Integrating an exercise specialist supported by mHealth technology to increase exercise and physical activity adherence in a paediatric Complications from Excess Weight Service (MOTIVATE-CEW): a feasibility study.

Abstract

Assess the feasibility of embedding an exercise specialist-led, mHealth-supported physical activity and exercise intervention (MOTIVATE-CEW) into a UK Complications from Excess Weight (CEW) service. Feasibility, single-site, parallel-group randomised controlled trial. Participants were recruited from Alder Hey Children's Hospital (AHCH) CEW service. Young people (12-18 years) receiving care from the AHCH CEW service. Participants were randomised 1:1 to usual care or usual care and intervention (MOTIVATE-CEW). MOTIVATE-CEW participants codesigned a 3-month, home-delivered, personalised progressive physical activity programme supported by virtual counselling sessions from an exercise specialist and biofeedback from wearable technologies. The primary outcomes were recruitment rate, retention and adherence to purposeful exercise. Exploratory clinical data on effectiveness were collected at baseline and post-intervention (3 months). n=72 young people aged over 12 years were registered with the AHCH CEW service and approached to participate. n=25 were ultimately randomised (age 15±1; 52% female; 84% white), giving a recruitment rate of 27%. Retention at 3 months was 88%. Over the 3-month intervention, heart rate monitor data suggested MOTIVATE-CEW participants completed more exercise sessions (MOTIVATE-CEW 2±2 sessions/week; usual care 0±0 sessions/week; d=1.04) and exercised for longer (MOTIVATE-CEW 80±102 min/week; usual care 8±20 min/week; d=0.99) than usual care. At 3 months, 33% of MOTIVATE-CEW participants were still exercising compared with 8% in usual care. The MOTIVATE-CEW intervention showed promising effects on exercise behaviour. Good reach and data availability suggest the study design could be feasible within future trials. NCT04854915.