Adapting a physical activity program for the real-world - a measured approach.

What is it about?

We need real-world solutions to increase physical activity. Researchers often “scale-up” solutions along a pipeline — from small trials (think ~50 childcare centres), to progressively larger and more real-world contexts (e.g. ~500 childcare centres). This scale-up leads to reducing effectiveness along the pipeline - with some solutions completely losing their effectiveness in the real-world. But why do we lose effectiveness? Well, one possible reason is the volume, size and type of adaptations that need to be made. For example, when delivering on a small scale, 1-2-1 human contact is often much higher than when delivering something statewide or nationally - as resources and costs become stretched.

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Photo by micheile henderson on Unsplash

Photo by micheile henderson on Unsplash

Why is it important?

In our national scale-up of “Play Active” (a childcare physical activity policy), we explored the extent, type, fidelity consistency, goals, size, scope, and proposed impact of proposed adaptations. We identified a large number of small adaptations - mostly consistent with the core components. Most adaptations were coded to have a proposed positive impact for scale-up - although a handful of adaptations should be carefully monitored given their potential negative impact on effectiveness. Adaptations were mainly made to increase effectiveness and reduce costs. This research will help us to interpret the findings of Play Active.

Perspectives