thank you very much for the comment. As was indicated in the article, cutoff points based on physical activity levels and screen time will be used to select inactive and sedentary individuals. The selection system will be totally random, but it is true, and based on our experience, it is rare that many more children participate in the program.

In this sense, it is highlighted that the localities where they are developed are not very large (the largest has 80,000 inhabitants), and in addition, there are many other alternative activities, so their degree of participation is usually limited.

For this reason, and given that several intervention programs have already been developed, we consider the quantity and the cut-off point to be adequate. In this way, we consider adequate and convenient the number of individuals participating in the intervention program, according to logical, geographical and practical reasons.

16. Contributions to review: Seems to be issue with Figure one – looks like it has been duplicated, difficult to read. Will randomisation need to occur at the selection of participants’ stage? Consider screening question above.

Authors: Thank you for your important contributions. Authors have improved the quality of Figure 1. However, we have appreciated that when we attach the figure to the Word document, quality is lost. Therefore, we have attached the figure in pdf document (Figure 1.pdf).

Regarding selection of participants ’stage, as we have pointed out in section included (page 5, line 195), authors attempt to develop a random selection of participants who do not meet the established levels of PA and / or sedentary screen time.

17. Contributions to review: Discussion – first line – ensure the aim is clear e.g. ‘to show…’ – ensure you clearly articulate what you mean.

Authors: Thanks you for your comments. The authors we have cleared the objective in the discussion section.

Page 12, line 505 – 506: “The main aim of this study is to assess an effectiveness of the Multidisciplinary Training Program for the Promotion of PA and Healthy Lifestyle in Inactive Adolescents”

Author Response File: Author Response.pdf

This manuscript is a resubmission of an earlier submission. The following is a list of the peer review reports and author responses from that submission.

Round 1

Reviewer 1 Report

the journal receive research and review manuscript. The present document does not fit any of these categories. There are no results and discussion.

Author Response

Comments for the Authors

1. Contributions of reviewer

The introduction did not provide enough background information for readers to understand the research aim, however the authors should clarify the importance of this topic and the actual knowledge. Define a clear and concise aims of the research.  

Some of the sentences in introduction are too long and sometimes makes difficult its understanding

Authors: Many thanks you for your insightful contributions. The authors agree with reviewer, so we have modified the introduction section.

Page 1 – 2, line 33 – 69 : "Prevalence of overweight and obesity is one of the most important public health issues worldwide because of the biological and psychosocial consequences they can cause [2]. Previous studies [3,4] have found that lack of physical activity (PA) [1,3,5] and a sedentary behaviour [4] is associated with a higher prevalence of overweight and obesity in youth.

The Physical Inactivity (PI) has been defined as decrease in body movement that produces decreased energy expenditure [6]. The WHO [1] has estimated the IP as the fourth risk factor to death in the world Moreover, 6% of the deaths registered annually in the world, as well as the reasons to promote some diseases (i.e. breast and colon cancer, diabetes, or heart disease), are caused by PI [7]. In Europe, 35% of adolescents between 9 and 17 years old are insufficiently active and, and just 50% of 15 years old adolescents practice physical activity [8]. Thus, the need to start promoting regular physical activity at schools is emphasized.

Several studies have evaluated the effect of PA on health [9–14]. PA is defined as body movement produced by the skeletal muscles that requires energy expenditure [1,15]. PA includes a wide variety of activities such as walking, dancing, housework, sports, etc. [1] An interaction between physical activity, body weight, and energy expenditure has been demonstrated because greater energy is required to move a large body than a small body [16].

To prevent the problems caused by overweight and obesity, several physical activity programs have been developed with the aim of promoting the habits related to adolescents´ health [10,14]. However, it has been found that after a period of inactivity of the program, the effectiveness of the program decreased [17]. The study by Michie [18] pointed out that some programs did not have a theoretical support, which increases the probability of decreasing the effectiveness of the program.

In this regard, Self Determination Theory (SDT) [19] has emerged as a complementary theoretical framework to implement school-based PA interventions. According to the SDT, different sources of support such as parents, friends and the school, can influence adolescents` motivation and, consequently, the initiation and maintenance of health-related behaviors.

The systematic reviews conducted by Vaquero-Solís et al. [20]and Teixeira et al. [9] have shown a good evidence for the value of SDT in understanding and promoting exercise behavior. Both reviews showed a greater effectiveness of the interventions that were developed under the postulates of the SDT, taking into account the individuals´ motivation. Despite these findings, the heterogeneity within sample (i.e..: age, gender, weight or body composition, and fitness status) and the short length of programs (< 3 months), were some of the main limitations [9,20].

Therefore, the present Multidisciplinary Training Program for the Promotion of Physical Activity and Healthy Lifestyle in Inactive Adolescents will provide a broad overview of factors associated with PA in adolescents and includes motivational constructs based on SDT such as autonomy, competence and relatedness, which has been found to be reliable in the promotion of physical activity [21].”

2. Contribution of reviewer

A better explanation of the methodology and its rationale is needed for better understand

Authors: Many thanks you for your insightful contributions. The authors agree with reviewer, so we have modified the method section.

Page 2 - 4, line 77 – 122: “This is a longitudinal study, where different measurements were developed (initial and end of the program, as well as a follow-up) in order to obtain information and to check adolescents´ health status in the Region of Extremadura. In addition, the collected information will be treated with the aim of analysing the effects of intervention programme for preventing overweight and obesity in adolescents.

The study will be carried out following the ethical guidelines of the Declaration of Helsinki, and its 2013 modification, and approved by the Human Research Ethics Committee of the University of Extremadura (89/2016).

2.2 Participants

This research is intended for adolescents enrolled in 1^st and 2^nd grade of High School, whose range age will be 12 – 14 years. A random selection will be made of the 46 school of Cáceres (Extremadura, Spain). After selection schools, a sample around 2000 students (1000 boys and 1000 girls) participants will be expected to obtain. Later, 120 students with all of the selection criteria will be recruited for the intervention programme, subdivide in control group and experimental group. Each group will have 60 students, 30 boys and 30 girls.

2.3 Procedure and measure

Figure 1 shows the phases into which the project is divided prior to the Multidisciplinary Program (intervention program). Previously, all participants will carry out an assessment phase in order to know the daily PA and sedentary screen time (see, inclusion criteria in Figure 1).

2.3.1 Procedure

Identification: a random selection by computer will be made of the 46 school of Cáceres (Extremadura, Spain). The first 23 school will be selected as potential participants and the next 23 school will be included in a reserve list. The reserve schools will serve to replace the potential schools, in case they declined their participation.

