ABSTRACT
Introduction: In Australia, it is estimated that 45% of adults meet the aerobic training recommendations (i.e., 150-300 minutes of MVPA) and only 9-30% meet the resistance training (RT) guidelines (i.e., minimum 2 sessions/week). Given the lack of 'scalable' physical activity community-based interventions promoting RT, the aim of this effectiveness trial (based on the published ecofit efficacy trial) was to determine the effects of an innovative community-based multicomponent physical activity intervention promoting resistance and aerobic-based physical activity using outdoor gym equipment, smartphone technology, and social support. Method(s): The ecofit effectiveness trial was evaluated using a two-arm (intervention versus wait-list control) randomised controlled design, with assessments at baseline, 3 (primary time-point) and 9-months (follow-up). Participants were recruited from the Newcastle and Lake Macquarie local government areas, NSW. Eligible participants were aged 18-80 years, had access to a smartphone, did not meet the aerobic and/or resistance-based physical activity guidelines, and passed the Adult Pre-Exercise Screening Tool. The intervention components included (i) smartphone technology (i.e., purpose-built application that included standardised workouts using local outdoor gym equipment across 11 locations), (ii) social support (i.e., option to enrol as a group and join the ecofit Facebook group), and (iii) a 90-minute introductory session. Linear mixed models were conducted with an adjusted alpha (p<.025) to account for the two primary outcomes of upper (i.e., push-up test) and lower (sit-to-stand test) body strength. Result(s): Participants (N=245;mean age 53.44 (SD=13.9);72% women) were recruited. There were no statistically significant (p<.025) group-by-time effects for the primary outcomes (i.e., upper and lower body muscular fitness) at 3-months. At 9-months, however, there were significant improvements in both upper (1.42 repetitions, 95%CI=0.25, 2.59) and lower body (2.6 repetitions, 95%CI=0.41, 4.82) muscular fitness, compared to controls. Among the secondary outcomes at 3-months, mean differences in visceral adipose tissue (-59.52 grams, 95%CI=-122.17, 3.12), and total fat (-494.30 grams, 95%CI=-1012.39, 23.79) approached statistical significance (p's=0.06). Discussion/Conclusion: To our knowledge this is the first community-based RT intervention that has employed a scalable approach targeting the general population. Despite the mixed findings, it was encouraging to see beneficial effects on the primary outcomes, particularly in light of the disruption to the trial caused by the COVID-19 pandemic. The positive findings presented warrant further examination of this scalable intervention mode for its dissemination to other local government areas. Impact and application to the field: * The ecofit program is promising with significant statistical and clinical effects and could be considered to be scaled-up in other Local Government Districts across Australia and abroad. This study was funded by NHMRC grant (APP1134914, 2017), registered with the Australian and NZ Clinical Trial Registry (ACTRN12619000868189) and received Human Ethics approval from the University of Newcastle (H-2018-0060). Conflict of interest statement: My co-authors and I acknowledge that we have no conflict of interest of relevance to the submission of this . Copyright © 2022
ABSTRACT
Background: An important stage of process evaluation in community-based interventions is assessing recruitment and engagement. Such an evaluation is being conducted alongside the FirstCPR cluster-randomised trial, which aims to increase community-level training and willingness to respond to cardiac arrests by providing education and training to members of community-based organisation. FirstCPR’s process evaluation sought to: (1) examine recruitment and understand barriers and enablers to organisation participation;and (2) examine the intervention’s fidelity and reach, including contextual factors related to participant engagement. Methods: A mixed-methods evaluation, integrated data collected during organisation recruitment comprising both quantitative record-keeping and qualitative coding. Quantitative data included recruitment rates, reasons for refusal, and organisational features;qualitative codes emerged from study-team observations. Descriptive analyses were used for quantitative data and thematic analyses for qualitative data. Results: In total, 220 (constituting 55% social/faith groups, 39% sports organisations, 6% workplaces/businesses) of 385 eligible organisations declined to participate. Lack of sufficient time to facilitate the project at their organisations, difficulties prioritising the program given competing activities, and COVID-related restrictions emerged as principal reasons for declining. Thematic analyses suggested that an organisation’s perception of the value of FirstCPR’s training was a key factor motivating enrolment. Conclusions: Organisational barriers included COVID restrictions, lack of perceived relevance, and staffing limitations. Obtaining adequate enrolment is essential for the generalisability of community intervention trials such as FirstCPR. Further semi-structured interviews with organisation leaders will delve into contextual factors that facilitated or impeded the intervention’s planned delivery;study records and web-analytics will inform intervention’s fidelity and reach.