scholarly journals Evaluating Digital Program Support for the Physical Activity 4 Everyone (PA4E1) School Program: Mixed Methods Study (Preprint)

2020 ◽  
Author(s):  
Matthew Mclaughlin ◽  
Jed Duff ◽  
Tom McKenzie ◽  
Elizabeth Campbell ◽  
Rachel Sutherland ◽  
...  
Keyword(s):  
Physical Activity ◽  
Mixed Methods ◽  
Subjective Experience ◽  
Scale Up ◽  
Descriptive Statistics ◽  
Delivery Mode ◽  
Implementation Support ◽  
Delivery Modes ◽  
Program Support ◽  
Digital Delivery

BACKGROUND Effectively scaled-up physical activity interventions are urgently needed to address the high prevalence of physical inactivity. To facilitate scale-up of an efficacious school-based physical activity program (Physical Activity 4 Everyone [PA4E1]), provision of implementation support to physical education (PE) teachers was adapted from face-to-face and paper-based delivery modes to partial delivery via a website. A lack of engagement (usage and subjective experience) with digital delivery modes, including websites, may in part explain the typical reduction in effectiveness of scaled-up interventions that use digital delivery modes. A process evaluation focused on the PA4E1 website was undertaken. OBJECTIVE The 2 objectives were to (1) describe the usage of the PA4E1 program website by in-school champions (PE teachers leading the program within their schools) and PE teachers using quantitative methods; (2) examine the usage, subjective experience, and usability of the PA4E1 program website from the perspective of in-school champions using mixed methods. METHODS The first objective used website usage data collected across all users (n=273) throughout the 9 school terms of the PA4E1 implementation support. The 4 usage measures were sessions, page views, average session duration, and downloads. Descriptive statistics were calculated and explored across the duration of the 26-month program. The second objective used mixed methods, triangulating data from the first objective with data from a think-aloud survey and usability test completed by in-school champions (n=13) at 12 months. Qualitative data were analyzed thematically alongside descriptive statistics from the quantitative data in a triangulation matrix, generating cross-cutting themes using the “following a thread” approach. RESULTS For the first objective, in-school champions averaged 48.0 sessions per user, PE teachers 5.8 sessions. PE teacher sessions were of longer duration (10.5 vs 7.6 minutes) and included more page views (5.4 vs 3.4). The results from the mixed methods analysis for the second objective found 9 themes and 2 meta-themes. The first meta-theme indicated that the website was an acceptable and appropriate delivery mode, and usability of the website was high. The second meta-theme found that the website content was acceptable and appropriate, and identified specific suggestions for improvement. CONCLUSIONS Digital health interventions targeting physical activity often experience issues of lack of user engagement. By contrast, the findings from both the quantitative and mixed methods analyses indicate high usage and overall acceptability and appropriateness of the PA4E1 website to school teachers. The findings support the value of the website within a multidelivery mode implementation intervention to support schools to implement physical activity promoting practices. The analysis identified suggested intervention refinements, which may be adopted for future iterations and further scale-up of the PA4E1 program. CLINICALTRIAL Australian New Zealand Clinical Trials Registry ACTRN12617000681358; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372870

scholarly journals Evaluating Digital Program Support for the Physical Activity 4 Everyone (PA4E1) School Program: Mixed Methods Study

10.2196/26690 ◽  
2021 ◽  
Vol 4 (3) ◽  
pp. e26690
Author(s):  
Matthew Mclaughlin ◽  
Jed Duff ◽  
Tom McKenzie ◽  
Elizabeth Campbell ◽  
Rachel Sutherland ◽  
...  
Keyword(s):  
Physical Activity ◽  
Mixed Methods ◽  
Subjective Experience ◽  
Scale Up ◽  
Descriptive Statistics ◽  
Trial Registration ◽  
Implementation Support ◽  
Delivery Modes ◽  
Program Support ◽  
Digital Delivery