The research team will inform by e-mail about the interest in participating in the research. Schools will have a maximum of 15 days to confirm their participation. It the supervisor does not respond or rejects participation in the project, the research team will contact corresponding reserve school. On the contrary, if they agree to participate, there will be a meeting with the research team in order to present the project and to establish dates for the evaluations.

Screening: the research team will go to the participant schools in order to measure PA levels and sedentary screen time. It is expected that 30 minutes will be enough to develop the measurements. These behaviours will use to identify the sample that not meet with the daily guidelines for adolescents [22] (< 60 minutes of physical activity daily, > 2 hours of sedentary screen time per day). Students who meet inclusion criteria (see Figure 1), will be invited to participle in the Multidisciplinary Program.

It will be recruited a total of 120 participants to the Multidisciplinary Program because previous researchers [10–12,23–26] considered adequate, feasible and a realistic sample size for this type of interventions.

Included: a simple randomization, unrestricted [31] will be developed of participants in control group (CG) and experimental group (EG). During randomization assignment, the assessment team (who will develop the evaluations) will be blinded to avoid contaminating data collection. Participants will be explicitly informed on the assigned group and will be reminded frequently not to disclose their set group. Finally, the Multidisciplinary Program will begin.

Figure 1. Procedure, phases and inclusion criteria of the program

Note. CG: Control group; CE: Experimental group”

3. Comments of reviewer: There is no results!

Authors: Many thanks you for reviewer contributions. As the reviewer says, the results of the intervention are not shown, because it is a protocol study. As you know, protocol studies do not have this section, because they are interventions that are going to be carried out in the future (hence also the verb tense of the article is future and not past). However, the authors have carried out an in-depth bibliographic review on procolo studies, and none of those we have found have incorporated the results section. Specifically, we highlight the protocol study by Mendoza et al. 2020 and Carlos-Vivas et al. 2020, since it is also in a magazine of the MDPI group and does not have that section either. However, we greatly appreciate your comments.

1. Amaro-Gahete, F. J., Jurado-Fasoli, L., Espuch-Oliver, A., Robles-Gonzalez, L., Navarro-Lomas, G., de Haro, T., ... & Gutierrez, A. (2018). Exercise training as S-Klotho protein stimulator in sedentary healthy adults: Rationale, design, and methodology. Contemporary clinical trials communications, 11, 10-19.
2. Castro-Piñero, J., Carbonell-Baeza, A., Martinez-Gomez, D., Gómez-Martínez, S., Cabanas-Sánchez, V., Santiago, C., ... & Veiga, O. L. (2014). Follow-up in healthy schoolchildren and in adolescents with DOWN syndrome: psycho-environmental and genetic determinants of physical activity and its impact on fitness, cardiovascular diseases, inflammatory biomarkers and mental health; the UP&DOWN Study. BMC Public Health, 14(1), 400.
3. Pesola, A. J., Hakala, P., Berg, P., Ramezani, S., Villanueva, K., Tuuva-Hongisto, S., ... & Laatikainen, T. E. (2020). Does free public transit increase physical activity and independent mobility in children? Study protocol for comparing children’s activity between two Finnish towns with and without free public transit. BMC Public Health, 20(1), 1-10.
4. Sanchez-Delgado, G., Martinez-Tellez, B., Olza, J., Aguilera, C. M., Labayen, I., Ortega, F. B., ... & Muñoz-Hernandez, V. (2015). Activating brown adipose tissue through exercise (ACTIBATE) in young adults: Rationale, design and Contemporary clinical trials, 45, 416-425.
5. Mendoza-Muñoz, M., Adsuar, J. C., Pérez-Gómez, J., Muñoz-Bermejo, L., Garcia-Gordillo, M. Á., & Carlos-Vivas, J. (2020). Well-Being, Obesity and Motricity Observatory in Childhood and Youth (WOMO): A Study Protocol. International Journal of Environmental Research and Public Health, 17(6), 2129.
6. Carlos-Vivas, J., Pérez-Gómez, J., Delgado-Gil, S., Campos-López, J. C., Granado-Sánchez, M., Rojo-Ramos, J., ... & Garcia-Gordillo, M. Á. (2020). Cost-Effectiveness of “Tele-Square Step Exercise” for Falls Prevention in Fibromyalgia Patients: A Study Protocol. International journal of environmental research and public health, 17(3), 695.
7. Comments of reviewer: There is no discussion and conclusions

Authors: Many thanks your for review contributions. The author agree with your contributions, therefore we have included discussion and conclusion section in the manuscript.

Page 10 – 15 : line 360 – 406:

"The main aim of this study is to show a Multidisciplinary Training Program for the Promotion of Physical Activity and Healthy Lifestyle in Inactive Adolescents. Thus, this program aims to achieve the increasing of PA levels through the inclusion of motivational strategies.

According to the main aim, and up to our knowledge, this would be the first study to promote physical activity and health-related habits taking into account heterogeneity of the sample based on SDT with adolescents inactive.

There are many previous [9–13] studies that have shown the positive effect of PA and the promotion of health-related habits in adolescents. However, as mentioned above, none of them took into account the individuals´ heterogeneity [20].

In this sense, the results obtained will allow us to determine whether a PA promotion program based on the SDT produces a positive effect on the behaviours related to the health of inactive and sedentary adolescents.

Regarding the impact of the project, there are several benefits that can be obtained. First, the findings of the study "Multidisciplinary Training Program for the Promotion of Physical Activity and Healthy Lifestyle in Inactive Adolescents" can help Health Information Systems and politician's makers to identify the target population for primary prevention and health prevention policies with the intention to develop and promote strategies that help promote healthy habits.

Secondly, the increase of physical activity could help to decrease in public expenditure caused by PI, overweight and obesity. The increase of physical activity would lead to a decrease in public expenditure to alleviate the consequences caused by PI, as only one disease such as obesity, represents 7% of the expenditure of the Spanish National Health System, equal to 0.6% of Gross Domestic Product. Therefore, even if the program does not produce significant improvements, it might play a compensatory role of exercise and its protective effects against the development of overweight and obesity, as well as promote participants ’social relationships.

Thirdly, this project will allow creating new guidelines on PA and healthy habits in the participants, helping them to improve their daily habits. Lastly, this study may also serve as a scientific basis for future intervention studies. PA seems to play a key role in the prevention and treatment of sedentary screen time and IP, and directly affects the prevention and treatment of overweight and obesity, as well as the improvement of body image, motivation toward physical activity, self-concept, satisfaction with life, etc. [58,59]. All this undoubtedly generates better performance in other aspects, such as school, future work or the acquisition of healthy habits, and has a high impact on the participants.

