CClinicalTrials.gg
CompletedNCT07770997Updated Aug 18, 2026

The Green Prescription Program for Increasing Physical Activity in Adolescents

An interventional study of Green Prescription (Teacher-Led) and Green Prescription (Interdisciplinary) in Social Support, Screen Time and Physical Inactivity, sponsored by Poznan University of Physical Education. Completed at 1 site in Poland. Open to participants aged 15 Years to 17 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-08-18.

Sponsored by Poznan University of Physical Education · Not applicable, Interventional, and Prevention

Phase
Not applicable
Study type
Interventional
Enrollment
308
Allocation
Non-randomized
Ages
15 Years to 17 Years
Sex
All
01

Study summary

This study evaluated the effectiveness of the Green Prescription, a school-based behavioral intervention that incorporated health education, designed to increase physical activity among adolescents aged 15-17 years who were insufficiently active.

Participants received individualized written physical activity recommendations together with motivational support to encourage gradual increases in leisure-time physical activity. The intervention was tailored to three target groups: adolescents with overweight or obesity, excessive screen time, or low perceived social support.

The study consisted of two sequential cohorts. In the first cohort, the Green Prescription was delivered by a physical education teacher. In the second cohort, the intervention was delivered by a physical education teacher supported by an interdisciplinary team consisting of a dietitian, psychologist, special education teacher, and physiotherapist.

Physical activity and other health-related outcomes were assessed at baseline, immediately after the 12-week intervention, and six months later.

The study evaluated the effectiveness of the Green Prescription in each intervention group and determined whether the interdisciplinary delivery model resulted in greater improvements in physical activity and healthy lifestyle behaviors than the teacher-led model.

Read the detailed description

Regular physical activity during adolescence contributes to physical, mental, and social well-being. Despite well-established health benefits, many adolescents do not achieve recommended levels of physical activity. Schools provide an important setting for implementing behavioral interventions that encourage lifelong healthy habits.

The Green Prescription was a school-based behavioral intervention that incorporated health education to promote leisure-time physical activity among adolescents with insufficient physical activity. The intervention combined individualized written physical activity recommendations with health education and regular motivational support. Activity goals were tailored to each participant and were progressively increased throughout the intervention.

The study consisted of two sequential cohorts. Participants with insufficient physical activity were assigned to one of three intervention groups according to their primary risk factor: overweight or obesity, excessive screen time, or low perceived social support. Each intervention group followed the same Green Prescription framework while receiving recommendations and educational materials tailored to its primary risk factor. Adolescents with sufficient physical activity served as a comparison group and did not receive the intervention.

In the first cohort, the Green Prescription was delivered by a physical education teacher. In the second cohort, the intervention was delivered by a physical education teacher supported by an interdisciplinary team consisting of a dietitian, psychologist, special education teacher, and physiotherapist. Each cohort included three parallel intervention groups and one comparison group, allowing evaluation of both the effectiveness of the Green Prescription within each target group and the added value of the interdisciplinary delivery model.

Outcomes were assessed at baseline, immediately after the 12-week intervention, and six months after completion of the intervention. The study evaluated both the immediate and sustained effects of the Green Prescription on physical activity and related health outcomes.

02

Conditions studied

  • Social Support
  • Screen Time
  • Physical Inactivity
  • Sedentary Lifestyle
  • Overweight and/or Obesity

Keywords

  • physical activity
  • risk groups
  • screen time
  • adolescents
  • overweight
  • social support
  • obesity
03

Who can participate

Ages eligible
15 Years to 17 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Eligibility criteria

General inclusion criteria

  • Adolescents aged 15-17 years.
  • Enrollment in a participating secondary school.
  • Health status allowing participation in physical activity.
  • Stable body weight during the month preceding enrollment (±1 kg).
  • Written informed consent from the participant and a parent or legal guardian, as required by local regulations.

Intervention Groups (A-C)

Participants were eligible if they met all of the following criteria:

- Insufficient physical activity, defined as reporting fewer than 5 days during the previous week with at least 60 minutes of moderate-to-vigorous physical activity, assessed using the MVPA questionnaire.

and met one of the following group-specific criteria:

Group A - Overweight or Obesity

  • Body fat percentage above the age- and sex-specific reference values.
  • BMI ≥25 kg/m² (used as an auxiliary screening criterion). Group B - High Screen Time
  • Recreational screen time ≥4 hours per day. Group C - Low Social Support
  • Low perceived social support assessed using the Student Social Support Scale for Young People (SSYSS).
  • Low psychological well-being assessed using the KIDSCREEN-52 questionnaire (boys \<37.29; girls \<42.64).

Comparison Group (Group D)

  • Sufficient physical activity, defined as reporting at least 5 days during the previous week with at least 60 minutes of moderate-to-vigorous physical activity, assessed using the MVPA questionnaire.
  • No participation in the Green Prescription intervention.

