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Implementation of physical activity on prescription for children with obesity in paediatric health care (IMPA) : protocol for a feasibility and evaluation study using quantitative and qualitative methods

Bernhardsson, Susanne ; Boman, Charlotte ; Lundqvist, Stefan ; Arvidsson, Daniel ; Börjesson, Mats ; Larsson, Maria E.H. ; Lundh, Hannah ; Melin, Karin ; Nilsen, Per and Lauruschkus, Katarina LU (2022) In Pilot and Feasibility Studies 8(1).
Abstract

Background: Physical inactivity is a main cause of childhood obesity which tracks into adulthood obesity, making it important to address early in life. Physical activity on prescription (PAP) is an evidence-based intervention that has shown good effect on physical activity levels in adults, but has not been evaluated in children with obesity. This project aims to evaluate the prerequisites, determinants, and feasibility of implementing PAP adapted to children with obesity and to explore children’s, parents’, and healthcare providers’ experiences of PAP. Methods: In the first phase of the project, healthcare providers and managers from 26 paediatric clinics in Region Västra Götaland, Sweden, will be invited to participate in a web-based... (More)

Background: Physical inactivity is a main cause of childhood obesity which tracks into adulthood obesity, making it important to address early in life. Physical activity on prescription (PAP) is an evidence-based intervention that has shown good effect on physical activity levels in adults, but has not been evaluated in children with obesity. This project aims to evaluate the prerequisites, determinants, and feasibility of implementing PAP adapted to children with obesity and to explore children’s, parents’, and healthcare providers’ experiences of PAP. Methods: In the first phase of the project, healthcare providers and managers from 26 paediatric clinics in Region Västra Götaland, Sweden, will be invited to participate in a web-based survey and a subset of this sample for a focus group study. Findings from these two data collections will form the basis for adaptation of PAP to the target group and context. In a second phase, this adapted PAP intervention will be evaluated in a clinical study in a sample of approximately 60 children with obesity (ISO-BMI > 30) between 6 and 12 years of age and one of their parents/legal guardians. Implementation process and clinical outcomes will be assessed pre- and post-intervention and at 8 and 12 months’ follow-up. Implementation outcomes are the four core constructs of the Normalization Process Theory; coherence, cognitive participation, collective action, and reflexive monitoring; and appropriateness, acceptability, and feasibility of the PAP intervention. Additional implementation process outcomes are recruitment and attrition rates, intervention fidelity, dose, and adherence. Clinical outcomes are physical activity pattern, BMI, metabolic risk factors, health-related quality of life, sleep, and self-efficacy and motivation for physical activity. Lastly, we will explore the perspectives of children and parents in semi-structured interviews. Design and analysis of the included studies are guided by the Normalization Process Theory. Discussion: This project will provide new knowledge regarding the feasibility of PAP for children with obesity and about whether and how an evidence-based intervention can be fitted and adapted to new contexts and populations. The results may inform a larger scale trial and future implementation and may enhance the role of PAP in the management of obesity in paediatric health care in Sweden. Trial registration: ClinicalTrials.gov Identifier: NCT04847271, registered 14 April 2021.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Children, Determinants, Feasibility, Implementation, Obesity, Physical activity on prescription
in
Pilot and Feasibility Studies
volume
8
issue
1
article number
117
publisher
BioMed Central (BMC)
external identifiers
  • scopus:85131075142
  • pmid:35650617
ISSN
2055-5784
DOI
10.1186/s40814-022-01075-3
language
English
LU publication?
yes
id
5c45a4fe-a01a-4c86-9d02-e4ae8e8af878
date added to LUP
2023-01-03 14:57:21
date last changed
2024-02-18 03:32:11
@article{5c45a4fe-a01a-4c86-9d02-e4ae8e8af878,
  abstract     = {{<p>Background: Physical inactivity is a main cause of childhood obesity which tracks into adulthood obesity, making it important to address early in life. Physical activity on prescription (PAP) is an evidence-based intervention that has shown good effect on physical activity levels in adults, but has not been evaluated in children with obesity. This project aims to evaluate the prerequisites, determinants, and feasibility of implementing PAP adapted to children with obesity and to explore children’s, parents’, and healthcare providers’ experiences of PAP. Methods: In the first phase of the project, healthcare providers and managers from 26 paediatric clinics in Region Västra Götaland, Sweden, will be invited to participate in a web-based survey and a subset of this sample for a focus group study. Findings from these two data collections will form the basis for adaptation of PAP to the target group and context. In a second phase, this adapted PAP intervention will be evaluated in a clinical study in a sample of approximately 60 children with obesity (ISO-BMI &gt; 30) between 6 and 12 years of age and one of their parents/legal guardians. Implementation process and clinical outcomes will be assessed pre- and post-intervention and at 8 and 12 months’ follow-up. Implementation outcomes are the four core constructs of the Normalization Process Theory; coherence, cognitive participation, collective action, and reflexive monitoring; and appropriateness, acceptability, and feasibility of the PAP intervention. Additional implementation process outcomes are recruitment and attrition rates, intervention fidelity, dose, and adherence. Clinical outcomes are physical activity pattern, BMI, metabolic risk factors, health-related quality of life, sleep, and self-efficacy and motivation for physical activity. Lastly, we will explore the perspectives of children and parents in semi-structured interviews. Design and analysis of the included studies are guided by the Normalization Process Theory. Discussion: This project will provide new knowledge regarding the feasibility of PAP for children with obesity and about whether and how an evidence-based intervention can be fitted and adapted to new contexts and populations. The results may inform a larger scale trial and future implementation and may enhance the role of PAP in the management of obesity in paediatric health care in Sweden. Trial registration: ClinicalTrials.gov Identifier: NCT04847271, registered 14 April 2021.</p>}},
  author       = {{Bernhardsson, Susanne and Boman, Charlotte and Lundqvist, Stefan and Arvidsson, Daniel and Börjesson, Mats and Larsson, Maria E.H. and Lundh, Hannah and Melin, Karin and Nilsen, Per and Lauruschkus, Katarina}},
  issn         = {{2055-5784}},
  keywords     = {{Children; Determinants; Feasibility; Implementation; Obesity; Physical activity on prescription}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{Pilot and Feasibility Studies}},
  title        = {{Implementation of physical activity on prescription for children with obesity in paediatric health care (IMPA) : protocol for a feasibility and evaluation study using quantitative and qualitative methods}},
  url          = {{http://dx.doi.org/10.1186/s40814-022-01075-3}},
  doi          = {{10.1186/s40814-022-01075-3}},
  volume       = {{8}},
  year         = {{2022}},
}