Throughout the project, the research team hopes to get the following publications:

Study 1: to develop a training program based on methodological strategies aimed at optimizing the level of satisfaction of basic psychological needs. Moreover, to know the motivations reasons for practice to modify behaviour patterns in inactive adolescents

Study 2: to check to what extent the modification of autonomous behaviour promotes an improvement in PA, and their effect about physical condition, the fatness and other healthy habits. In addition, it is intended to know if the effect of the intervention will be different in boys and girls. Furthermore, if the increase in PA produced by the modification of autonomous behaviour is different in boys than in girls.

4. Conclusion

This project will investigate the effect about health related behaviours of a PA program based on SDT in adolescents. Also, the results of this study will be important to know the habits of Extremadura adolescents and to be able to undertake the pertinent interventions to attend this situation. Moreover, orientations will be given to transfer the obtained results to the public sector to evaluate or change the adopted policies about health promotion.”  

Author Response File: Author Response.pdf

Reviewer 2 Report

 

 

 

Author Response

1. Contributions of reviewer: In the Methods, please describe the sample size setting in detail.

Authors: Many thanks your for review contributions. The author agree with your contributions, therefore we have improved the describe the sample size setting.

Page 3, line 86 – 91 : "This research is intended for adolescents enrolled in 1^st and 2^nd grade of High School, whose range age will be 12 – 14 years. A random selection will be made of the 46 school of Cáceres (Extremadura, Spain). After selection schools, a sample around 2000 students (1000 boys and 1000 girls) participants will be expected to obtain. Later, 120 students with all of the selection criteria will be recruited for the intervention programme, subdivide in control group and experimental group. Each group will have 60 students, 30 boys and 30 girls.”

2. Comments of reviewer: In the Figure 1, the numbers of participants and schools are mixed. It is better to list these separately.

Authors: Many thanks you for reviewer contributions. The authors have made a modification of the Figure 1 as requested by the reviewer. However, we have not considered it necessary to separate the participants and the schools, because the authors think that in this way it follows the structure that we describe in the text. However, we are very grateful to the reviewer for their contributions.

3. Comments of reviewer: Overall, I think this paper is quite long.

Authors: Many thanks you for review contributions. The authors agree with your contributions, therefore we reduced the manuscript.

For example, Table 1 of the old manuscript has been removed. Table 2 included as complementary material. In addition, a significant reduction of the method section has also been developed.

Reviewer 3 Report

Although this program is funded (this is noted in the manuscript), in order for this protocol manuscript to be published, the authors will need to consider how to ensure that there is improved alignment with the title and purpose of the manuscript, with the measures. For instance, the title of the manuscript is based around a "Program for the promotion of a healthy lifestyle in inactive adolescents: A protocol study." Yet there is very little expansion on the "Multidisciplinary Program" section (including suitable justifications), which should really be the core/fundamental focus of this manuscript (not how the program will be evaluated/measured, which does not align with the program detailed). The program currently describes being based upon self-determination theoretical components of autonomy, competence and relatedness, yet the response to previous reviewer queries about this fundamental aspect has not been adequately addressed. 

There are only 10 x lines dedicated within the manuscript to this "Multidisciplinary Program". One of the three SDT components is autonomy, and the authors describe how the program is built upon participants being able "to choose freely and being the main character of their one’s actions". Unfortunately (alongside the other SDT components), this multidisciplinary program is not detailed sufficiently, and there is insufficient detail in how the measures used do not compromise these program intentions. 

Please provide detailed examples throughout of how this "Multidisciplinary Program" enables freedom and involves participants in the decision-making processes". A rigorous measurement regime is at odds to these statements. As previously stated to the authors, there is also research/literature out there that has interviewed students of this age bracket, which has resulted in suggestions for physical activity promotion in schools (e.g. the EPIC-PA study is one example of many). There needs to be much better alignment and integration of how the interests of the participants are catered for. Previous responses to this were not integrated and addressed sufficiently into the manuscript. This update will not be light work, and requires careful consideration. For instance, suitable measures (& literature) that can be used to determine what the students' interests are, as a logical first phase, would be ideal. There is literature out there which has included interviewing/surveying students of what their physical activity needs are, and there are ways to discover what measures might suit the interests of the group e.g. many students do not enjoy undertaking a number of the tests listed, which is at odds to the framework/program outlined briefly. In short, there is too much focus on the strict measurement regime (not so autonomous), with not enough substance and alignment showcasing the details of the SDT "Multidisciplinary Program". The justifications for the measurements selected, would be better positioned with how they align with SDT. 

 

 

Author Response

Pedro Antonio Sánchez Miguel
University of Extremadura
Faculty of Teaching Training
Av/ de la Universidad s/n
Cáceres, (Spain)
+34 927 257049

May, 21^st 2020

Dear Anita Chang
We would like to thank reviewers for their comments and suggestions on the manuscript which have improved the quality of the article.
We hope to have responded correctly all the reviewers` comments.Lastly, with respect to English language and style, 
e would like to thank reviewer for his/her suggestion to improve que quality of English grammar. In this sense,
we have carefully revised in depth the whole manuscript by an English native speaker. Nevertheless, if reviewer considered necessary,
the authors would accept the editing service of Sustainability Journal in order to publish the manuscript.
Dr. Pedro Antonio Sánchez-Miguel
Teacher Training College
University of Extremadura
On behalf of all authors.

Response to review

Reviewer#3

First of all, we would like to thank the reviewer the positive points regarding our work. We have tried to respond, in each specific requirement, to all the comments and suggestions with the aim to improve the quality of the manuscript. We have also highlighted the changes in red to make them easy to read/find in the main document.

Although this program is funded (this is noted in the manuscript), in order for this protocol manuscript to be published, the authors will need to consider how to ensure that there is improved alignment with the title and purpose of the manuscript, with the measures. For instance, the title of the manuscript is based around a "Program for the promotion of a healthy lifestyle in inactive adolescents: A protocol study." Yet there is very little expansion on the "Multidisciplinary Program" section (including suitable justifications), which should really be the core/fundamental focus of this manuscript (not how the program will be evaluated/measured, which does not align with the program detailed). The program currently describes being based upon self-determination theoretical components of autonomy, competence and relatedness, yet the response to previous reviewer queries about this fundamental aspect has not been adequately addressed.

 

There are only 10 x lines dedicated within the manuscript to this "Multidisciplinary Program". One of the three SDT components is autonomy, and the authors describe how the program is built upon participants being able "to choose freely and being the main character of their one’s actions". Unfortunately, (alongside the other SDT components), this multidisciplinary program is not detailed sufficiently, and there is insufficient detail in how the measures used do not compromise these program intentions.