Exclusion Criteria

  • Secondary obesity.
  • Acute or chronic medical conditions preventing participation in physical activity.
  • Pregnancy or breastfeeding.
  • Current psychological or psychiatric diagnosis requiring active treatment.
  • Failure to provide written informed consent.
04

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Non-randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
308 participants (actual)

Study arms

  • Experimental
    OW - Teacher-Led Green Prescription

    Adolescents with insufficient physical activity and overweight or obesity participated in the first study cohort. Participants received the Green Prescription delivered by a physical education teacher. The intervention included individualized physical activity recommendations, motivational support, and educational materials focused on increasing physical activity and improving weight-related health behaviors.

    Behavioral: Green Prescription (Teacher-Led)

  • Experimental
    HST - Teacher-Led Green Prescription

    Adolescents with insufficient physical activity and excessive screen time participated in the first study cohort. Participants received the Green Prescription delivered by a physical education teacher. The intervention included individualized physical activity recommendations, motivational support, and educational materials focused on increasing physical activity and reducing recreational screen time.

    Behavioral: Green Prescription (Teacher-Led)

  • Experimental
    LSS - Teacher-Led Green Prescription

    Adolescents with insufficient physical activity and low perceived social support participated in the first study cohort. Participants received the Green Prescription delivered by a physical education teacher. The intervention included individualized physical activity recommendations, motivational support, and educational materials focused on increasing physical activity and strengthening social support for active lifestyles.

    Behavioral: Green Prescription (Teacher-Led)

  • No intervention
    Comparison Group - Cohort 1

    Adolescents with sufficient physical activity participated in the first study cohort. Participants completed the same assessments as the intervention groups but did not receive the Green Prescription intervention.

  • Experimental
    OW - Interdisciplinary Green Prescription

    Adolescents with insufficient physical activity and overweight or obesity participated in the second study cohort. Participants received the Green Prescription delivered by a physical education teacher with support from an interdisciplinary team consisting of a dietitian, psychologist, special education teacher, and physiotherapist. The intervention included individualized physical activity recommendations, motivational support, and educational materials focused on increasing physical activity and improving weight-related health behaviors.

    Behavioral: Green Prescription (Interdisciplinary)

  • Experimental
    HST - Interdisciplinary Green Prescription

    Adolescents with insufficient physical activity and excessive screen time participated in the second study cohort. Participants received the Green Prescription delivered by a physical education teacher with support from an interdisciplinary team consisting of a dietitian, psychologist, special education teacher, and physiotherapist. The intervention included individualized physical activity recommendations, motivational support, and educational materials focused on increasing physical activity and reducing recreational screen time.

    Behavioral: Green Prescription (Interdisciplinary)

  • Experimental
    LSS - Interdisciplinary Green Prescription

    Adolescents with insufficient physical activity and low perceived social support participated in the second study cohort. Participants received the Green Prescription delivered by a physical education teacher with support from an interdisciplinary team consisting of a dietitian, psychologist, special education teacher, and physiotherapist. The intervention included individualized physical activity recommendations, motivational support, and educational materials focused on increasing physical activity and strengthening social support for active lifestyles.

    Behavioral: Green Prescription (Interdisciplinary)

  • No intervention
    Comparison Group - Cohort 2

    Adolescents with sufficient physical activity participated in the second study cohort. Participants completed the same assessments as the intervention groups but did not receive the Green Prescription intervention.

Interventions

  • BehavioralGreen Prescription (Teacher-Led)

    The Green Prescription is a school-based behavioral intervention incorporating health education to promote leisure-time physical activity among adolescents with insufficient physical activity. The intervention includes individualized weekly written physical activity recommendations, educational materials, and weekly motivational support, supplemented by additional support when required, delivered by a physical education teacher over a 12-week period. All participants follow the same Green Prescription framework, with group-specific objectives, physical activity recommendations, and educational materials tailored to their primary risk profile (overweight or obesity, excessive recreational screen time, or low perceived social support). Activities were adapted to group needs and recommended PA levels. Written recommendations and educational materials were delivered electronically.

  • BehavioralGreen Prescription (Interdisciplinary)

    The Green Prescription is a school-based behavioral intervention incorporating health education to promote leisure-time physical activity among adolescents with insufficient physical activity. The intervention includes individualized weekly written physical activity recommendations, educational materials, and weekly motivational support, supplemented by additional support when required, over a 12-week period. The intervention is delivered by a physical education teacher together with an interdisciplinary team consisting of a dietitian, psychologist, special education teacher, and physiotherapist. All participants follow the same Green Prescription framework, with group-specific objectives, physical activity recommendations, and educational materials tailored to their primary risk profile (overweight or obesity, excessive screen time, or low perceived social support). Written recommendations and educational materials were delivered electronically.

05

What researchers measure

Primary outcomes

  1. Change in Moderate-to-Vigorous Physical Activity (MVPA) Screening Score

    Self-reported physical activity was assessed using the MVPA screening measure. Participants reported the number of days on which they engaged in at least 60 minutes of moderate-to-vigorous physical activity (1) during the previous week (P1) and (2) during a typical week (P2). The MVPA screening score was calculated as the mean of the two responses: (P1 + P2) / 2, with a possible range of 0-7 days. Higher scores indicate a greater number of days with at least 60 minutes of MVPA.

