Supporting Physical Activity for Informal Caregivers during and beyond COVID-19: Exploring the Feasibility, Usability and Acceptability of a Digital Health Smartphone Application, 'CareFit'.

The COVID-19 pandemic has exposed how our global societies rely upon the care and support of informal (unpaid) caregivers: in the UK alone, there are an estimated 6.5 million informal carers. The caring role is not just precarious, it is often associated with high levels of stress, poor/deteriorating health and crisis points (hospitalisations, worsening of health). Fittingly, there has been much research in recent years focusing on mental health supports. A lesser explored area is physical health and physical activity. To address this, we conducted a real-world feasibility, usability and acceptability study of a novel codesigned digital health app for caregivers to improve levels of physical activity. Our study was designed to test the prototype app use for three weeks, following participants across questionnaires/in app data/qualitative data. Our findings (from 27 caregivers) highlights key knowledge gaps around physical activity-national guidelines were not reaching populations studies and behavioural change techniques hold promise to help support caregivers in the longer term. Our collective results support the acceptability, usability and feasibility of the Carefit app and warrant further investigation.

Challenges and opportunities for sustainable solid waste management in private nature reserves: The case of Sabi Sand Wildtuin, South Africa

The mismanagement of waste in protected areas may lead to significant and irreversible environmental, economic and social impacts, such as land degradation, resource depletion, surface and groundwater pollution, loss of biodiversity and impacts on the aesthetic value of these areas. This paper aims to identify the challenges and opportunities for sustainable solid waste management in privately protected areas, given the limited research conducted on this topic. A case study approach was followed, which focused on the Sabi Sand Wildtuin, a private nature reserve (PNR) in South Africa. Interviews were conducted with 30 participants, which included representatives from the management authority, commercial lodges, non-commercial properties and a waste service provider. Several challenges have been identified by interviewees. Behaviour was the most frequently mentioned challenge, where interviewees raised concerns about negative attitudes, unwillingness to implement waste management measures and a possible lack of support. Other frequently mentioned challenges included foreseen difficulties due to the size and location of the reserve and concerns around funding of waste management measures, especially given the financial implications of coronavirus disease 2019 (COVID-19) travel and tourism restrictions. The most frequently identified opportunities included creating jobs and improving livelihoods, providing assurance and transparency of what happens to waste ‘beyond the gate’ and improving awareness, knowledge and skills related to waste management. To optimise the opportunities towards sustainable solid waste management, PNRs should focus on aligning their strategic direction to achieve legal compliance and support community initiatives to establish waste-related infrastructure and services that cannot be implemented within the reserve. Conservation implications: The pursuit of waste-related opportunities within privately protected areas could enhance the implementation of sustainable solid waste management in PNRs, whilst also contributing to pollution prevention, community upliftment and other secondary benefits, which could ultimately result in increased conservation efforts.

A Novel Mobile App ("CareFit") to Support Informal Caregivers to Undertake Regular Physical Activity From Home During and Beyond COVID-19 Restrictions: Co-design and Prototype Development Study.

BACKGROUND: Informal caregivers, or carers (unpaid family members and friends), are instrumental to millions worldwide for the ongoing delivery of health and well-being needs. The risk of crisis points (eg, hospitalizations) for caregivers increases with the absence of physical activity. The COVID-19 pandemic is highly likely to have increased the risk of crisis points for caregivers by increasing the amount of time spent indoors due to shielding and lockdown restrictions. Thus, accessible evidence-based tools to facilitate physical activity for caregivers indoors are urgently needed. OBJECTIVE: The aim of this study was to co-design and develop a novel mobile app to educate and support carers in the undertaking of regular physical activity at home during and beyond COVID-19 restrictions via integration of the transtheoretical model of behavior change and UK physical activity guidelines. METHODS: We co-designed a mobile app, "CareFit," by directly involving caregivers, health care professionals, and social care professionals in the requirements, capturing, and evaluation phases of three Agile Scrum design and development sprints. Seven participants representing multistakeholder views took part in three co-design sessions, each of which was followed by a development sprint. Requirements for CareFit were grounded in a combination of behavioral change science and UK government guidelines for physical activity. RESULTS: Participants identified different barriers and enablers to physical activity, such as a lack of time, recognition of existing activities, and concerns regarding safely undertaking physical activity. Requirements analysis highlighted the importance of simplicity in design and a need to anchor development around the everyday needs of caregivers (eg, easy-to-use video instructions). Our final prototype app integrated guidance for undertaking physical activity at home through educational, physical activity, and communication components. CONCLUSIONS: Integrating government guidelines with models of behavioral change into a mobile app to support the physical activity of carers is novel. We found that integrating core physical activity guidelines into a co-designed smartphone app with functionality such as a weekly planner and educational material for users is feasible. This work holds promise to fill the gap of effective physical activity solutions for caregivers both during and beyond the COVID-19 pandemic. Further work is now needed to explore the feasibility, acceptability, and usability of the approach in real-world settings.