The Burn 2 Learn Plus feasibility study: A school-based intervention combining physical activity breaks with cognitive behavioural therapy (CBT) techniques

Adolescence is the peak period for the onset of mental health disorders. Physical activity and cognitive behavioural therapy (CBT) are evidence-based approaches for supporting mental health. Their integration may provide complementary benefits. Although schools are well positioned to support adolescent mental health, previous interventions have typically been delivered by health professionals or trained researchers. Time constraints also remain a key barrier to implementation. In this study, we examined the feasibility of the Burn 2 Learn Plus (B2L+) program, a time-efficient intervention combining physical activity with CBT-informed techniques. The intervention was delivered by trained high school teachers to support mental health in senior school students. We recruited 43 Year 12 students (16.6 ± 0.5 years, 57% girls) and their teachers from one high school in New South Wales, Australia. Teachers (n = 6) were provided with training, resources, and support to deliver the eight-week intervention, which included two (15-20 minutes) CBT-informed activity breaks per week. Several feasibility domains (recruitment, acceptability, implementation, fidelity, practicality) were examined along with teachers’ capability, opportunity, and motivation to deliver the program. Progression criteria were preidentified for recruitment (achieving ≥ 70% of the target sample; 21/30 students) and implementation (delivering >70% of prescribed sessions). Depression, anxiety, and wellbeing were assessed as mental health indicators at baseline and post-intervention, with changes in student outcomes explored using paired sample t-tests. Recruitment exceeded the pre-specified progression criteria of 21 students, participant retention was high (95%), and the program was well implemented by teachers, with 89% of activity breaks delivered. Fidelity observations revealed that the program was being delivered as intended. Acceptability findings were mixed, with high teacher satisfaction and moderate student satisfaction, highlighting opportunities for refinement prior to a future randomised controlled trial. Teachers’ perceived capability and opportunity increased across the study period, while motivation decreased slightly. Students' mental health indicators showed small increases in depression and anxiety, and reductions in wellbeing over the study period (all d < 0.3). Our findings support the feasibility of training high school teachers to deliver activity breaks infused with CBT-informed techniques for senior school students. In the absence of a control group, no conclusions can be drawn regarding the mental health effectiveness of the intervention. Trial registration ACTRN12625001067460