Co-creating a 24-hour movement behavior tool together with 9–12-year-old children using mixed-methods: MyDailyMoves

Abstract

Background: All 24-h movement behaviors, i.e. physical activity, sedentary behavior and sleep, are important for optimal health in children. Currently, no tools exist that include all 24-h behaviors and have been proven to be both reliable and valid. Potential reasons for the inadequate validity and reliability of existing questionnaires are the lack of focus on the content validity and lack of involvement of children in the development. Therefore, the aim of this study was to co-create a 24-h movement behavior tool together with 9-12-year-old children. Methods: Concept mapping and photovoice meetings were held to identify children's physical activity behaviors. During concept mapping meetings with four groups of children (n = 40), children generated an extensive list of physical activities they engaged in, sorted the activities in categories and rated the frequency and perceived intensity of these activities. Using photovoice, three groups of children (n = 24) photographed their physical activities during one weekday and one weekend day, named the photographs, and placed them on a timeline. Furthermore, researchers obtained information on relevant items regarding sleep and sedentary behavior by screening existing questionnaires. Thereafter, we developed the first version of MyDailyMoves. Subsequently, we examined the content validity of the tool together with three groups of children (n = 22) and one group of researchers (n = 7) using focus group meetings. Results: MyDailyMoves has a timeline format, onto which children add the activities they performed the previous day. Based on the concept mapping and photovoice studies, eight physical activity categories were included: playing inside, playing outside, sports, hobbies, chores, personal care, transport, and others. Sleep questions and two more sedentary categories (schoolwork and screen time) were added to MyDailyMoves to define and complete the timeline. The content validity study showed that all items in the tool were relevant. However, children mentioned that the activity category 'eating' was missing and the understandability of how to use the tool should be improved by adding an explanatory video. Both suggestions were adopted in the second version. Conclusion: Including the children's perceptions throughout the tool development process resulted in a comprehensive and practical tool which is easy for children to use.

A Web-Based Time-Use Application to Assess Diet and Movement Behavior in Asian Schoolchildren: Development and Usability Study of My E-Diary for Activities and Lifestyle (MEDAL)

“…With regard to gamification, existing studies did not include this element [ 14 - 17 ]. In our study, girls appeared to be more motivated by the virtual gardening game to complete MEDAL recording than boys.…”

“…Both electronic and hand-searched strategies were adopted to identify existing software-based diet and physical activity assessment tools for schoolchildren. MyDailyMoves in the Netherlands [ 17 ], WebCAAFE in Brazil [ 16 ], Synchronised Nutrition and Activity Program in England [ 15 ], and Multimedia Activity Recall for Children and Adolescents in Australia [ 14 ] were evaluated. We also held interviews and meetings with experts from various knowledge domains, including custom software developers, experienced educators, and dieticians.…”

“…Most existing studies rely on paper-based diaries [11], whereas recent studies have developed software-based diaries [14][15][16][17], which have been demonstrated to engage children more effectively. However, to our knowledge, these studies focus mostly on capturing physical activities and sedentary behaviors but less comprehensively on dietary behaviors; for example, types of food consumed [14,17] and food portions [15,16] were not collected. Furthermore, there is a lack of application containing databases of Asian foods and common activities of children within the Asian context, such as tuition, also known as shadow education, which is prominent in East Asian countries [18].…”

“…In addition, they allow the simultaneous capture of multiple energy balance–related behaviors. Most existing studies rely on paper-based diaries [ 11 ], whereas recent studies have developed software-based diaries [ 14 - 17 ], which have been demonstrated to engage children more effectively. However, to our knowledge, these studies focus mostly on capturing physical activities and sedentary behaviors but less comprehensively on dietary behaviors; for example, types of food consumed [ 14 , 17 ] and food portions [ 15 , 16 ] were not collected.…”

Engaging with Children and Adolescents: A Systematic Review of Participatory Methods and Approaches in Research Informing the Development of Health Resources and Interventions

“…Authors described a wide variety of participatory approaches utilized including community-based participatory research (n = 6), codesign (n = 4), participatory design (n = 3), coproduction (n = 3), user-centred design (n = 3), and other types of participatory research (n = 4). Two studies did not overtly state their approach (Abrines et al 2015;Hidding et al, 2020) and thus their apparent approach has been reported in brackets in Table 3 to show it was only indicated; and one study (Carlton, 2013) did not state or indicate an approach. Four broad types of study designs were utilized in the identified studies.…”