Integrating an exercise specialist supported by mHealth technology to increase exercise and physical activity adherence in a paediatric Complications from Excess Weight Service (MOTIVATE-CEW): a feasibility study

OBJECTIVES: Assess the feasibility of embedding an exercise specialist-led, mHealth-supported physical activity and exercise intervention (MOTIVATE-CEW) into a UK Complications from Excess Weight (CEW) service. DESIGN: Feasibility, single-site, parallel-group randomised controlled trial. SETTING: Participants were recruited from Alder Hey Children's Hospital (AHCH) CEW service. PATIENTS: Young people (12-18 years) receiving care from the AHCH CEW service. INTERVENTIONS: Participants were randomised 1:1 to usual care or usual care and intervention (MOTIVATE-CEW). MOTIVATE-CEW participants codesigned a 3-month, home-delivered, personalised progressive physical activity programme supported by virtual counselling sessions from an exercise specialist and biofeedback from wearable technologies. MAIN OUTCOME MEASURES: The primary outcomes were recruitment rate, retention and adherence to purposeful exercise. Exploratory clinical data on effectiveness were collected at baseline and post-intervention (3 months). RESULTS: n=72 young people aged over 12 years were registered with the AHCH CEW service and approached to participate. n=25 were ultimately randomised (age 15±1; 52% female; 84% white), giving a recruitment rate of 27%. Retention at 3 months was 88%. Over the 3-month intervention, heart rate monitor data suggested MOTIVATE-CEW participants completed more exercise sessions (MOTIVATE-CEW 2±2 sessions/week; usual care 0±0 sessions/week; d=1.04) and exercised for longer (MOTIVATE-CEW 80±102 min/week; usual care 8±20 min/week; d=0.99) than usual care. At 3 months, 33% of MOTIVATE-CEW participants were still exercising compared with 8% in usual care. CONCLUSIONS: The MOTIVATE-CEW intervention showed promising effects on exercise behaviour. Good reach and data availability suggest the study design could be feasible within future trials. TRIAL REGISTRATION NUMBER: NCT04854915.