Feasibility of scaling-up a community-based exercise program for young people with disability

Abstract

Purpose

To evaluate feasibility of scaling up a 12-week community-based exercise program (FitSkills) in which young people with disability exercise with a student mentor.

Method

Within a stepped wedge cluster randomised trial, seven domains of feasibility were assessed: demand, implementation, acceptability, practicality, adaptation, integration, and expansion.

Results

Of the 163 participants with disability (61 females; 20.8 ± 5 y) and 226 mentors who enrolled, 123 participants and mentors completed FitSkills. Population demand was estimated at 9% of members of participating organisations. Most participants (76%) completed the twice-weekly program within 12 weeks, attending 79% of sessions (mean 18.9 ± 4.7). Key program elements valued by participants were the mentor, tailored exercise, and regular program schedule. Majority (87%) of mentors were recruited from physiotherapy, occupational therapy, and exercise science courses. Positives for participants were perceived benefits and organisational support, and for mentors, understanding disability. Communication and scheduling were burdens. Three serious and 28 non-serious adverse events occurred. Adaptations (additional screening, risk analysis, extra mentor support, or in-person consultation) enabled 29 young people with complexity to participate. The number of trial sites was expanded to 11 to accommodate participants.

Conclusions

Scaling-up FitSkills is feasible, but with caveats related to communication, scheduling, and efficiency of recruitment.

IMPLICATIONS FOR REHABILITATION

• Key elements valued by participants as part of the successful scale-up of a community-based exercise program (FitSkills) across a large metropolitan city included a peer-mentor, tailored exercise, and organisational support structure.

• FitSkills can be adapted to include young people with complex disability with additional supports including screening, risk analysis, and professional support for the peer-mentor.

• The benefits of FitSkills, including social connectedness for young people with a disability and normalisation of disability for mentors, outweigh the burdens of participation.

• Communication with program organisers and scheduling logistics between the young person, their family/carers and peer mentors are important factors to manage for the successful implementation of FitSkills.

Keywords:

• Physical activity
• adolescents
• student mentor
• implementation
• acceptability
• gymnasium

Acknowledgements

We wish to express our sincere gratitude to the young people with disability, their families and caregivers, and the student mentors from La Trobe University, Australian Catholic University, and Monash University who volunteered their time and engaged in the spirit of FitSkills.

We would also like to thank our FitSkills partnership project team partner investigators for their ongoing support:

• Shawn Stephenson (Sport and Recreation Victoria),

• Justine Robbins (Joanne Tubb Foundation),

• Richard Amon, Ayden Shaw (Disability Sport and Recreation),

• Simone Power, Rebecca McCabe (Cerebral Palsy Support Network),

• Debby Fraumano (Down Syndrome Victoria),

• Fiona Kriaris (YMCA Victoria),

• Sam Taylor (City of Boroondara),

• Abigail Elliot (consumer representative),

• Lachlan O’Brien (consumer representative), and

• Dr Stacey Cleary; Dr Brooke Adair; Dr Melissa Moore; and Jess Kuek (project staff).

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by an Australian National Health and Medical Research Council (NHMRC) partnership project grant [ID 1132579]. The project also received financial and substantial in-kind support from each of our seven partners: Victorian Department of Health and Human Services, City of Boroondara, Cerebral Palsy Support Network, Down Syndrome Victoria, Disability Sport and Recreation, YMCA Victoria, and Joanne Tubb Foundation.