The study protocol of the ePro-Schools project: an eHealth program for promoting physical activity and healthy nutrition in schools

Background: Early adolescence is key for adopting healthier lifestyles, yet disadvantaged communities often lack resources to support these changes, perpetuating health inequities. Schools play a crucial role in promoting physical activity and healthy eating. eHealth solutions, like online platforms, offer scalable, cost-effective ways to deliver interventions. These platforms can also enhance adolescent engagement and help bridge health resource gaps. The ePro-Schools project aims to co-design and test an eHealth platform to promote healthy habits among adolescents in socially disadvantaged settings.

Methods: A randomized controlled trial (RCT) will be carried out with the participation of 6 secondary schools (three controls and three intervention), with a sample size estimated at 1000 students of Central Catalonia (Spain). In the intervention schools, focus groups sessions and meetings with stakeholders have been conducted to co-create the ePro-Schools eHealth platform. Students and school staff are pilot testing the platform to assess the platform's usability, functionality, and layout. Finally, the RCT will be conducted, in which the intervention group will have full access to the ePro-Schools platform (an interactive and informative platform), while the control group will only have access to the informative platform with health literacy content on physical activity, nutrition, and healthy habits. In both groups, adolescents will complete validated questionnaires at baseline, post-intervention, and at the six-month follow-up to assess their physical activity and eating habits, including depressive symptoms, quality of life, social isolation, and mental health. Sociodemographic characteristics will also be collected. Implementation, effectiveness, and cost-effectiveness analysis will be performed.

Discussion: The ePro-Schools project introduces a co-designed eHealth platform that integrates physical activity and healthy eating promotion within schools. The intervention aims to enhance adoption, relevance, and sustainability across diverse settings. ePro-Schools project could reduce health inequalities, improve adolescents' physical and mental well-being, and strengthen daily health habits. The model's scalability and embedded implementation planning may support long-term integration into school systems, informing future policies and contributing to educational engagement, reduced disease risk, and broader population health impact.

Trial registration: This trial is registered in ClinicalTrials.gov, with the registration number NCT06792461.