 

Please provide detailed examples throughout of how this "Multidisciplinary Program" enables freedom and involves participants in the decision-making processes". A rigorous measurement regime is at odds to these statements. As previously stated to the authors, there is also research/literature out there that has interviewed students of this age bracket, which has resulted in suggestions for physical activity promotion in schools (e.g. the EPIC-PA study is one example of many). There needs to be much better alignment and integration of how the interests of the participants are catered for. Previous responses to this were not integrated and addressed sufficiently into the manuscript. This update will not be light work, and requires careful consideration. For instance, suitable measures (& literature) that can be used to determine what the students' interests are, as a logical first phase, would be ideal. There is literature out there which has included interviewing/surveying students of what their physical activity needs are, and there are ways to discover what measures might suit the interests of the group e.g. many students do not enjoy undertaking a number of the tests listed, which is at odds to the framework/program outlined briefly. In short, there is too much focus on the strict measurement regime (not so autonomous), with not enough substance and alignment showcasing the details of the SDT "Multidisciplinary Program". The justifications for the measurements selected, would be better positioned with how they align with SDT.

 

Response: We have included more information in introduction and in the multidisciplinary program sections with the aim to improve the importance of adopting teachers’ strategies to promote the individual’ basic psychological needs. We have added literature to justify the relevance to carry out this kind of programs not only based on the encouraging of autonomy support. In addition, we have changed the title of the manuscript: “Promoting Healthy Lifestyle through Basic Psychological Needs in Inactive Adolescents: A Protocol Study from Self-Determination Approach”

1. Introduction

 Page 2, line 56 – 73: “In this regard, Self Determination Theory (SDT) [19] builds a theoretical framework of reference for the design of this protocol. This motivational theory has received significant attention in the investigation of the promotion of physical activity [20,21]. SDT highlights the students' basic psychological needs (autonomy, competence, and relatedness) as inherent motivational assets that, when supported or satisfied, facilitate adaptive personal and social functioning [22]. In physical education setting, basic psychological needs (BPN) are considered essential to understand how teaching behaviors are related to the forms of students’ motivation [23,24]. The psychological need for autonomy concerns a students’ sense of initiative concerns a sense of initiative and ownership in one’s actions [24]. Competence refers to the students’ feeling of mastery, a sense that one can succeed and grow tasks. Finally, relatedness satisfaction concerns a students’ sense of belonging and connection with other classmates [24]. According to the SDT, the social environments (i.e.: teachers, parents, classmates) that support or thwart the BPN can influence the motivation of the adolescents  [25], which contributes to the initiation and maintenance of healthy behaviors. The highest level of motivation is intrinsic motivation, which refers to carrying out an activity because it is perceived as consistent with the person's intrinsic goals and is considered important or interesting. Extrinsic motivation represents behavior that arises from feelings of pressure, punishment, feelings of shame, external rewards, or approval. Finally, amotivation refers a lack of positive attitude and a sense of usefulness that is required to persist in the activity.”

References included:

20. González-Cutre, D.; Sierra, A.C.; Beltrán-Carrillo, V.J.; Peláez-Pérez, M.; Cervelló, E. A school-based motivational intervention to promote physical activity from a self-determination theory perspective. J. Educ. Res. 2016, 111, 320–330.
21. Sánchez-Oliva, D.; Pulido-González, J.J.; Leo, F.M.; González-Ponce, I.; García-Calvo, T. Effects of an intervention with teachers in the physical education context: A Self-Determination Theory approach. PLoS One 2017, 12, e0189986.
22. Ryan, R.M.; Deci, E.L. Self-Determination Theory: Basic Psychological Needs in Motivation, Development, and Wellness page 98. Guilford Press 2017, 98.
23. Reeve, J.; Jang, H. What teachers say and do to support students’ autonomy during a learning activity. J. Educ. Psychol. 2016, 98, 209–218.
24. Ryan, R.M.; Deci, E.L. Intrinsic and extrinsic motivation from a self-determination theory perspective: Definitions, theory, practices, and future directions. Contemp. Educ. Psychol. 2020, 101860.

2.4 Multidisciplinary program

Page 4, line 154-187: “Table 1 shows the developed of the Multidisciplinary Program. This program will be based on the promotion of the three basics psychological needs. According to the rationale of this proposal, despite many research have exclusively analysed the incidence of autonomy-supportive (some of them also the thwarting style) on the BPN as a global factor in education generally [37,38] and in physical education in particular [39,40], a recent meta-analysis has shown that teachers autonomy support only predicted the need satisfaction for autonomy [41]. These findings highlight the importance of examining and including in the intervention program the teachers’ competence and relatedness supports. Both, competence and relatedness supports showed significant prediction on the three BPN [41]. In the same line, previous studies have already revealed that the support to the three BPN is a significant predictor of BPN as a global factor [42].   

Specifically, the strategies used to promote motivation and physical activity will be based on the satisfaction and support of basic psychological needs. In the field of education, autonomy support means nurturing their inner motivational resources by respecting their attitudes and suggestions (adopting the students’ point of view to do an activity), providing rationales to attribute meaningfulness to learning (explaining why a task is important and where/when it could be used), relying on non-controlling language, providing opportunities for choice, displaying patience to allow students the time they need for self-paced learning to occur, and acknowledging and accepting expressions of negative affect [41,43]. In this sense, students will be asked about their interests and their points of view, giving them greater prominence during the sessions. Students will be also allowed to choose those activities that they liked the most or to which they would be permitted to deepen their knowledge of them. Moreover, teachers can use specific autonomy support strategies, referring to the use of cognitive teaching styles, to give responsibility for selecting tasks, as well as allowing the volition and the acknowledgment of the pupils’ perspective. Competence support refers to the way the teacher organizes and delivers the activities in which the objectives of each task were adapted to the capacities of each participant, creating the opportunity for everyone to feel competent while being offered supportive feedback [41]. In this line, students will choose the activity in which he or she could develop with a sense of efficacy. For instance, teachers should propose different options to achieve the objectives of the tasks adjusted to the abilities of each one. Relatedness support (involvement) includes teachers taking time and resources to their students and use a considerate and warm approach to promote an inclusive learning environment, proposing cooperative and interdependent tasks [44]. In relation to this support, for example, teachers could create group work activities and cooperative work strategies will be used. This strategy will be based on creating learning contexts that develop the sense of inclusion, integration, trust and respect among peers. Similarly, teachers would participate with the students.

