Move Well, Feel Good: Feasibility and acceptability of a school-based motor competence intervention to promote positive mental health.

BACKGROUND: In response to the adverse impacts of the COVID-19 lockdown measures Move Well, Feel Good (MWFG) was developed as a school intervention using improvement of motor competence as a mechanism for promoting positive mental health. Study objectives were to evaluate the feasibility and acceptability of MWFG and to describe changes in child-level outcomes. METHODS: Five northwest England primary schools were recruited. MWFG was delivered over 10-weeks through physical education (PE) lessons, which were supplemented by optional class-time, break-time, and home activities. The intervention focused on development of 9-10 year-old children's motor competence in locomotor, object control, and stability skills, and psychosocial skills. Feasibility was evaluated against nine pre-defined criteria using surveys, interviews (teachers), and focus groups (children). Pre- and post-intervention assessments of motor competence, mental health, prosocial behaviour, wellbeing, and 24-hour movement behaviours were also completed. RESULTS: The five recruited schools represented 83% of the target number, 108 children consented (54% of target) with teachers recruited in all schools (100% of target). Intervention dose was reflected by 76% of the 45 scheduled PE lessons being delivered, and adherence was strong (>85% of children attending ≥75% of lessons). Positive indicators of acceptability were provided by 86% of children, 83% of PE teachers, and 90% of class teachers. Data collection methods were deemed acceptable by 91% of children and 80% of class teachers, and children spoke positively about participating in the data collection. Child-level outcome data collection was completed by 65%-97% of children, with a 3%-35% attrition rate at post-intervention, depending on measure. Favourable changes in motor competence (+13.7%), mental health difficulties (-8.8%), and prosocial behaviour (+7.6%) were observed. CONCLUSIONS: MWFG is an acceptable and feasible motor competence intervention to promote positive mental health. Content and delivery modifications could inform progression to a pilot trial with a more robust design.

Characteristics of 24-hour movement behaviours and their associations with mental health in children and adolescents.

Background: Time-use estimates are typically used to describe 24-hour movement behaviours. However, these behaviours can additionally be characterised by other easily measured metrics. These include sleep quality (e.g., sleep efficiency), 24-hour rest-activity rhythmicity (e.g., between-day rhythm variability), and directly measured acceleration metrics (e.g., intensity gradient). Associations between these characteristics and youth mental health are unclear. This study aimed to [1] compare 24-hour movement behaviour characteristics by sex and age groups, [2] determine which movement behaviour characteristics were most strongly associated with mental health outcomes, and [3] investigate the optimal time-use behaviour compositions for different mental health outcomes. Methods: Three-hundred-and-one children and adolescents (age 9-13 y; 60% girls) wore accelerometers for 24-hours/day over 7-days. Overall mental health, externalising, and internalising problems were self-reported using the Strengths and Difficulties Questionnaire. 24-hour movement behaviour characteristics were categorised as time-use estimates, sleep quality, 24-hour activity rhythmicity, and directly measured acceleration. Linear mixed models and compositional data analysis were used to analyse the data in alignment with the study aims. Results: Time-use estimates, directly measured accelerations, and 24-hour rest-activity rhythm metrics indicated that children were significantly more physically active (p = .01-<0.001) than adolescents. Children were also less sedentary (p < .01), slept longer (p = .02-0.01), and had lower sleep efficiency. Boys were significantly more active than girls (p < .001) who in turn accrued more time in sleep (p = .02). The timing of peak activity was significantly later among adolescents (p = .047). Overall mental health and externalising problems were significantly associated with sleep, sedentary time, sleep efficiency, amplitude, and inter-daily stability (p = .04-0.01). The optimal time-use compositions were specific to overall mental health and externalising problems and were characterised by more sleep, light and vigorous physical activity, and less sedentary time and moderate physical activity than the sample's mean time-use composition. Conclusions: Extracting and examining multiple movement behaviour characteristics from 24-hour accelerometer data can provide a more rounded picture of the interplay between different elements of movement behaviours and their relationships with mental health than single characteristics alone, such as time-use estimates. Applying multiple movement behaviour characteristics to the translation of research findings may enhance the impact of the data for research users. Supplementary Information: The online version contains supplementary material available at 10.1186/s44167-023-00021-9.

Co-Creation of a School-Based Motor Competence and Mental Health Intervention: Move Well, Feel Good.

Low motor competence (MC) and inhibited psychosocial development are associated with mental health difficulties. Improving children's MC through school-based physical activity interventions emphasising psychosocial development may therefore be a mechanism for promoting positive mental health. This study describes and provides reflective insights into the co-creation of 'Move Well Feel Good', a primary school physical activity intervention to improve children's MC and mental health. Class teachers, school leaders, physical activity specialists, and children (aged 8-9 years) participated in a series of co-creation workshops. Stakeholders' knowledge and experiences were integrated with existing research evidence using creative methods (e.g., post-it note tasks, worksheets, and drawings) to facilitate discussion. The co-creation process culminated in stakeholder consensus voting for one of three proposed intervention ideas. Children cited physical and mental health benefits, enjoyment with friends, and high perceived competence as motives for being physically active. Opportunities to develop MC across the different segments of the school day were identified by adult stakeholders, who perceived children's lack of resilience, an overloaded curriculum, and poor parental support for physical activity as barriers to intervention implementation. The chosen intervention idea received six out of a possible twelve votes. Co-creation projects are specific to the contexts in which they are implemented. This study reinforces the complex nature of school-based intervention development and highlights the value of engaging with stakeholders in co-creation processes.