Background Effectively scaled-up physical activity interventions are urgently needed to address the high prevalence of physical inactivity. To facilitate scale-up of an efficacious school-based physical activity program (Physical Activity 4 Everyone [PA4E1]), provision of implementation support to physical education (PE) teachers was adapted from face-to-face and paper-based delivery modes to partial delivery via a website. A lack of engagement (usage and subjective experience) with digital delivery modes, including websites, may in part explain the typical reduction in effectiveness of scaled-up interventions that use digital delivery modes. A process evaluation focused on the PA4E1 website was undertaken. Objective The 2 objectives were to (1) describe the usage of the PA4E1 program website by in-school champions (PE teachers leading the program within their schools) and PE teachers using quantitative methods; (2) examine the usage, subjective experience, and usability of the PA4E1 program website from the perspective of in-school champions using mixed methods. Methods The first objective used website usage data collected across all users (n=273) throughout the 9 school terms of the PA4E1 implementation support. The 4 usage measures were sessions, page views, average session duration, and downloads. Descriptive statistics were calculated and explored across the duration of the 26-month program. The second objective used mixed methods, triangulating data from the first objective with data from a think-aloud survey and usability test completed by in-school champions (n=13) at 12 months. Qualitative data were analyzed thematically alongside descriptive statistics from the quantitative data in a triangulation matrix, generating cross-cutting themes using the “following a thread” approach. Results For the first objective, in-school champions averaged 48.0 sessions per user, PE teachers 5.8 sessions. PE teacher sessions were of longer duration (10.5 vs 7.6 minutes) and included more page views (5.4 vs 3.4). The results from the mixed methods analysis for the second objective found 9 themes and 2 meta-themes. The first meta-theme indicated that the website was an acceptable and appropriate delivery mode, and usability of the website was high. The second meta-theme found that the website content was acceptable and appropriate, and identified specific suggestions for improvement. Conclusions Digital health interventions targeting physical activity often experience issues of lack of user engagement. By contrast, the findings from both the quantitative and mixed methods analyses indicate high usage and overall acceptability and appropriateness of the PA4E1 website to school teachers. The findings support the value of the website within a multidelivery mode implementation intervention to support schools to implement physical activity promoting practices. The analysis identified suggested intervention refinements, which may be adopted for future iterations and further scale-up of the PA4E1 program. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12617000681358; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372870

scholarly journals Extent, Type and Reasons for Adaptation and Modification When Scaling-Up an Effective Physical Activity Program: Physical Activity 4 Everyone (PA4E1)

2021 ◽  
Author(s):  
Matthew Mclaughlin ◽  
Elizabeth Campbell ◽  
Rachel Sutherland ◽  
Tom McKenzie ◽  
Lynda Davies ◽  
...  
Keyword(s):  
Physical Activity ◽  
Program Effectiveness ◽  
Negative Impact ◽  
Positive Impact ◽  
Scale Up ◽  
Evaluation Methods ◽  
Physical Activity Program ◽  
Implementation Support ◽  
Support Strategies ◽  
Activity Program

Abstract Background Few studies have described the extent, type and reasons for making changes to a program prior to and during its delivery using a consistent taxonomy. Physical Activity 4 Everyone (PA4E1) is a secondary school physical activity program that was scaled-up for delivery to a greater number of schools. We aimed to describe the extent, type and reasons for changes to the PA4E1 program (the evidence-based physical activity practices, implementation support strategies and evaluation methods) made before its delivery at scale (adaptations) and during its delivery in a scale-up trial (modifications). Methods The Framework for Reporting Adaptations and Modifications-Enhanced (FRAME) was used to describe adaptations (planned and made prior to the scale-up trial) and modifications (made during the conduct of the trial). A list of adaptations was generated from a comparison of the efficacy and scale-up trials via published PA4E1 protocols, trial registrations and information provided by trial investigators. Monthly trial team meetings tracked and coded modifications in ‘real-time’ during the conduct of the scale-up trial. The extent, type and reasons for both adaptations and modifications were summarized descriptively. Results In total, 20 adaptations and 20 modifications were identified, these were to physical activity practices (n = 8; n = 3), implementation support strategies (n = 6; n = 16) and evaluation methods (n = 6, n = 1), respectively. Few adaptations were ‘fidelity inconsistent’ (n = 2), made ‘unsystematically’ (n = 1) and proposed to have a ‘negative’ impact on the effectiveness of the program (n = 1). Reasons for the adaptations varied. Of the 20 modifications, all were ‘fidelity consistent’ and the majority were made ‘proactively’ (n = 12), though most were ‘unsystematic’ (n = 18). Fifteen of the modifications were thought to have a ‘positive’ impact on program effectiveness. The most common decision-maker in the modification process was the ‘program manager’ (n = 17). The main reason for modification was the ‘available resources’ (n = 14) of the PA4E1 Implementation Team. For both adaptations and modifications respectively, the most common goal was to ‘improve fit with recipients’ (n = 8; n = 7). Conclusions A considerable number of adaptations and modifications were made for scale-up that could have important impacts on intervention effects and are important to the interpretation of trial findings. Trial Registration Australia New Zealand Clinical Trial Registry: ACTRN12617000681358

scholarly journals Young Men’s Preferences for Design and Delivery of Physical Activity and Nutrition Interventions: A Mixed-Methods Study

