School-level intraclass correlation for physical activity in adolescent girls

Purpose: The Trial for Activity in Adolescent Girls (TAAG) is a multi-center group-randomized trial to reduce the usual decline in moderate to vigorous physical activity (MVPA) among middle-school girls. In group-randomized trials, the group-level intraclass correlation (ICC) has a strong inverse relationship to power and a good estimate of ICC is needed to determine sample size. As a result, we conducted a substudy to estimate the school-level ICC for intensity-weighted minutes of MVPA measured using an accelerometer. Methods: To estimate the ICC, each of six sites recruited two schools and randomly selected 45 eighth grade girls from each school; 80.7% participated. Each girl wore an Actigraph accelerometer for 7 d. Readings above 1500 counts per half minute were counted as MVPA. These counts were converted into metabolic equivalents (MET) and summed over 6 a.m. to midnight to provide MET-minutes per 18-h day of MVPA. Minutes of MVPA per 18-h day also were calculated ignoring the MET value. Results: The unadjusted school-level ICC for minutes of MVPA was 0.0205 (95%CI: -0.0079, 0.1727) and for MET-minutes of MVPA was 0.0045 (95% CI: -0.0147, 0.1145). Adjustment for age and BMI had no measurable effect, whereas adjustment for ethnicity reduced both ICC; adjusted values were 0.0175 (95% CI: -0.0092, 0.1622) for minutes of MVPA and 0.0000 (95% CI: -0.0166, 0.0968) for MET-minutes of MVPA. This information was used to calculate the number of schools and girls needed for TAAG to have 90% power to detect a 50% reduction in the decline of MET-minutes of MVPA between sixth and eighth grade. Conclusions: The results called for 36 schools in TAAG, with 120 girls invited for measurements at each school, and a minimum participation rate of 90%.