O2.18 - Participatory approaches and perspectives in behavioral research
Wednesday, June 9, 2021 |
8:10 - 9:25 |
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Speaker
Exploring adolescent boys’ understanding, perceptions and experiences of muscular fitness activity.
Abstract
Purpose: English youth typically do not sufficiently engage in the types and intensities of physical activity (PA) that develop muscular fitness (MF). The aim of this study was to use a combination of qualitative techniques to explore adolescent boys’ knowledge, understanding, perceptions and experiences of MF activity. It was envisaged that the contextual information gathered from this study would provide novel insights into the meanings adolescent boys ascribe towards MF activity.
Methods: Thirty-two adolescent boys aged 14-16 years from northwest England were recruited. Focus groups generated three separate sources of data, a frequency count (thoughts and perceptions of PA), write/draw (WDST) data, and verbatim transcripts which were triangulated. Data were first analysed deductively using the Youth Physical Activity Promotion Model as a thematic framework and then inductively.
Results: Physical activity knowledge specifically relating to MF and recommended guidelines was limited. Physical activity was frequently associated with organised sport. Opportunities to conduct MF activity were perceived as limited with no structured exposure available. Enjoyment, masculinity, and competence were predisposing factors to MF activity. The school environment served as both an enabler (e.g., access to equipment) and a barrier (e.g., lack of appropriate teaching and support through physical education) to MF activity. Friends were frequently reported as a reinforcing factor to PA participation. Data from the WDST activity suggested that traditional team sports conducted in a school environment were the predominant form of PA opportunity.
Conclusion: Our results demonstrate a lack of knowledge surrounding PA guidelines amongst adolescent boys, particularly around MF activity. A desire to demonstrate a level of competency in activities that are deemed masculine may be satisfied through the delivery of MF activity and appeal to adolescent boys as an attractive form of PA. Despite the importance of MF in the healthy development of adolescents, there is a perceived lack of opportunity to participate in MF activity. The contribution of school-based PE is highlighted as key to facilitating exposure to MF activity and PE programmes should ensure opportunities for MF development through engagement in developmentally-appropriate activities.
A Formative Evaluation of a Home-Based Physical Activity Intervention for Adolescent Girls—The HERizon Project: A Randomised Controlled Trial
Abstract
Purpose. The HERizon Project is a home-based multi-component physical activity (PA) intervention for adolescent girls in the UK and Ireland. This study was a formative evaluation of its implementation during the initial COVID-19 lockdown restrictions.
Methods.42 female participants aged 13 to 16 years old (mean = 14.2, SD = 1.1), were randomly allocated to: (i) the HERizon intervention group (n = 22) or (ii) a wait-list control group (n =20). Participants in the six-week intervention group were asked to complete three PA sessions of their choice each week, engage in weekly need-supportive videocalls with an Activity Mentor, and had access to live workouts and a private social media group. The primary outcome was self-reported habitual PA. Secondary outcomes included cardiorespiratory fitness (20 m shuttle run), muscular strength (standing long jump), muscular endurance (push up test), and psychosocial outcomes (Perceived Competence Scale, Body Appreciation Scale, Self-Esteem Questionnaire, Behavioural Regulation in Exercise Questionnaire). Outcome measures were assessed at baseline and after the six-week intervention. Quantitative and qualitative process evaluation data were also collected which included online interviews (n = 10). Linear mixed modelling and reflexive thematic analysis were used to analyse the data.
Results.There was no significant change in habitual PA between groups (p =0.767). The intervention group had significantly increased cardiorespiratory fitness (p =0.001), muscular endurance (p =0.022), intrinsic motivation (p =0.037), and body appreciation (p <0.003) in comparison to the wait-list control group. All participants in the intervention group completed the intervention and compliance to the intervention was high (participants completed 18 ± 2 sessions).The live workouts, behaviour change support and routine were identified as key facilitators to adhering to the programme. Benefits of the programme reported during interviews included increased enjoyment of exercise, increased confidence and improved performance.
Conclusions. Although no change in PA was observed, HERizon resulted in improved physical fitness and psychosocial outcomes. These preliminary findings, alongside positive findings for feasibility and acceptability, highlight potential benefits from the home-based intervention, thus further investigation is warranted. Future trials should include accelerometers for a more accurate measurement of habitual PA.
Developing an intervention promoting healthy weight development during infancy: Home health visitors’ and parents’ perceptions of potential barriers regarding an intervention
Abstract
Background: Childhood obesity is a major public health challenge and it is recommended to promote a healthy weight development already during infancy. Danish home health visitors cover almost all families with a new-born child. This leaves a huge potential for an early intervention to promote healthy weight development. According to the Intervention Mapping framework it is important to understand the characteristics of the setting and the individuals, who will be involved in the intervention, and therefore needs assessment is fundamental to understand potential barriers.