Finally, these needs will be thwarted if the authority figures (teachers) use a controlling style (e.g., Haerens et al. [39]), treated coercive or putting pressure. Therefore, the program will consider the interests of participants to improve the autonomy, competence and relatedness, with the aim to persist in the activities.

References included:

37. Amoura, C.; Berjot, S.; Gillet, N.; Caruana, S.; Cohen, J.; Finez, L. Autonomy-Supportive and Controlling Styles of Teaching. Psychological reports 2015, 116, 33-59.
38. Jang, H.; Reeve, J.; Ryan, R.M.; Kim, A. Can Self-Determination Theory Explain What Underlies the Productive, Satisfying Learning Experiences of Collectivistically Oriented Korean Students? J. Educ. Psychol. 2009, 101, 644–661.
39. Haerens, L.; Aelterman, N.; Vansteenkiste, M.; Soenens, B.; Van Petegem, S. Do perceived autonomy-supportive and controlling teaching relate to physical education students’ motivational experiences through unique pathways? Distinguishing between the bright and dark side of motivation. Psychol. Sport Exerc. 2015, 16, 26–36.
40. Taylor, I.M.; Ntoumanis, N.; Standage, M.; Spray, C.M. Motivational predictors of physical education students’ effort, exercise intentions, and leisure-time physical activity: A multilevel linear growth analysis. J. Sport Exerc. Psychol. 2010, 32, 99–120.
41. Vasconcellos, D.; Parker, P.D.; Hilland, T.; Cinelli, R.; Owen, K.B.; Kapsal, N.; Lee, J.; Antczak, D.; Ntoumanis, N.; Ryan, R.M.; et al. Self-Determination Theory Applied to Physical Education: A Systematic Review and Meta-Analysis. J. Educ. Psychol. 2019.
42. Sánchez-Oliva, D.; Sánchez-Miguel, P.A.; Kinnafick, F.-E.; Leo, F.M.; García-Calvo, T. Physical education lessons and physical activity intentions within Spanish Secondary Schools: A Self-Determination perspective. J. Teach. Phys. Educ. 2014, 33, 232–249.
43. Reeve, J. Why teachers adopt a controlling motivating style toward students and how they can become more autonomy supportive. Educ. Psychol. 2009, 44, 159–175.
44. Cox, A.; Williams, L. The roles of perceived teacher support, motivational climate, and psychological need satisfaction in students’ physical education motivation. J. Sport Exerc. Psychol. 2008, 30, 222–239.

Lastly, with respect to English language and style, e would like to thank reviewer for his/her suggestion to improve que quality of English grammar. In this sense, we have carefully revised in depth the whole manuscript by an English native speaker. Nevertheless, if reviewer considered necessary, the authors would accept the editing service of Sustainability Journal in order to publish the manuscript.

Author Response File: Author Response.DOC

Round 2

Reviewer 1 Report

Thank for the response

Author Response

Pedro Antonio Sánchez Miguel

University of Extremadura

Faculty of Teaching Training

Av/ de la Universidad s/n

Cáceres, (Spain)

+34 927 257049

 

 

May, 21^st 2020

Dear Anita Chang

We would like to thank reviewers for their comments and suggestions on the manuscript which have improved the quality of the article.

We hope to have responded correctly all the reviewers` comments.

Dr. Pedro Antonio Sánchez-Miguel

Teacher Training College

University of Extremadura

On behalf of all authors.

 

 

Response to review

 

Reviewer#3

 

First of all, we would like to thank the reviewer the positive points regarding our work. We have tried to respond, in each specific requirement, to all the comments and suggestions with the aim to improve the quality of the manuscript. We have also highlighted the changes in red to make them easy to read/find in the main document.

 

Although this program is funded (this is noted in the manuscript), in order for this protocol manuscript to be published, the authors will need to consider how to ensure that there is improved alignment with the title and purpose of the manuscript, with the measures. For instance, the title of the manuscript is based around a "Program for the promotion of a healthy lifestyle in inactive adolescents: A protocol study." Yet there is very little expansion on the "Multidisciplinary Program" section (including suitable justifications), which should really be the core/fundamental focus of this manuscript (not how the program will be evaluated/measured, which does not align with the program detailed). The program currently describes being based upon self-determination theoretical components of autonomy, competence and relatedness, yet the response to previous reviewer queries about this fundamental aspect has not been adequately addressed.

 

There are only 10 x lines dedicated within the manuscript to this "Multidisciplinary Program". One of the three SDT components is autonomy, and the authors describe how the program is built upon participants being able "to choose freely and being the main character of their one’s actions". Unfortunately, (alongside the other SDT components), this multidisciplinary program is not detailed sufficiently, and there is insufficient detail in how the measures used do not compromise these program intentions.

 

Please provide detailed examples throughout of how this "Multidisciplinary Program" enables freedom and involves participants in the decision-making processes". A rigorous measurement regime is at odds to these statements. As previously stated to the authors, there is also research/literature out there that has interviewed students of this age bracket, which has resulted in suggestions for physical activity promotion in schools (e.g. the EPIC-PA study is one example of many). There needs to be much better alignment and integration of how the interests of the participants are catered for. Previous responses to this were not integrated and addressed sufficiently into the manuscript. This update will not be light work, and requires careful consideration. For instance, suitable measures (& literature) that can be used to determine what the students' interests are, as a logical first phase, would be ideal. There is literature out there which has included interviewing/surveying students of what their physical activity needs are, and there are ways to discover what measures might suit the interests of the group e.g. many students do not enjoy undertaking a number of the tests listed, which is at odds to the framework/program outlined briefly. In short, there is too much focus on the strict measurement regime (not so autonomous), with not enough substance and alignment showcasing the details of the SDT "Multidisciplinary Program". The justifications for the measurements selected, would be better positioned with how they align with SDT.

