How can we get more people with long-term health conditions involved in parkrun? A qualitative study evaluating parkrun’s PROVE project

Background People with long-term health conditions face barriers to physical activity and community health interventions despite potential life-changing benefits for self-management of their condition and wellbeing. A weekly mass participation running, walking and volunteering event called parkrun launched a project called PROVE in 2016 to engage people living with long-term health conditions in England. Over the 3 year project, parkrun appointed volunteer Outreach Ambassadors with a specialist interest in the health condition they represented whose role was to ensure parkrun was welcoming, supportive and inclusive. This qualitative study aimed to understand the experience of the PROVE project for people with long-term health conditions. Methods Semi-structured interviews were conducted with 15 PROVE Outreach Ambassadors representing 13 different long-term health conditions in England. Interviews were recorded, transcribed verbatim and analysed using thematic analysis. Rigour and transparency were sought in addition to utilising independent researchers to offer alternative interpretations of the data. Results Data analysis resulted in 4 overarching themes and 13 subthemes. Outreach Ambassadors believed that parkrun was already supportive of people with long-term health conditions, but that the PROVE project enabled the support to be delivered in a more structured way across health conditions and locations. Outreach Ambassadors believed that the PROVE project had the potential to create a welcoming, safe space for people with long-term health conditions to participate as walkers, runners or volunteers. Success of the PROVE project was believed to be dependent on being realistic about the potential to bring about change, challenging people’s perceptions of parkrun and engaging with key stakeholders and advocacy groups. Challenges for parkrun were believed to be around communication, demonstrating impact and the project’s dependence on volunteers for delivery. Conclusions This is the first study of its kind to explore the public health potential of parkrun for people with long-term health conditions. parkrun’s PROVE project was regarded to be important for ensuring that people with long-term health conditions can engage in physical activity and volunteering in a safe and supportive environment. The findings have important implications for parkrun, policy makers and physical activity providers looking to deliver inclusive community physical activity opportunities

The Role of Technology in Promoting Physical Activity: A Case-Study of parkrun

Around a third of people worldwide are physically inactive, causing 3.2 million deaths each year. People often use wearables and smartphone trackers to motivate them to be active, but there is evidence to show that use of these trackers declines quickly, often within weeks. One intervention that appears to successfully motivate people to be active is parkrun, a free, weekly timed 5 km run or walk every Saturday morning. The system used by parkrun is surprisingly low-tech: it uses printable barcodes, stopwatches and scanners, and the internet. A survey of 60,694 parkrun participants showed that levels of self-reported physical activity increased following participation in parkrun, especially for those with previously low levels of activity. Nine out of ten reported feeling a sense of personal achievement and improvements to fitness and physical health since starting parkrun. Based on a taxonomy of behaviour change interventions, the technology used by parkrun was shown to incorporate at least seven techniques that inform and encourage parkrunners. It is concluded that physical activity technologies should not be central to an intervention, rather, they should enhance interventions where behaviour change takes precedence

Does ethnic density influence community participation in mass participation physical activity events? The case of parkrun in England

Background: parkrun has been successful in encouraging people in England to participate in their weekly 5km running and walking events. However, there is substantial heterogeneity in parkrun participation across different communities in England: after controlling for travel distances, deprived communities have significantly lower participation rates. Methods: This paper expands on previous findings by investigating disparities in parkrun participation by ethnic density. We combined geo-spatial data available through the Office for National Statistics with participation data provided by parkrun, and fitted multivariable Poisson regression models to study the effect of ethnic density on participation rates at the Lower layer Super Output Level. Results: We find that areas with higher ethnic density have lower participation rates. This effect is independent of deprivation. Conclusions: An opportunity exists for parkrun to engage with these communities and reduce potential barriers to participation

Physical activity among children with type 1 diabetes: an exploration of children’s experiences and development of an intervention to promote self-efficacy and participation

