Move to Improve: A single-arm, pragmatic feasibility trial of an individualised physical activity program for children with chronic conditions

Move to Improve has been co-designed by consumers, researchers and health professionals, and the program will be individually tailored to support children to develop physical activity goals that are fun and sustainable. The multidisciplinary Move to Improve team will help children to build motivation, skills and the confidence required to lead an active lifestyle. The Move to Improve program team will consist of a Senior Exercise Physiologist, Senior Physiotherapist, Senior Clinical Psychologist, Senior Dietician, Enrolled Nurse, Allied Health Assistant, Advanced Trainee, and Aboriginal Health Worker. The Move to Improve team will work with the child and family to develop an individualised physical activity program aligned with the participants’ goals as identified using the Canadian Occupational Performance Measure (COPM) tool. During the initial assessment, the Move to Improve program team will work with the family to draft a rough plan for the 8 sessions. The Move to Improve program team will then have approximately 10 days to develop a more structured plan based on this initial conversation. This 8 week plan will be flexible, and likely to change throughout the intervention, in order to reflect how the family is going and the child’s individual circumstances and needs. The program will broadly aim to build towards meeting the physical activity guidelines of 60 minutes per day of moderate-vigorous physical activity and will include a combination of aerobic, strength training, flexibility, and coordination exercises. Participants will be encouraged to follow the program over the 8-week duration of the intervention. To support participation in the individualised program and address specific barriers to physical activity, the Move to Improve team will provide additional resources (e.g., information sheets) as required. Over the course of the 8-week intervention, participants will have access to 1 hour/week one-to-one sessions from the Move to Improve program team to support implementation of the program (e.g., addressing any barriers) and achievement of identified goals. Additional psychology and dietetic support will be provided to participants for whom these are identified barriers to physical activity participation. Based on initial screening from the referral, questionnaires and medical chart review, clinical psychology will provide consultation and liaison to families and their treating teams about mental health support and also about utilising physical activity to improve mood, anxiety and general wellbeing. Based on the initial screening and diet history, the dietician will conduct one-to-one consultations with families of children identified as needing dietetic input during the program. Dietetic support may include (but is not limited to) individual dietary goals and diabetes management support as required. During this period, programs may be adjusted by the Move to Improve team based on the child’s progression towards the predetermined end goal. One-to-one sessions may take place at Perth Children’s Hospital, via Telehealth, in community settings, or home visits depending on clinical judgment of what is required to support the child’s progression towards their physical activity goals. The Move to Improve team will capture adherence in the form of session notes by prompting families on their engagement in the prescribed program and physical activity more broadly since the previous session. Feasibility of intervention delivery will be assessed by the Move to Improve research team using the RE-AIM framework. A parent/primary caregiver of participating children will also be included in the study. Their involvement will be to respond to online parent-report questionnaires and complete physical activity diaries to record their child's physical activity).