Thesis Format
Integrated Article
Degree
Doctor of Philosophy
Program
Health and Rehabilitation Sciences
Supervisor
Dr. Trish Tucker
Abstract
The purpose of this dissertation was to examine the physical activity context for children in rural and smaller urban settings and identify strategies for scaling up interventions for lower-density communities by exploring how to appropriately and effectively expand the ACT-i-Pass Program, a community-based intervention for children ages 9-11 years, into the counties of Oxford, Elgin and Middlesex in Southwestern Ontario. This dissertation entailed four interrelated studies, which start with exploring the movement behaviours of the children in the study area via online surveys. Study 1 entailed a longitudinal assessment of children’s physical activity levels pre-pandemic and during COVID-19 public health measures, while Study 2 explored the movement behaviours of children following the COVID-19 protections based on socio-demographic and geographic factors. To assess the communities for the potential scale-up of the ACT-i-Pass Program, Study 3 comprised community forums with service providers (n = 37) and parents (n = 9) to understand their perspectives on, and recommendations for, physical activity programming in rural and smaller urban areas. Study 4 expanded on these findings, with the prevalence of the existing physical activity offerings and their relationship with neighbourhood-level characteristics analyzed via an environmental scan. The findings from the parent-reported surveys highlighted declines in children’s physical activity and shift to screen-based activities during COVID-19 stay-at-home orders, with parents reporting their children continue to exhibit lower physical activity levels than the national guidelines and many detailing excessive screen use. The findings indicated children from areas with limited local amenities and lower urbanicity engaged in less physical activity. The environmental scan revealed numerous recreational facilities (n = 238) and organized programs (n = 212) in smaller communities, demonstrating their capacity to adopt physical activity promotion interventions. Important considerations for future physical activity interventions include the areas with higher proportions of children having fewer physical activity facilities, vehicular transport not alleviating disparities in local recreational opportunities, investment in skill-building programming and non-competitive activities, and commitment to cross-sectoral collaborators during intervention development. In conclusion, the findings from this dissertation provide key insights into scaling up physical activity interventions and recommendations for adapting interventions to rural and smaller urban settings.
Summary for Lay Audience
Physical inactivity and excessive screen time have been decades-long issues in children’s health. Accordingly, health promotion efforts that encourage active lifestyles are required. While the physical activity literature is growing exponentially, there is a lack of evidence to guide physical activity interventions for rural and smaller urban settings. Through an evaluation assessing the county-expanded ACT-i-Pass, a community-based physical activity intervention that offers free programs to grade 5 children (ages 9-11 years), the overarching purpose of this dissertation was to examine the physical activity levels of children during the first year of the COVID-19 pandemic (Study 1), measure the recent trends in children’s movement behaviours (Study 2), collect community perspectives on the existing physical activity opportunities for children in rural and smaller urban settings (Study 3), and determine the types of assets (i.e., recreational facilities and organized programming) that exist in different settings (Study 4).
Studies 1 and 2 assessed children’s movement behaviours through online surveys with parents. Study 1 showed declines in children’s physical activity from pre-COVID to early-pandemic, and a shift to more screen-based activities. Similarly, in Study 2, most parents reported their children were not meeting the national physical activity and screen time recommendations. Further analysis of children’s physical activity identified areas with limited local amenities, and rural and smaller urban communities as low-activity settings that warrant health promotion efforts.
Study 3 included community meetings with recreational service providers and parents to understand physical activity opportunities and intervention development in rural and smaller urban areas. Parents primarily discussed skill development, non-competitive activity options, and affordable programs, while service providers focused on building partnerships, challenges staffing activities, and maintenance costs.
Finally, Study 4 involved an environmental assessment of the existing physical activity offerings in relationship to neighbourhood characteristics. The findings revealed the areas outside of the large urban centre had multiple locations with organized programs to support physical activity interventions. A lack of recreational facilities in child-concentrated areas and facility accessibility issues at walking and driving distances are potential intervention barriers. In conclusion, the findings from this dissertation provide key insights into translating physical activity interventions to dispersed communities.
Recommended Citation
Ostermeier, Emma E., "Exploring the Scale-up of a Free Community-Based Physical Activity Intervention to Rural and Smaller Urban Settings in Southwestern Ontario" (2024). Electronic Thesis and Dissertation Repository. 10640.
https://ir.lib.uwo.ca/etd/10640