Regular physical activity among children with Type 1 Diabetes Mellitus (T1DM) can help optimise long-term health outcomes. This thesis explores the experience of physical activity among children aged 9-11 years with T1DM and their parents, develops a physical activity intervention and evaluates its feasibility. Social cognitive theories have been drawn upon to develop our understanding and inform theoretically-driven behaviour change strategies. First, a systematic review with meta-analysis evaluates existing physical activity interventions for children with T1DM. The findings confirm the health benefits associated with regular physical activity, including improved glycaemic control and lipid profile. Gaps in the existing literature are identified, such as the need for theoretically-driven interventions. Second, the experience of physical activity for children with T1DM from the perspective of i) parents and ii) paediatric diabetes healthcare professionals are explored. Qualitative research findings highlight the challenges faced, as well as the methods used by families to overcome obstacles to physical activity. Healthcare professionals recognise their role in promoting physical activity, but perceive barriers to the successful fulfilment of this role. Third, the feasibility and acceptability of wrist-worn ActiGraph GT3X+ accelerometers in children with T1DM is explored. The findings demonstrate that the accelerometer is feasible, acceptable, sensitive to change and objective data correlates with self-reported physical activity. Fourth, correlates of physical activity are explored alongside children’s values, beliefs and expectations. The findings suggest that self-efficacy and enjoyment have a role in physical activity and children perceive few diabetes-related barriers to participation. Finally, the feasibility and acceptability of the Steps To Active Kids-Diabetes (STAK-D) programme for children with T1DM is explored using mixed-methods. The capacity to detect change over time in selected health outcomes is also explored (e.g., physical activity level, self-efficacy and parental fear of hypoglycaemia) All findings are discussed in terms of their implications for knowledge and understanding, a future definitive trial and clinical practice

“We don’t worry about diabetes that much”: A qualitative study exploring perceptions of physical activity among children with Type 1 Diabetes

Background: Despite the health benefits of physical activity, children across the population are insufficiently active. Physical activity is essential in the management of Type 1 Diabetes Mellitus (T1DM), therefore its promotion should be a priority, yet little research has explored the experience of physical activity from the viewpoint of children with this condition. This study sought to provide insight into how children with T1DM perceive and participate in physical activity to further the design of initiatives and clinical interventions that promote active lifestyles in this population. Methods: Researchers collected data through in-depth interviews with twelve children aged 9-11 years with T1DM in the UK. Interviews were recorded, transcribed verbatim and data were analysed using thematic analysis. Results: The overarching themes captured: children’s understanding of physical activity; children’s physical activity is motivated by friendship and social interaction; children’s physical activity is motivated by positive perceptions, fun and enjoyment; children describe how their family helps them to be active; school provides children with an opportunity to be active; children’s access to facilities and outdoor space encourages physical activity; children refer to personal mastery and competence in physical activity and; children perceive difficulties that make physical activity harder. Conclusions: This study is the first to distinguish children’s perceptions toward physical activity from other key stakeholders. Listening to children has identified what they believe is important, for example enjoyment and socialisation, which should be considered when developing strategies to promote physical activity in this population

Parkrun as a tool to support public health: insights for clinicians

Background: To support efforts to grow social prescribing and reduce levels of physical inactivity, parkrun UK and the Royal College of GPs developed the parkrun Practice initiative to link General Practices to local parkruns (free, weekly, timed, physical activity events). Practice staff are encouraged to take part themselves and also encourage their patients to participate. Aim: To provide insight for clinicians about parkrun participants, especially those with characteristics of a patient who might be signposted to physical activity. Design and setting: Secondary analysis of an online survey of 59,999 parkrunners in the UK. Method: Respondents were ranked into 13 categories using mean parkrun finish time allowing the following definitions: front runners, median runners, slower runners, runners/walkers and walkers. Measures included demographics, health conditions, motives for first participating and perceived impact of health and wellbeing. Results: Over 9% of all participants were found to have at least one long term health condition: this rose to 45% for walkers and included arthritis, obesity, depression, chronic pain, hypertension and anxiety. Walkers were less likely to be motivated by fitness or competition and more likely to be motivated by physical health. Despite these differences, perceived improvements to wellbeing were broadly similar for all parkrunners regardless of finishing time. Conclusions: The study shows that parkrunners are a diverse population in terms of physical health. The information here could be combined with other research on barriers to participation and successful brief interventions to help address the key issues of practitioner knowledge and confidence

The health benefits of volunteering at a free, weekly, 5 km event in the UK: a cross-sectional study of volunteers at parkrun

