Abstract
BackgroundThere is a need for high-quality research aiming to increase physical activity in families. This study assessed the feasibility and acceptability of FRESH (Families Reporting Every Step to Health), a child-led family-based physical activity intervention delivered online.MethodsIn a two-armed randomised feasibility study, 12 families (with an 8–10-year-old index child) were allocated to a ‘child-only’ (CO) or ‘family’ arm (FAM) of the theory-based FRESH intervention. Both received access to the FRESH website, allowing participants to select step challenges to ‘travel’ to target cities around the world, log their steps, and track their progress as they virtually globetrot. Only index children wore pedometers in CO; in FAM, all family members wore pedometers and worked towards collective goals. All family members were eligible to participate in the evaluation. Mixed-methods process evaluation (questionnaires and family focus groups) at 6-week follow-up consisted of completing questionnaires assessing acceptability of the intervention and accompanying effectiveness evaluation, focussed on physical (e.g. fitness, blood pressure), psychosocial (e.g. social support), and behavioural (e.g. objectively-measured family physical activity) measures.ResultsAll families were retained (32 participants). Parents enjoyed FRESH and all children found it fun. More FAM children wanted to continue with FRESH, found the website easy to use, and enjoyed wearing pedometers. FAM children also found it easier to reach goals. Most CO families would have preferred whole family participation. Compared to CO, FAM exhibited greater website engagement as they travelled to more cities (36 ± 11 vs. 13 ± 8) and failed fewer challenges (1.5 ± 1 vs. 3 ± 1). Focus groups also revealed that most families wanted elements of competition. All children enjoyed being part of the evaluation, and adults disagreed that there were too many intervention measures (overall, 2.4 ± 1.3) or that data collection took too long (overall, 2.2 ± 1.1).ConclusionFRESH was feasible and acceptable to participating families; however, findings favoured the FAM group. Recruitment, intervention fidelity and delivery and some measurement procedures are particular areas that require further attention for optimisation. Testing the preliminary effectiveness of FRESH on family physical activity is a necessary next step.Trial registrationThis study was registered and given an International Standard Randomised Controlled Trials Number (ISRCTN12789422). Registered 16 March 2016. http://www.isrctn.com/ISRCTN12789422
Highlights
Recent systematic reviews confirm numerous health benefits of regular physical activity for children [1, 2]
As children become less active in adolescence [4], there is a need for physical activity promotion [5, 6]
Calls for physical activity research in young people and families highlight the dearth of research in this area [18] and the need to develop and evaluate innovative interventions targeting children and families. Responding to this challenge, in this paper, we (1) describe the development of the Families Reporting Every Step to Health (FRESH) intervention and recruitment strategy; (2) assess the feasibility and acceptability of the FRESH recruitment strategy, intervention, and accompanying outcome evaluation; and (3) explore how FRESH could be optimised through a mixed-methods process evaluation
Summary
Recent systematic reviews confirm numerous health benefits of regular physical activity for children [1, 2]. As children become less active in adolescence [4], there is a need for physical activity promotion [5, 6]. Physical activity promotion efforts have been conducted predominantly in the school setting, despite the impact of these school-based interventions on overall physical activity being questioned [10]. Family-based physical activity interventions may present a promising avenue to promote children’s activity [11]. There is a need for high-quality research aiming to increase physical activity in families. This study assessed the feasibility and acceptability of FRESH (Families Reporting Every Step to Health), a child-led familybased physical activity intervention delivered online
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