    Time frame: Baseline, immediately after the 12-week intervention, and 6 months after completion of the intervention.

  2. Change in Mean Daily Step Count (Huawei Watch Fit SE)

    Objective physical activity assessed using Huawei Watch Fit SE. Participants wore the device for a 7-day baseline monitoring period, continuously throughout the 12-week intervention, for a 7-day post-intervention monitoring period, and for a 7-day monitoring period at the 6-month follow-up. The primary outcome is the mean daily step count derived from the monitoring periods used for outcome assessment.

    Time frame: Baseline, immediately after the 12-week intervention, and 6 months after completion of the intervention.

Secondary outcomes

  1. Change in Body Mass Index (BMI)

    Body Mass Index (BMI) was calculated from measured body weight and height as weight in kilograms divided by height in meters squared (kg/m²). Weight and height were combined to derive a single reported BMI value; the reported unit of measure was kg/m².

    Time frame: Baseline, immediately after the 12-week intervention, and 6 months after completion of the intervention.

  2. Change in Waist Circumference

    Waist circumference was measured in centimetres (cm) and reported as a single waist circumference value in cm at each assessment point.

    Time frame: Baseline, immediately after the 12-week intervention, and 6 months after completion of the intervention.

  3. Change in Hip Circumference

    Hip circumference measured in centimetres (cm).

    Time frame: Baseline, immediately after the 12-week intervention, and 6 months after completion of the intervention.

  4. Change in Body Fat Percentage

    Body fat percentage (FatP) assessed using Tanita bioelectrical impedance analysis.

    Time frame: Baseline, immediately after the 12-week intervention, and 6 months after completion of the intervention.

  5. Change in Fat Mass

    Fat mass (FatM) measured using Tanita bioelectrical impedance analysis.

    Time frame: Baseline, immediately after the 12-week intervention, and 6 months after completion of the intervention.

  6. Change in Fat-Free Mass

    Fat-free mass (FFM) measured using Tanita bioelectrical impedance analysis.

    Time frame: Baseline, immediately after the 12-week intervention, and 6 months after completion of the intervention.

  7. Change in Total Body Water

    Total body water (TBW) assessed using Tanita bioelectrical impedance analysis.

    Time frame: Baseline, immediately after the 12-week intervention, and 6 months after completion of the intervention.

  8. Change in Predicted Muscle Mass

    Predicted muscle mass (PMM) measured using Tanita bioelectrical impedance analysis.

    Time frame: Baseline, immediately after the 12-week intervention, and 6 months after completion of the intervention.

  9. Change in Screen Time

    Screen time was assessed using selected items from the Health Behaviour in School-aged Children (HBSC) questionnaire and average daily active screen time recorded from participants' smartphones.

    Time frame: Baseline, immediately after the 12-week intervention, and 6 months after completion of the intervention.

  10. Change in Sleep Duration

    Sleep duration assessed using Huawei Watch Fit SE. The outcome is the mean total sleep duration derived from 7-day monitoring periods.

    Time frame: Baseline (7-day monitoring period), immediately after the 12-week intervention (7-day monitoring period), and 6 months after completion of the intervention (7-day monitoring period).

  11. Change in Perceived Social Support

    Perceived Social Support assessed using the Short Scale of Youth's Social Support Assessment (SSYSS). Total scores range from 1.0 to 4.0, with higher scores indicating higher perceived support.

    Time frame: Baseline, immediately after the 12-week intervention, and 6 months after completion of the intervention.

  12. Change in Health-Related Quality of Life

    Health-related quality of life assessed using the KIDSCREEN-52 questionnaire. Total scores range from 23.3 to 100.0, with higher scores indicating better health-related quality of life.

    Time frame: Baseline, immediately after the 12-week intervention, and 6 months after completion of the intervention.

06

Study locations

1 site
  • Poznan University of Physical Education
    Poznan, Greater Poland Voivodeship 61-871, Poland
07

References and documents

Publications

  • Marlena Łopatka, Michał Bronikowski, Małgorzata Bronikowska, Agata Korcz, Maryna Khorkova, Dagny Adamczak, Jana Krzysztoszek; Physical activity recommendations for adolescents with overweight, high screen time, and low social support - A scoping review; Biomedical Human Kinetics; Volume 18 Issue 1; pp. 100-111. DOI: 10.2478/bhk-2026-0011

Individual participant data

Plan to share: No — Individual participant data (IPD) will not be shared because the study involved minors, and no data-sharing plan was included in the study protocol or participant consent procedures.

08

Registry details

Key details

Study ID
NCT07770997
Lead sponsor
Poznan University of Physical Education
Collaborators
Ministry of Science and Higher Education, Poland
Responsible party
Sponsor
First posted
Aug 18, 2026
Start date
Jun 3, 2024
Primary completion
Jun 20, 2026
Completion
Jun 30, 2026
Last update
Aug 18, 2026

Study contacts

Jana Krzysztoszek, PhD, DSc
principal investigator · Poznan University of Physical Education

Oversight

FDA-regulated drug
No
FDA-regulated device
No
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