This paper investigates the motives for first participating in parkrun and its impact for those who volunteered compared to those who did not volunteer. A cross-sectional survey was emailed to parkrun registrants, resulting in 60,680 survey returns from parkrun participants who self-identified as volunteers only (n = 681), runners/walkers who volunteered (n = 21,928) or runners/walkers who did not volunteer (38,071). Two survey questions were analysed in this paper: (1) their motives for first participating in parkrun as a volunteer or runner/walker; and (2) the perceived impact on their health and wellbeing. More than half of respondents were female and were predominantly from a white ethnic background. Compared to runners/walkers who volunteered, those who volunteered exclusively were older, more likely to be retired and more likely to be inactive at registration. Exclusive volunteers were motivated by wanting to give something back to the community (45.8%), to feel part of a community (26.1%), to help people (24.5%) or because they were unable to run (21.1%). Runners/walkers who volunteered were more likely to volunteer because they felt obliged to (49.3%). A large proportion of exclusive volunteers reported improvements to connections with others such as feeling part of a community (83.5%), the number of new people met (85.2%) and time spent with friends (45.2%). While mental and physical health were ranked low by volunteers as a motive (4.7% and 2.7% respectively), improvements were reported by 54.5 and 29.3% respectively. The data shows that volunteering at parkrun without participating as a runner or walker can deliver some of the components of the Five Ways to Wellbeing advocated by the NHS. The characteristics of parkrun (free, regular, local, accessible and optional) make it a viable social prescribing offer that can be used as a model for other community events seeking to attract volunteers

Feasibility and acceptability of physical activity monitoring as an educational tool in the management of pediatric type 1 diabetes

Introduction The spontaneous, sporadic and sometimes unpredictable nature of children's physical activity causes fluctuations in blood glucose level and challenges for children with type 1 diabetes. Physical activity monitoring has potential utility. This study aimed to explore the perceptions of physical activity monitoring among healthcare professionals and assess the feasibility and acceptability of using it in the management of paediatric type 1 diabetes. Methods Seven healthcare professionals from one paediatric diabetes centre in the UK were involved in a focus group. Data were analysed thematically. Physical activity monitoring using a wrist-worn monitor was tested for feasibility with thirteen children aged 7-11 years with type 1 diabetes. The primary outcome was feasibility (i.e., recruitment, adherence, data completion, adverse events and acceptability). Secondary measures were glycaemic control, parental self-efficacy for diabetes management and parental fear of hypoglycaemia. Results Healthcare professionals valued having an awareness of the level, type and intensity of children’s physical activity. They identified unmet training and resource needs that would facilitate them being able to give physical activity advice to children and families. Recruitment rate was 20%, adherence to the activity monitoring was good and study completion rate was 62%. No adverse events were reported. Physical activity monitoring was deemed acceptable by parents. Conclusions Physical activity monitoring could be a feasible part of routine clinical practice, but further research is needed to understand whether healthcare professionals are best placed to implement it and what impact it has on health outcomes

Feasibility of an online intervention (STAK-D) to promote physical activity in children with type 1 diabetes: protocol for a randomised controlled trial

Background: Regular physical activity has important health benefits for children with type 1 diabetes mellitus (T1DM), yet children and their parents face barriers to participation such as lack of self-efficacy or concerns around hypoglycaemia. Multimedia interventions are useful for educating children about their health and demonstrate potential to improve children’s health-related self-efficacy, but few paediatric clinics offer web-based resources as part of routine care. The Steps to Active Kids with Diabetes (STAK-D) programme is an online intervention grounded in psychological theory (social cognitive theory) and informed by extensive preliminary research. The aim of the programme is to encourage and support safe engagement with physical activity for children with T1DM. The aim of this research is to explore the feasibility of delivering the STAK-D programme to children aged 9–12 years with T1DM, and to assess the feasibility of further research to demonstrate its clinical and cost-effectiveness. Methods: Up to 50 children aged 9–12 years with T1DM and their parents will be recruited from two paediatric diabetes clinics in the UK. Child-parent dyads randomised to the intervention group will have access to the intervention website (STAK-D) and a wrist-worn activity monitor for 6 months. The feasibility of intervention and further research will be assessed by rate of recruitment, adherence, retention, data completion and adverse events. Qualitative interviews will be undertaken with a subsample of children and parents (up to 25 dyads) and health care professionals (up to 10). Health outcomes and the feasibility of outcome measurement tools will be assessed. These include self-efficacy (CSAPPA), objective physical activity, self-reported physical activity (PAQ), fear of hypoglycaemia (CHFS; PHFS), glycaemic control (HbA1c), insulin dose, Body Mass Index (BMI), health related quality of life (CHU9D; CHQ-PF28), health service use and patient-clinician communication. Assessments will be taken at baseline (T0), 8 weeks (T1) and at 6-month follow-up (T2). Discussion: The goal of this feasibility trial is to assess the delivery of STAK-D to promote physical activity among children with T1DM, and to assess the potential for further, definitive research to demonstrate its effectiveness. Results will provide the information necessary to design a larger randomised controlled trial and maximise the recruitment rate, intervention delivery and trial retention