A whole family-based physical activity promotion intervention: findings from the families reporting every step to health (FRESH) pilot randomised controlled trial

Abstract

Introduction This study assessed the feasibility and acceptability of FRESH (Families Reporting Every Step to Health), a theory-based child-led family physical activity (PA) intervention delivered online. We also assessed the preliminary effectiveness of the intervention on outcomes of interest and whether pre-specified criteria were met to progress to a full-scale definitive trial. Methods In a three-armed randomised pilot trial, 41 families (with a 7–11-year-old index child) were allocated to a: ‘family’ (FAM), ‘pedometer-only’ (PED), or a no-treatment control (CON) arm. The FAM arm 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 progress as families virtually globetrot. FAM and PED arms also received family sets of pedometers. All family members could participate in the evaluation. Physical (e.g., fitness, blood pressure), psychosocial (e.g., social support), behavioural (e.g., objectively-measured PA), and economic (e.g., expenditure for PA) data were collected at baseline, 8- and 52-weeks. Results At 8- and 52-weeks, 98 and 88% of families were retained, respectively. Most children liked participating in the study (> 90%) and thought it was fun (> 80%). Compared to the PED (45%) and CON (39%) arms, a higher percentage of children in the FAM (81%) arm reported doing more activities with their family. Adults agreed that FRESH encouraged their family do more PA and made their family more aware of the amount of PA they do. No notable between-group differences were found for childrens’ minutes in moderate-to-vigorous PA. Sizeable changes of 9.4 (95%CI: 0.4, 18.4) and 15.3 (95%CI: 6.0, 24.5) minutes in moderate-to-vigorous PA was found for adults in the FAM group compared to those in the PED or CON groups, respectively. No other notable differences were found. Conclusion This study demonstrates feasibility and acceptability of the FRESH intervention. All progression criteria were at least partially satisfied. However, we failed to recruit the target sample size and did not find a signal of effectiveness on PA particularly long-term or in children. Further refinements are required to progress to a full-scale trial. Trial registration This study was prospectively registered (ISRCTN12789422) on 16/03/2016.

Feasibility and Effect of Adding a Concurrent Parental Component to a School-Base Wellness Program Using Two Modes of Mobile-Based Technology – Mixed Methods Evaluation of RCT

“…There is robust evidence of the associated positive outcomes of parental engagement in school-based prevention programs [27][28][29]. This evidence is consistent with Bronfenbrenner's ecological systems theory [30,31], which proposes that interactions with parents around learned topics at school might help address internalizing concerns [4,32].…”

Effective and resource‐efficient strategies for recruiting families in physical activity, sedentary behavior, nutrition, and obesity prevention research: A systematic review with expert opinion

“…12,15 Recruitment of families to research projects is particularly challenging. 9,[16][17][18] Elsewhere, we have described specific recruitment challenges we have encountered in previous work, [19][20][21] but there has not been a comprehensive assessment of how to recruit families to family-based health promotion research.…”

Children of Smoking and Non-Smoking Households’ Perceptions of Physical Activity, Cardiorespiratory Fitness, and Exercise

“…Some children commented how ‘inspiring people’ and role models often motivate them to be engaged in PA. Recent research has shown that family-based interventions are rated as more ‘fun’ and result in greater improvements in MVPA [ 153 ] and so strategies to enhance PA could therefore target co-participation via family-wide interventions, which would confer the additional benefits of social support and adult behavioural modelling. Social support from family, friends, teachers, and coaches could also be utilised in strategies to assist children in overcoming the discussed perceived barriers to PA for this population.…”