 

Response: We have included more information in introduction and in the multidisciplinary program sections with the aim to improve the importance of adopting teachers’ strategies to promote the individual’ basic psychological needs. We have added literature to justify the relevance to carry out this kind of programs not only based on the encouraging of autonomy support. In addition, we have changed the title of the manuscript: “Promoting Healthy Lifestyle through Basic Psychological Needs in Inactive Adolescents: A Protocol Study from Self-Determination Approach”

 

1. Introduction

 Page 2, line 56 – 73: “In this regard, Self Determination Theory (SDT) [19] builds a theoretical framework of reference for the design of this protocol. This motivational theory has received significant attention in the investigation of the promotion of physical activity [20,21]. SDT highlights the students' basic psychological needs (autonomy, competence, and relatedness) as inherent motivational assets that, when supported or satisfied, facilitate adaptive personal and social functioning [22]. In physical education setting, basic psychological needs (BPN) are considered essential to understand how teaching behaviors are related to the forms of students’ motivation [23,24]. The psychological need for autonomy concerns a students’ sense of initiative concerns a sense of initiative and ownership in one’s actions [24]. Competence refers to the students’ feeling of mastery, a sense that one can succeed and grow tasks. Finally, relatedness satisfaction concerns a students’ sense of belonging and connection with other classmates [24]. According to the SDT, the social environments (i.e.: teachers, parents, classmates) that support or thwart the BPN can influence the motivation of the adolescents  [25], which contributes to the initiation and maintenance of healthy behaviors. The highest level of motivation is intrinsic motivation, which refers to carrying out an activity because it is perceived as consistent with the person's intrinsic goals and is considered important or interesting. Extrinsic motivation represents behavior that arises from feelings of pressure, punishment, feelings of shame, external rewards, or approval. Finally, amotivation refers a lack of positive attitude and a sense of usefulness that is required to persist in the activity.”

References included:

20. González-Cutre, D.; Sierra, A.C.; Beltrán-Carrillo, V.J.; Peláez-Pérez, M.; Cervelló, E. A school-based motivational intervention to promote physical activity from a self-determination theory perspective. J. Educ. Res. 2016, 111, 320–330.
21. Sánchez-Oliva, D.; Pulido-González, J.J.; Leo, F.M.; González-Ponce, I.; García-Calvo, T. Effects of an intervention with teachers in the physical education context: A Self-Determination Theory approach. PLoS One 2017, 12, e0189986.
22. Ryan, R.M.; Deci, E.L. Self-Determination Theory: Basic Psychological Needs in Motivation, Development, and Wellness page 98. Guilford Press 2017, 98.
23. Reeve, J.; Jang, H. What teachers say and do to support students’ autonomy during a learning activity. J. Educ. Psychol. 2016, 98, 209–218.
24. Ryan, R.M.; Deci, E.L. Intrinsic and extrinsic motivation from a self-determination theory perspective: Definitions, theory, practices, and future directions. Contemp. Educ. Psychol. 2020, 101860.

2.4 Multidisciplinary program

 

Page 4, line 154-187: “Table 1 shows the developed of the Multidisciplinary Program. This program will be based on the promotion of the three basics psychological needs. According to the rationale of this proposal, despite many research have exclusively analysed the incidence of autonomy-supportive (some of them also the thwarting style) on the BPN as a global factor in education generally [37,38] and in physical education in particular [39,40], a recent meta-analysis has shown that teachers autonomy support only predicted the need satisfaction for autonomy [41]. These findings highlight the importance of examining and including in the intervention program the teachers’ competence and relatedness supports. Both, competence and relatedness supports showed significant prediction on the three BPN [41]. In the same line, previous studies have already revealed that the support to the three BPN is a significant predictor of BPN as a global factor [42].   

Specifically, the strategies used to promote motivation and physical activity will be based on the satisfaction and support of basic psychological needs. In the field of education, autonomy support means nurturing their inner motivational resources by respecting their attitudes and suggestions (adopting the students’ point of view to do an activity), providing rationales to attribute meaningfulness to learning (explaining why a task is important and where/when it could be used), relying on non-controlling language, providing opportunities for choice, displaying patience to allow students the time they need for self-paced learning to occur, and acknowledging and accepting expressions of negative affect [41,43]. In this sense, students will be asked about their interests and their points of view, giving them greater prominence during the sessions. Students will be also allowed to choose those activities that they liked the most or to which they would be permitted to deepen their knowledge of them. Moreover, teachers can use specific autonomy support strategies, referring to the use of cognitive teaching styles, to give responsibility for selecting tasks, as well as allowing the volition and the acknowledgment of the pupils’ perspective. Competence support refers to the way the teacher organizes and delivers the activities in which the objectives of each task were adapted to the capacities of each participant, creating the opportunity for everyone to feel competent while being offered supportive feedback [41]. In this line, students will choose the activity in which he or she could develop with a sense of efficacy. For instance, teachers should propose different options to achieve the objectives of the tasks adjusted to the abilities of each one. Relatedness support (involvement) includes teachers taking time and resources to their students and use a considerate and warm approach to promote an inclusive learning environment, proposing cooperative and interdependent tasks [44]. In relation to this support, for example, teachers could create group work activities and cooperative work strategies will be used. This strategy will be based on creating learning contexts that develop the sense of inclusion, integration, trust and respect among peers. Similarly, teachers would participate with the students.

Finally, these needs will be thwarted if the authority figures (teachers) use a controlling style (e.g., Haerens et al. [39]), treated coercive or putting pressure. Therefore, the program will consider the interests of participants to improve the autonomy, competence and relatedness, with the aim to persist in the activities.

 

References included:

37. Amoura, C.; Berjot, S.; Gillet, N.; Caruana, S.; Cohen, J.; Finez, L. Autonomy-Supportive and Controlling Styles of Teaching. Psychological reports 2015, 116, 33-59.
38. Jang, H.; Reeve, J.; Ryan, R.M.; Kim, A. Can Self-Determination Theory Explain What Underlies the Productive, Satisfying Learning Experiences of Collectivistically Oriented Korean Students? J. Educ. Psychol. 2009, 101, 644–661.
39. Haerens, L.; Aelterman, N.; Vansteenkiste, M.; Soenens, B.; Van Petegem, S. Do perceived autonomy-supportive and controlling teaching relate to physical education students’ motivational experiences through unique pathways? Distinguishing between the bright and dark side of motivation. Psychol. Sport Exerc. 2015, 16, 26–36.
40. Taylor, I.M.; Ntoumanis, N.; Standage, M.; Spray, C.M. Motivational predictors of physical education students’ effort, exercise intentions, and leisure-time physical activity: A multilevel linear growth analysis. J. Sport Exerc. Psychol. 2010, 32, 99–120.
41. Vasconcellos, D.; Parker, P.D.; Hilland, T.; Cinelli, R.; Owen, K.B.; Kapsal, N.; Lee, J.; Antczak, D.; Ntoumanis, N.; Ryan, R.M.; et al. Self-Determination Theory Applied to Physical Education: A Systematic Review and Meta-Analysis. J. Educ. Psychol. 2019.
42. Sánchez-Oliva, D.; Sánchez-Miguel, P.A.; Kinnafick, F.-E.; Leo, F.M.; García-Calvo, T. Physical education lessons and physical activity intentions within Spanish Secondary Schools: A Self-Determination perspective. J. Teach. Phys. Educ. 2014, 33, 232–249.
43. Reeve, J. Why teachers adopt a controlling motivating style toward students and how they can become more autonomy supportive. Educ. Psychol. 2009, 44, 159–175.
44. Cox, A.; Williams, L. The roles of perceived teacher support, motivational climate, and psychological need satisfaction in students’ physical education motivation. J. Sport Exerc. Psychol. 2008, 30, 222–239.

