Results
Interviews
Analysis yielded eight themes: 1) interest in a parenting course; 2) barriers to attending a parenting course; 3) facilitators of attending a parenting course; 4) formatting recruitment materials; 5) recruitment locations; 6) preferences for course content; 7) preferences for delivery style and 8) session frequency, length and duration.
Interest in attending a PA parenting course
Although many parents from both areas said they were interested in and would go to a PA-based parenting course, this was reported more frequently by parents in the low SES area. Parents reported they were interested in the course because they wanted ideas and advice about PA, because they specifically wanted to help their child or because they felt it would help them with other areas of concern (e.g. parenting skills).
“Well we've got quite a big family erm I mean I'm open to pretty much any idea that would help them be more … because when they're well exercised and stuff they're calmer. And calmer kids is all good by me” (023 Mother, Low-SES)
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“Yeah, I would, I’d quite like learn things, to find out what is around and about that you can use.” (029 Mother, Low-SES)
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“Yes, yeah, very interesting, yeah. Because if you’ve got a lot of, you know, children as mine, they are not doing enough, you know, PA and stuff.” (017 Father, Middle-SES)
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Barriers to attending a parenting course
As the parenting course would be attended only by parents without their children the majority of parents considered childcare to be a barrier to attending a parenting course:
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“Just the childcare, that’s the only thing, barriers of who would look after the kids.” (002 Mother, Middle-SES)“
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“..if it was after school and I’d have to bring all 4 of the kids, or. ..I’d have to sort out someone to look after my kids” (007 Mother, Middle- SES)
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For some parents, childcare would only present as a barrier if both parents were to attend.
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“But only if there was childcare provided (could we attend), because otherwise we’d be stuck where they’d only be one of us able to do it.” (028 Mother, Low-SES)
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Other barriers that parents reported were being busy, other commitments (including work) and financial cost for some.
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“the obstacles that you’ll probably come across with most parents is that they do stuff with their kids, i.e. swimming lessons …because when you’re trying to sort of arrange things with other parents it’s ‘oh no, we’ve got ballet tomorrow’.” (001 Mother, Middle-SES)
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“…obviously we have got a lot of commitments in the evening … I think probably my only personal problem is whether I am free.” (016 Mother, Middle-SES)
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“…because I’m looking into getting a part time job so for me it would depend on what I’m working and stuff.” (020 Mother, Low-SES)
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“…money is quite an issue as well, with sort of, if you get the bus and everything, you’re talking £7.50 for me and [child’s name].” (022 Mother, Low-SES)
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Facilitators to attending a parenting course
Common facilitators were offering free lunch/refreshments and the social aspect of attending a parenting course. In particular, social support and making new friends were noted by parents.
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“..obviously if you make friends with someone at a group and they’re five minutes down the road you could both meet up with your kids and go off and do stuff. (018 Mother, Low-SES)
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“I think it probably would be quite good to meet other people … I can’t be the only person that … feels like they need to do a little bit more.” (020 Mother, Low-SES)
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Recruitment materials
Some parents mentioned that they would need to feel that the course would be appropriate for them by assessing their goals or needs. It would be important to address this in the promotional material.
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“I’d need to have some sort of, expectation… sort of aim or goal before …” (009 Mother, Middle-SES)
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“…I think there is a danger that, you know that there … it’s just geared up towards, as I say, children who appear obese.” (015 Mother, Middle-SES)
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Locations for advertising
The most commonly cited location for promotion of a parenting course was schools, possibly using face to face recruitment:
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“Yeah, but also you kind of always try and read everything from the school you don’t know… it might affect your kids.” (014 Mother, Middle-SES)
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“Schools are fantastic, yeah schools are fantastic, because then it goes straight to the child, hopefully then if it goes through.” (027 Mother, Low-SES)
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“Oh it is always the best way to go through the schools to get through to the parents…whereas half the time if you just send out leaflets and stuff and not see them face-to-face the chances of getting them is very difficult, whereas if they actually have contact with you and they feel at ease with you, then they don’t mind so much.” (011 Mother, Middle-SES)
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Other suggestions for promotion included children’s centres or nurseries, healthcare surgeries and local projects.
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“I know that I always look at the adverts in places like doctors’ surgeries, dentists and playgroups, cafes. Even like the local coffee shops that you have got around sort of areas, you know people pick up leaflets from there.” (016 Mother, Middle-SES)
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Preferences for course content – learning approach and topics to be covered
Receiving advice was valued by most parents, and this took two forms: advice from experts and advice from other parents. The majority of parents reported that sharing ideas and learning from the experience of others would be important.
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“I suppose until I’ve really done one I wouldn’t really know but I just, I do like the idea of you know talking with other parents because they’re living it.” (001 Mother, Middle SES)
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“You learn a lot from other parents so I would definitely value that” (003 Mother, Middle SES)
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“I just think that you know, bouncing ideas off everybody, you know if it’s just me it’s not, you know you just hear my point of view, you’re not hearing all the other people, it’s always more heads are better than one.” (001 Mother, Middle-SES)
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“I prefer a group, then you pick up on people’s ideas because I might not have thought of something you know” (019 Mother, Low-SES)
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The inclusion of professional or expert advice and workshops/demonstrations was also valued.
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“… like obviously the professionals… Because they’ve obviously been there, done it, got the t-shirt sort of thing.” (018 Mother, Low-SES)
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“It’s obviously great to have the professional input, but to hear on a more practical level what has worked for others you know, it could well be something that you hadn’t thought of, something so sort of simple.” (027 Mother, Low-SES)
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Parents also talked about their preference for topics to cover in the course. Some parents described how they would benefit from knowing what would be appropriate types and quantities of PA for their children.