Purpose: This study examines Danish health visitors’ perceptions of barriers for delivering an intervention promoting healthy weight development. Furthermore, parents’ perceptions of barriers regarding an intervention promoting healthy weight development of their child is studied.
Method: Interviews with health visitors and managing health visitors from twenty Danish municipalities were carried out (n=22). Furthermore, seven interviews with parents of infants less than one year of age were conducted. Parents were strategically sampled representing variations across child’s age, family socioeconomic position, migration status and geography. Both the interviews with health visitors and parents were based on a semi-structured interview guide.
Results: Barriers were identified on different levels. Organizational barriers within the work of health visitors included lack of economic resources and political priority especially regarding the possibility to monitor children’s weight development more frequently and for a longer period. Furthermore, health visitors lacked relevant tools to guide parents about promoting healthy weight development. Interpersonal barriers between health visitors and parents were identified as the difficulties of having conversations about healthy weight development, especially if the parents or health visitors were overweight themselves. Cultural differences including language barriers and different perception of for example healthy food choices were also found. Furthermore, barriers in families included that parents found it difficult to navigate in large amounts of information concerning healthy weight development of their child and difficulties of being good role models.
Conclusion: It is important to understand the potential barriers when developing a new intervention. Involving parents and health visitors in the development of an intervention aims at increasing the chances of producing a relevant, successful, and sustainable intervention.
Adolescents’ perspectives on the drivers of obesity using a group model building approach
Abstract
Purpose: Overweight and obesity increases the risk for a range of poor physiological and psychosocial health outcomes. Previous work with well-defined cohorts have explored the determinants of obesity employed various methods and measures, however, less studies have focussed on the broader societal influences, beyond individual-level influences using a systems framework. The aim of this study was to explore the drivers of obesity from adolescents perspectives using a group model building approach.
Methods: Collaborative, conceptual mapping workshops were held with a group of 60 adolescents (16-18 years). The adolescents built a systems model to generate maps in the form of causal loop diagrams to determine the drivers of obesity. These maps were merged into one finalised map. Within the final map, feedback loops were identified and recognition of opportunities for policy intervention were discussed.
Results/findings: The work of adolescents (N=60), engaged in separate system mapping groups, generated four comprehensive causal loop diagrams. The finalised, merged diagram exhibits six important sub-themes: (i) use of social media; (ii)affordability and accessibility of unhealthy food; (iii) outdoor safety; (iv) psychological health; (v) knowledge of health-related behaviours and (vi) domestic discord.
Conclusions: Despite the limited empirical evidence available, our study presents meaningful, complex and policy-relevant insights into the drivers of obesity. This approach, both the process of construction and the final visualisation, provides a basis for planning the prevention and improvement of obesity that engages with multiple levels of causes and existing policies. Interventions to address obesity need to address psychosocial challenges, advertisement through social media and affordability and accessibility of unhealthy food. This, however, demands for a broad understanding across a variety of individual and social levels.
Children as architects: A realist synthesis of motor competence and physical activity behaviour change interventions
Abstract
Purpose: Research including young people in the design of interventions, report an increased awareness of healthy behaviours and an improvement in confidence and feelings of empowerment. Traditional systematic review methodology aims to provide a summary of the effectiveness of interventions in terms of their effect sizes. This does not take in to account the complexity of movement development or the relationship between researcher and child. The aim was to understand the complex research that includes children in the design of physical activity (PA) and motor competence (MC) interventions.
Methods: A novel approach within MC and PA research. Combining a systematic review following PRISMA guidelines and realist synthesis following RAMSES quality and publication guidelines.
Studies included all of the criteria: PA behaviour and/or motor competence, school aged children (5-18 years), able bodied participants, children involved in the intervention design, level of involvement clearly evidenced. Studies were excluded if they identified as ‘top-down’, addressed perceived PA opportunities and barriers with no follow up intervention or were designed by children not included in the intervention.
Study characteristics and primary data extracted through the Mixed Methods Appraisal Tool (MMAT) and inductive and realist thematic analysis. Hypothesis research framework created to extract additional data and complete realist analysis.
Findings: Full text of 93 publications retrieved out of 51,739. 9 studies fulfilled all inclusion criteria, verified by second researcher. Mixed method studies and companion papers, included RCT’s, process evaluations, feasibility and case studies. Realist synthesis provided rich, social context to the complexity of MC and PA behaviours. How youth are engaged is important, it must be developmentally and culturally suitable. All studies reported a sense of empowerment or self-efficacy however, the only studies to improve PA had greater involvement of youth. Youth as researchers may negate cultural barriers to PA participation and enjoyment.
Conclusions: Research that shares power and knowledge with our youth may elicit greater results at increasing PA and MC. When delivered in the knowledge that youth are assets, following a behavior theory we may have the opportunity to empower disadvantaged and at risk groups to take control of their health behaviours.