2017 ◽  
Vol 11 (5) ◽  
pp. 1588-1599 ◽  
Author(s):  
Lee M. Ashton ◽  
Philip J. Morgan ◽  
Melinda J. Hutchesson ◽  
Megan E. Rollo ◽  
Clare E. Collins
Keyword(s):  
Physical Activity ◽  
Mixed Methods ◽  
Focus Group ◽  
Focus Groups ◽  
Mixed Methods Study ◽  
Delivery Mode ◽  
Negative Consequences ◽  
Nutrition Interventions ◽  
Face To Face ◽  
Program Content

Young adult men are under-represented in health research, and little is known about how to reach and engage them in lifestyle interventions. This mixed-methods study aimed to explore young males’ preferences for recruitment strategies, content, format (delivery mode and program duration and frequency), and facilitator characteristics for future physical activity and nutrition interventions. Ten focus groups involving 61 men (aged 18–25 years) in the Hunter region, New South Wales, Australia and an online survey distributed within Australia were completed by 282 males (aged 18–25 years). Key focus group themes included a preference for recruitment via multiple sources, ensuring images and recruiters were relatable; intervention facilitators to be engaging and refrain from discussing negative consequences of being unhealthy. Key program content preferences included skill development and individualized goals and feedback. Focus groups and the survey confirmed a preference for multiple delivery modes, including; face-to-face (group and individual), with support using eHealth technologies. Survey results confirmed the most favored program content as: “healthy eating on a budget,” “quick and easy meals,” and “resistance training.” Focus group responses suggested a program duration of ≥6 months, with 2–3 combined face-to-face and supportive eHealth sessions per week. Survey intervention duration preference was 3 months with 4 face-to-face sessions per month. Findings can guide the design, conduct, and evaluation of relevant contemporary physical activity and or nutrition interventions for young men. There is a need to identify the most effective ways to address young men’s individual preferences in intervention research.

scholarly journals Classroom Movement Breaks Reduce Sedentary Behavior and Increase Concentration, Alertness and Enjoyment during University Classes: A Mixed-Methods Feasibility Study

2021 ◽  
Vol 18 (11) ◽  
pp. 5589
Author(s):  
Casey L. Peiris ◽  
Gráinne O’Donoghue ◽  
Lewis Rippon ◽  
Dominic Meyers ◽  
Andrew Hahne ◽  
...  
Keyword(s):  
Physical Activity ◽  
Mixed Methods ◽  
Qualitative Data ◽  
Sedentary Time ◽  
Descriptive Statistics ◽  
Mixed Methods Study ◽  
Focus Group Interviews ◽  
Physical Activity Monitoring ◽  
Group Interviews ◽  
Comparison Data

This mixed-methods study aimed to determine the feasibility of incorporating movement breaks into university classes in terms of acceptability (disruption, engagement, satisfaction), practicality (ease of scheduling and conducting breaks) and efficacy (sedentary time, concentration, alertness, enjoyment). Movement breaks of five to 10 min duration were scheduled after 20 min of sedentary time during 2-h classes. Classes without movement breaks were used as a comparison. Data were collected using surveys, objective physical activity monitoring and focus group interviews of students (n = 85) and tutors (n = 6). Descriptive statistics (quantitative data) and independent coding and thematic analysis (qualitative data) were completed. Students (mean age 23 ± 2 years, 69% female) actively engaged in movement breaks with no adverse events. Movement breaks were perceived to be beneficial for concentration, engagement and productivity. Timing of the break was perceived to be important to enhance the benefit and reduce disruption. Students preferred outdoor or competitive movement breaks. Students spent 13 min less time sitting (95%CI 10 to 17), took 834 more steps (95%CI 675 to 994) and had higher levels of concentration, alertness and enjoyment (p < 0.001) in classes with movement breaks compared to classes without. Classroom movement breaks are feasible and may be considered for incorporation into university classes to reduce sedentary behaviour and increase physical activity, alertness, concentration and enjoyment.

A Mixed-Methods Study of Two Modes of the Circle of Security

2021 ◽  
pp. 104973152110093
Author(s):  
Christina Sadowski ◽  
Rachel Goff ◽  
Neroli Sawyer
Keyword(s):  
Mixed Methods ◽  
Parental Stress ◽  
Reflective Functioning ◽  
Mixed Methods Study ◽  
Delivery Mode ◽  
Parental Reflective Functioning ◽  
Delivery Modes ◽  
Home Based ◽  
Circle Of Security ◽  
The Impact

Purpose: This study compared the impact, challenges, and benefits of the Circle of Security-Parenting (COS-P) intervention across two delivery modes: group center-based (GCCOS-P) and individual home-based (IHCOS-P). Methods: This mixed-methods study compared the impact of the COS-P on parental reflective functioning and parental stress across two delivery modes: GCCOS-P ( n = 7) and IHCOS-P ( n = 7). It compared the challenges and benefits of each, from the qualitative perspectives of participants ( n = 2 IHCOS-P; n = 3 GCCOS-P) and facilitators ( n = 4). Results: Quantitative statistical analysis comparing pre- and postintervention measures suggest that each delivery mode was equally effective in reducing parental stress and generally noneffective with respect to parental reflective functioning. Challenges and benefits of each mode, inherent in the peer/shared learning environment of the GCOS-P and the individualized, flexible delivery of the IHCOS-P, were identified. Discussion: This study adds to knowledge about the widely utilized COS-P, highlighting challenges and benefits of two modes of delivery.

