A whole family-based physical activity promotion intervention: findings from the families reporting every step to health (FRESH) pilot randomised controlled trial.
The international journal of behavioral nutrition and physical activity 2020 ; 17: 120.
PubMed ID : 32962724
PMCID : PMC7510101
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.
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.
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.
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.
This study was prospectively registered ( ISRCTN12789422 ) on 16/03/2016.
A low level of physical activity raises the risk of obesity, mental health problems and poor bone development. Currently, children’s physical activity levels are low and decline as they get older. Physical activity declines mostly outside of school, yet physical activity promotion mainly focuses on schools. Therefore, family-based physical activity promotion has potential, but rarely targets the whole family. This project aimed to refine and test the FRESH (Families Reporting Every Step to Health) programme, developed to increase physical activity in 7-11 year old children and their families. A total of 41 families took part and they were randomly assigned to one of three groups a: ‘family’, ‘pedometer-only’, or a control group that carried on as normal. The ‘family’ group 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. The ‘family’ and ‘pedometer-only’ groups also received family sets of pedometers. We followed families up to 1 year after they first joined the study. We found that families enjoyed taking part in FRESH, enjoyed wearing the pedometers and said that the website was easy to use. Parents and children in the ‘family group’ reported that they were more active together and they more aware of the amount of physical activity they did. However, we saw little change in physical activity in most participants, apart from a short-term positive change for parents. We also had difficulty recruiting families to take part in FRESH. The FRESH programme is a feasible and acceptable, but did not promote physical activity in families. Further work should refine FRESH and optimise its evaluation.
Study : FRESH: Families Reporting Every Step to Health