Physical Activity Clinical Trial
Official title:
Family Planning to Promote Regular Physical Activity: A Randomized Controlled Trial
The primary research question is:
1) Does the planning condition improve adherence to regular physical activity compared to the
control condition at six months? Hypothesis: Adherence will be higher for the planning
condition in comparison to the more standard physical activity education condition. The
effect may wane over time from the initial measurement period but all outcomes will remain
significantly higher at six months.
Secondary Research Questions
1. Does the planning condition improve motivational, health-related quality of life, and
health-related fitness outcomes compared to the control condition at six months?
Hypothesis: The planning condition will not affect intentions or underlying motives
(theory of planned behaviour constructs) for physical activity because its effect on
behavior is to tie initial intentions better to behavioural action (i.e., behavioural
regulation) and not to enhance motivation. Health-related fitness and quality of life,
however, will be higher for the planning condition in comparison to the standard
physical activity education intervention condition. The effect may wane over time from
the initial measurement period but all outcomes will remain significantly higher at six
months in the planning condition compared to the standard physical activity education
group.
2. Can group differences among these motivational, behavioural, and health-related fitness
outcomes be explained through a mediation model? Hypothesis: The covariance of the
assigned conditions (planning, education) on use/adherence will be explained by planning
and use of behavioural regulation strategies (i.e., manipulation check). In turn, the
covariance between planning and behavioural regulation strategies and health-related
outcomes will be explained by physical activity adherence among conditions.
3. Can motivational variables predict adherence? Do these differ by condition?
Hypothesis: The approach will test Ajzen's theory of planned behavior, extended by the
concept of active planning. Affective attitude and perceived behavioural control will
predict intention, intention will predict planning and planning will predict adherence
across conditions.
4. Is there an intergenerational, seasonal, or gender difference across primary outcomes by
assigned condition? Hypothesis: Children will show greater adherence to the planning
condition than their parents. No differences in gender or season are hypothesized but
these are exploratory research questions because there is limited research at present to
make any definitive statement.
Background:
Obesity is rapidly becoming one of the more serious public health challenges of this century,
especially when considering that overweight and obese children are likely to stay obese into
adulthood and are at a higher risk of developing chronic diseases at a younger age. The need
for changes to modifiable risk factors associated with obesity and chronic diseases is
paramount. Physical activity is associated with the reduction of several chronic diseases in
adults, including breast cancer, colorectal cancer, CVD, stroke, high blood pressure, type 2
diabetes, osteoporosis, and hypertension. In children 5 to 17 years old, physical activity
and high physical fitness help guard against high blood pressure, high blood cholesterol,
metabolic syndrome, low bone density, depression, injuries, and obesity. Unfortunately in
Canada, well over half the adult population, and almost half the child population, are not
active enough to reap these health benefits. Children spend considerable time within the care
of their parents, and indeed parents appear to be the 'gatekeepers' of children and their
experiences during family time. Our review of 34 intergenerational studies showed that
parental support was synonymous with physical activity in their children. Thus, focusing on
the parent as a means to changing youth physical activity appears a necessity. At present,
physical activity interventions focused on the family are limited and have resulted in
negligible changes. A recent review of these studies demonstrated very low success in
producing behavior change - considerably lower than the comparable adult literature. The
authors suggest that focused research attention needs to be placed on the family in order to
improve our current practice of physical activity promotion. Our pilot study [15], which
serves as the template for this research proposal, demonstrated that focused planning on
when, what, how, where, and overcoming other expected barriers followed by prompts and cues
resulted in a significant change in physical activity over the more standard
persuasion/education approach. The following proposal is an extension of this line of
successful research with improvements to the methodological rigor and sample generalizability
used in the pilot study.
Target population:
The targeted population will be inactive families within the Greater Victoria Area, British
Columbia.
Sample size:
A total of 160 families will be recruited (n=80 per group).
Intervention:
The intervention will follow the prior work conducted in our successful pilot trial. The
standard (comparison group) package will consist of Canada's family guide to physical
activity guidelines recommending 60 minutes of activity a day in bouts as short as five to
ten minutes for children and a breakdown of ways for the family to achieve this physical
activity (structured, unstructured, endurance, strength, activities, less than 60 minutes of
sustained sedentary activity, reduce screen viewing by 30 min per day) commensurate with this
guide. This will include the new insert by CSEP. The guide also contains arguments and
information about the benefits of physical activity.
The intervention condition will receive the same guidelines as the comparison condition but
will also be provided with family physical activity planning material. This material will
include skill training content (workbook how to plan for family physical activity) and
practical material to create a plan (i.e., a colourful dry erase wall calendar for family
activities with fridge magnets). The skill training material for planning is based on several
streams of prior work in the adult physical activity literature. Families were instructed to
plan for "when," "where," "how," and "what" physical activity will be performed commensurate
with the creation of implementation intentions/action planning. The workbook, however, also
focuses on problem solving barriers to physical activity which is more akin to coping
planning and traditional goal setting. The design of all material was created for the pilot
study and features graphic design and colour images that represent family physical activity.
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