 

Lastly, with respect to English language and style, we would like to thank reviewer for his/her suggestion to improve que quality of English grammar. In this sense, we have carefully revised in depth the whole manuscript by an English native speaker. Nevertheless, if reviewer considered necessary, the authors would accept the editing service of Sustainability Journal in order to publish the manuscript.

Author Response File: Author Response.DOC

Reviewer 2 Report

This ptotocol study has submitted to the Journal again.

However, this was not revise based on the reviewer’s comments exactly yet.

So, I could not accept this.

Author Response

Pedro Antonio Sánchez Miguel

University of Extremadura

Faculty of Teaching Training

Av/ de la Universidad s/n

Cáceres, (Spain)

+34 927 257049

 

 

May, 21^st 2020

Dear Anita Chang

We would like to thank reviewers for their comments and suggestions on the manuscript which have improved the quality of the article.

We hope to have responded correctly all the reviewers` comments.

Dr. Pedro Antonio Sánchez-Miguel

Teacher Training College

University of Extremadura

On behalf of all authors.

 

 

Response to review

 

Reviewer#3

 

First of all, we would like to thank the reviewer the positive points regarding our work. We have tried to respond, in each specific requirement, to all the comments and suggestions with the aim to improve the quality of the manuscript. We have also highlighted the changes in red to make them easy to read/find in the main document.

 

Although this program is funded (this is noted in the manuscript), in order for this protocol manuscript to be published, the authors will need to consider how to ensure that there is improved alignment with the title and purpose of the manuscript, with the measures. For instance, the title of the manuscript is based around a "Program for the promotion of a healthy lifestyle in inactive adolescents: A protocol study." Yet there is very little expansion on the "Multidisciplinary Program" section (including suitable justifications), which should really be the core/fundamental focus of this manuscript (not how the program will be evaluated/measured, which does not align with the program detailed). The program currently describes being based upon self-determination theoretical components of autonomy, competence and relatedness, yet the response to previous reviewer queries about this fundamental aspect has not been adequately addressed.

 

There are only 10 x lines dedicated within the manuscript to this "Multidisciplinary Program". One of the three SDT components is autonomy, and the authors describe how the program is built upon participants being able "to choose freely and being the main character of their one’s actions". Unfortunately, (alongside the other SDT components), this multidisciplinary program is not detailed sufficiently, and there is insufficient detail in how the measures used do not compromise these program intentions.

 

Please provide detailed examples throughout of how this "Multidisciplinary Program" enables freedom and involves participants in the decision-making processes". A rigorous measurement regime is at odds to these statements. As previously stated to the authors, there is also research/literature out there that has interviewed students of this age bracket, which has resulted in suggestions for physical activity promotion in schools (e.g. the EPIC-PA study is one example of many). There needs to be much better alignment and integration of how the interests of the participants are catered for. Previous responses to this were not integrated and addressed sufficiently into the manuscript. This update will not be light work, and requires careful consideration. For instance, suitable measures (& literature) that can be used to determine what the students' interests are, as a logical first phase, would be ideal. There is literature out there which has included interviewing/surveying students of what their physical activity needs are, and there are ways to discover what measures might suit the interests of the group e.g. many students do not enjoy undertaking a number of the tests listed, which is at odds to the framework/program outlined briefly. In short, there is too much focus on the strict measurement regime (not so autonomous), with not enough substance and alignment showcasing the details of the SDT "Multidisciplinary Program". The justifications for the measurements selected, would be better positioned with how they align with SDT.

 

Response: We have included more information in introduction and in the multidisciplinary program sections with the aim to improve the importance of adopting teachers’ strategies to promote the individual’ basic psychological needs. We have added literature to justify the relevance to carry out this kind of programs not only based on the encouraging of autonomy support. In addition, we have changed the title of the manuscript: “Promoting Healthy Lifestyle through Basic Psychological Needs in Inactive Adolescents: A Protocol Study from Self-Determination Approach”

 

1. Introduction

 Page 2, line 56 – 73: “In this regard, Self Determination Theory (SDT) [19] builds a theoretical framework of reference for the design of this protocol. This motivational theory has received significant attention in the investigation of the promotion of physical activity [20,21]. SDT highlights the students' basic psychological needs (autonomy, competence, and relatedness) as inherent motivational assets that, when supported or satisfied, facilitate adaptive personal and social functioning [22]. In physical education setting, basic psychological needs (BPN) are considered essential to understand how teaching behaviors are related to the forms of students’ motivation [23,24]. The psychological need for autonomy concerns a students’ sense of initiative concerns a sense of initiative and ownership in one’s actions [24]. Competence refers to the students’ feeling of mastery, a sense that one can succeed and grow tasks. Finally, relatedness satisfaction concerns a students’ sense of belonging and connection with other classmates [24]. According to the SDT, the social environments (i.e.: teachers, parents, classmates) that support or thwart the BPN can influence the motivation of the adolescents  [25], which contributes to the initiation and maintenance of healthy behaviors. The highest level of motivation is intrinsic motivation, which refers to carrying out an activity because it is perceived as consistent with the person's intrinsic goals and is considered important or interesting. Extrinsic motivation represents behavior that arises from feelings of pressure, punishment, feelings of shame, external rewards, or approval. Finally, amotivation refers a lack of positive attitude and a sense of usefulness that is required to persist in the activity.”

References included:

20. González-Cutre, D.; Sierra, A.C.; Beltrán-Carrillo, V.J.; Peláez-Pérez, M.; Cervelló, E. A school-based motivational intervention to promote physical activity from a self-determination theory perspective. J. Educ. Res. 2016, 111, 320–330.
21. Sánchez-Oliva, D.; Pulido-González, J.J.; Leo, F.M.; González-Ponce, I.; García-Calvo, T. Effects of an intervention with teachers in the physical education context: A Self-Determination Theory approach. PLoS One 2017, 12, e0189986.
22. Ryan, R.M.; Deci, E.L. Self-Determination Theory: Basic Psychological Needs in Motivation, Development, and Wellness page 98. Guilford Press 2017, 98.
23. Reeve, J.; Jang, H. What teachers say and do to support students’ autonomy during a learning activity. J. Educ. Psychol. 2016, 98, 209–218.
24. Ryan, R.M.; Deci, E.L. Intrinsic and extrinsic motivation from a self-determination theory perspective: Definitions, theory, practices, and future directions. Contemp. Educ. Psychol. 2020, 101860.