A Mixed-Methods Evaluation of a School Wellness Initiative: An Examination of Longer Lunch Periods and More Physical Activity Opportunities

2021 ◽  
Author(s):  
Juliana F.W. Cohen ◽  
Michael Scott ◽  
Melanie Sutton ◽  
Katie Cueva ◽  
Eleanor T. Shonkoff ◽  
...  
Keyword(s):  
Physical Activity ◽  
Mixed Methods ◽  
School Wellness ◽  
Mixed Methods Evaluation ◽  
Wellness Initiative

Mixed Methods with Strategic Collaborations: Systematically Designing an After-School Physical Activity and Nutrition Program

2020 ◽  
Vol 14 (4) ◽  
pp. 431-442
Author(s):  
Kara C. Hamilton ◽  
Shewanee Howard-Baptiste ◽  
Kori J. Hahn ◽  
Melissa C. Powell ◽  
E'tienne F. Easley ◽  
...  
Keyword(s):  
Physical Activity ◽  
Mixed Methods ◽  
After School ◽  
Nutrition Program

scholarly journals Type 2 diabetes patients’ views on prevention of hypoglycaemia – a mixed methods study investigating self-management issues and self-identified causes of hypoglycaemia

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Stijn Crutzen ◽  
Tessa van den Born-Bondt ◽  
Petra Denig ◽  
Katja Taxis
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Mixed Methods ◽  
Food Intake ◽  
Mixed Methods Study ◽  
Self Management ◽  
Hypoglycaemic Event ◽  
Glucose Levels ◽  
Management Issues

Abstract Background Hypoglycaemia is a common and potentially avoidable adverse event in people with type 2 diabetes (T2D). It can reduce quality of life, increase healthcare costs, and reduce treatment success. We investigated self-management issues associated with hypoglycaemia and self-identified causes of hypoglycaemia in these patients. Methods In this mixed methods study qualitative semi-structured interviews were performed, which informed a subsequent quantitative survey in T2D patients. All interviews were audio recorded, transcribed verbatim and coded independently by two coders using directed content analysis, guided by the Theoretical Domains Framework. Descriptive statistics were used to quantify the self-management issues and causes of hypoglycaemia collected in the survey for the respondents that had experienced at least one hypoglycaemic event in the past. Results Sixteen participants were interviewed, aged 59–84 years. Participants perceived difficulties in managing deviations from routine, and they sometimes lacked procedural knowledge to adjust medication, nutrition or physical activity to manage their glucose levels. Grief and loss of support due to the loss of a partner interfered with self-management and lead to hypoglycaemic events. Work ethic lead some participant to overexerting themselves, which in turn lead to hypoglycaemic events. The participants had difficulties preventing hypoglycaemic events, because they did not know the cause, suffered from impaired hypoglycaemia awareness and/or did not want to regularly measure their blood glucose. When they did recognise a cause, they identified issues with nutrition, physical activity, stress or medication. In total, 40% of respondents reported regular stress as an issue, 24% reported that they regularly overestimated their physical abilities, and 22% indicated they did not always know how to adjust their medication. Around 16% of patients could not always remember whether they took their medication, and 42% always took their medication at regular times. Among the 83 respondents with at least one hypoglycaemic event, common causes for hypoglycaemia mentioned were related to physical activity (67%), low food intake (52%), deviations from routine (35%) and emotional burden (28%). Accidental overuse of medication was reported by 10%. Conclusion People with T2D experience various issues with self-managing their glucose levels. This study underlines the importance of daily routine and being able to adjust medication in relation to more physical activity or less food intake as well as the ability to reduce and manage stress to prevent hypoglycaemic events.

scholarly journals BaSAlt — A mixed-methods study protocol on setting-based physical activity promotion and counseling in nursing homes

2021 ◽  
pp. 100828
Author(s):  
A. Thiel ◽  
G. Sudeck ◽  
A. Niess ◽  
G.W. Eschweiler ◽  
D. Altmeier ◽  
...  
Keyword(s):  
Physical Activity ◽  
Mixed Methods ◽  
Nursing Homes ◽  
Study Protocol ◽  
Physical Activity Promotion ◽  
Mixed Methods Study ◽  
Activity Promotion
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