2.4 Multidisciplinary program

 

Page 4, line 154-187: “Table 1 shows the developed of the Multidisciplinary Program. This program will be based on the promotion of the three basics psychological needs. According to the rationale of this proposal, despite many research have exclusively analysed the incidence of autonomy-supportive (some of them also the thwarting style) on the BPN as a global factor in education generally [37,38] and in physical education in particular [39,40], a recent meta-analysis has shown that teachers autonomy support only predicted the need satisfaction for autonomy [41]. These findings highlight the importance of examining and including in the intervention program the teachers’ competence and relatedness supports. Both, competence and relatedness supports showed significant prediction on the three BPN [41]. In the same line, previous studies have already revealed that the support to the three BPN is a significant predictor of BPN as a global factor [42].   

Specifically, the strategies used to promote motivation and physical activity will be based on the satisfaction and support of basic psychological needs. In the field of education, autonomy support means nurturing their inner motivational resources by respecting their attitudes and suggestions (adopting the students’ point of view to do an activity), providing rationales to attribute meaningfulness to learning (explaining why a task is important and where/when it could be used), relying on non-controlling language, providing opportunities for choice, displaying patience to allow students the time they need for self-paced learning to occur, and acknowledging and accepting expressions of negative affect [41,43]. In this sense, students will be asked about their interests and their points of view, giving them greater prominence during the sessions. Students will be also allowed to choose those activities that they liked the most or to which they would be permitted to deepen their knowledge of them. Moreover, teachers can use specific autonomy support strategies, referring to the use of cognitive teaching styles, to give responsibility for selecting tasks, as well as allowing the volition and the acknowledgment of the pupils’ perspective. Competence support refers to the way the teacher organizes and delivers the activities in which the objectives of each task were adapted to the capacities of each participant, creating the opportunity for everyone to feel competent while being offered supportive feedback [41]. In this line, students will choose the activity in which he or she could develop with a sense of efficacy. For instance, teachers should propose different options to achieve the objectives of the tasks adjusted to the abilities of each one. Relatedness support (involvement) includes teachers taking time and resources to their students and use a considerate and warm approach to promote an inclusive learning environment, proposing cooperative and interdependent tasks [44]. In relation to this support, for example, teachers could create group work activities and cooperative work strategies will be used. This strategy will be based on creating learning contexts that develop the sense of inclusion, integration, trust and respect among peers. Similarly, teachers would participate with the students.

Finally, these needs will be thwarted if the authority figures (teachers) use a controlling style (e.g., Haerens et al. [39]), treated coercive or putting pressure. Therefore, the program will consider the interests of participants to improve the autonomy, competence and relatedness, with the aim to persist in the activities.

 

References included:

37. Amoura, C.; Berjot, S.; Gillet, N.; Caruana, S.; Cohen, J.; Finez, L. Autonomy-Supportive and Controlling Styles of Teaching. Psychological reports 2015, 116, 33-59.
38. Jang, H.; Reeve, J.; Ryan, R.M.; Kim, A. Can Self-Determination Theory Explain What Underlies the Productive, Satisfying Learning Experiences of Collectivistically Oriented Korean Students? J. Educ. Psychol. 2009, 101, 644–661.
39. Haerens, L.; Aelterman, N.; Vansteenkiste, M.; Soenens, B.; Van Petegem, S. Do perceived autonomy-supportive and controlling teaching relate to physical education students’ motivational experiences through unique pathways? Distinguishing between the bright and dark side of motivation. Psychol. Sport Exerc. 2015, 16, 26–36.
40. Taylor, I.M.; Ntoumanis, N.; Standage, M.; Spray, C.M. Motivational predictors of physical education students’ effort, exercise intentions, and leisure-time physical activity: A multilevel linear growth analysis. J. Sport Exerc. Psychol. 2010, 32, 99–120.
41. Vasconcellos, D.; Parker, P.D.; Hilland, T.; Cinelli, R.; Owen, K.B.; Kapsal, N.; Lee, J.; Antczak, D.; Ntoumanis, N.; Ryan, R.M.; et al. Self-Determination Theory Applied to Physical Education: A Systematic Review and Meta-Analysis. J. Educ. Psychol. 2019.
42. Sánchez-Oliva, D.; Sánchez-Miguel, P.A.; Kinnafick, F.-E.; Leo, F.M.; García-Calvo, T. Physical education lessons and physical activity intentions within Spanish Secondary Schools: A Self-Determination perspective. J. Teach. Phys. Educ. 2014, 33, 232–249.
43. Reeve, J. Why teachers adopt a controlling motivating style toward students and how they can become more autonomy supportive. Educ. Psychol. 2009, 44, 159–175.
44. Cox, A.; Williams, L. The roles of perceived teacher support, motivational climate, and psychological need satisfaction in students’ physical education motivation. J. Sport Exerc. Psychol. 2008, 30, 222–239.

 

Lastly, with respect to English language and style, we would like to thank reviewer for his/her suggestion to improve que quality of English grammar. In this sense, we have carefully revised in depth the whole manuscript by an English native speaker. Nevertheless, if reviewer considered necessary, the authors would accept the editing service of Sustainability Journal in order to publish the manuscript.

Author Response File: Author Response.DOC

Reviewer 3 Report

For the following measures, which will be utilized throughout to evaluate the program/intervention- can the authors please detail how the following measures will align and complement the program’s focuses? How will the evaluation approach not compromise the approach of the proposed program? For example, how do the following, structured, rigorous tests align with the program’s SDT components/focuses of autonomy (especially), relatedness and competence:

- Wearing accelerometer-devices

- Undertaking multiple survey administrations (PANAS, SWLS, BREQ-2, RSE, BIDA…)

- Weight measurements

- Height measurements

- Waist circumferences

- Neck circumferences

- 20 metre shuttle run tests

- Handgrip strength test

- Lower limb strength test

- 10 metre shuttle run tests

How will and can these be designed based on the interests of participants? There is text stating that some tests can be selected above others, yet this would compromise the evaluation and numbers etc? It states several strategies will be used, but only one is detailed relating to dropout. Perhaps it would be better to specifically tabulate in the paper how the measures above align with the program’s SDT focuses. How can choice be promoted for each of those tests and still have stable conditions for experimentation (e.g. you need the environment to be constant/consistent for any comparisons, measurements, for outcomes to be reliable)?