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“..it would be interesting to know what, you know, the experts think about well what’s the right amount of exercise…” (001 Mother, Middle-SES)
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“So what things do you normally do that could actually qualify as exercise and how much more would you have to do to sort of take them over a boundary…” (003 Mother, Middle-SES)
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Most parents said that they would like more ideas of activities to do with their child with a particular interest in low costs ideas as well as ideas for being active in bad weather, limited space and limited time.
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“..some play thing that might be easier to do in a sort of small space and that’s not organised but can be done sort of in you know ten or twenty minutes just to keep you sort of ticking over” (004 Mother, Middle-SES)
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“A sheet full of ideas and things that you can do, places that you can go that don’t cost money and where you kids can get some exercise” (028 Mother, Low-SES)
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Other parental suggestions included content on healthy eating, help with scheduling and planning PA and motivating their children to do more PA.
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“For me personally it would be more … making my son understanding how important it is. You know, us as parents, we spend a long time saying like, it’s good to do this. But instilling that into them would … would be good” (020 Mother, Low-SES)
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“It would be nice to know how to plan, I have a major problem with planning ..” (023 Mother, Low SES)
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Preferred delivery style
The majority of parents reported that they would prefer a group-based approach as it was perceived to provide opportunities for sharing ideas and learning from others.
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“I’m not normally a group working person, but this sort of thing you know, where you can sort of share ideas and, well even if you haven’t got any view, just to be able to sort of learn from others.” (027 Mother, Low-SES)
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Many parents talked about benefiting from the social support offered through a group. In addition, parents frequently cited feeling more comfortable in a group session and feeling less isolated.
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“If you make friends with someone at a group and they’re five minutes down the road you could both meet up with your kids and go off and do stuff……And obviously if you’re, if you’re, if you are finding it really tough obviously to get the kids out then you’ve got the emotional support there from other parents….” (018 Mother, Low-SES)
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Making new friends and meeting new people were important aspects of the group approach for some parents.
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“..it is an easy way to meet other people as well.”(007 Mother, Middle-SES)
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Session frequency, length, duration and timing
In response to the question about the desired course duration the participants indicated that four sessions was preferred because this number seemed achievable for families, but was also long enough for parents to feel involved:
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“No, I think that (4–5 sessions) would be perfect, that’s enough to keep them interested but you know not enough to sort of you know where it’s too much.” (021 Mother, Low-SES)
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Parents gave similar rationales for their preferences for weekly sessions of about 90 minutes. A regular slot is more likely to be remembered:
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“I think weekly, personally I’ve found weekly is a big commitment but you get more benefit, if it’s two or three weeks sometimes people forget, you know.”(005 Father, Middle-SES)
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“Yes I think it should so people get into the habit, oh every Thursday this is going to be on for the next five weeks…..” (006 Mother, Middle-SES)
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An hour and a half was felt to allow time to settle in, and to discuss material in depth:
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“Because when people arrive they tend to sort of be fidgeting around and sitting and maybe chatting with other people, so you know, you need that. Whenever I go to things they’re always like an hour and a quarter because there’s always that little bit at the beginning…” (001 Mum, Middle-SES)
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“No I think that’s quite good [90 minutes] because once you get in, everyone says I'm here that’s 10 minutes gone isn't it?” (023 Mother, Low-SES)
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A small number of parents, all in the Middle SES area, said they would prefer more than 5 sessions, one commented that this was because child care commitment would be difficult to alter for a short period of time.
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“….there’s nothing worse, you can’t really alter your child care commitments if it’s just for about four weeks …” (003 Mother, Middle-SES)
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Parents in both locations gave similar preferences to the time of the day of the session, and in all cases these were related to practical difficulties of attending rather than affective factors. Most parents said that the daytime would be preferable, and a smaller number said that the evening would be most suitable. Daytimes were felt to fit better around flexible work patterns and because school aged children would be at school.
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“Once children are in school you’ve got that school time” (010 Father, Middle-SES)
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Parents who regarded evenings to be most suitable, explained their preference due to work commitments in the day or because they would be looking after young children in the day.
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“Because I work it would be evening definitely.” (002 Mother, Middle-SES)
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Overall it is noticeable that the interviews indicate that the parents were very much focussed on the logistical issues associated with attending a physical activity parenting programme with less focus on how to actually increase children’s physical activity.
Quantitative data
The survey was live for a total of 4 weeks and 750 responses were recorded. Demographic characteristics of the survey respondents are presented in Table
1. The sample was predominately female (97.5%) and most were working full or part time (63%) and had stayed in education at least through further education (97.5%). The age ranged between 19 and 57 years of age (mean =35.5, SD = 6.0).
Table 1
Demographic characteristics of survey respondents (n = 750)
Age (years)
| 35.5 | 6.0 |
Gender
|
N
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%
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Male | 8 | 1.1 |
Female | 731 | 97.5 |
Missing
| 11 | 1.5 |
Current employment status
| | |
Full-time employed | 157 | 20.9 |
Part-time employed | 316 | 42.1 |
Housewife/husband | 231 | 30.8 |
Student | 23 | 3.1 |
Unemployed | 23 | 3.1 |
Highest education in household
| | |
Did not complete secondary school | 19 | 2.5 |
GCSE or GNVQ1,2
| 177 | 23.6 |
A Levels/Advanced GNVQ | 213 | 28.4 |
University degree | 212 | 28.3 |
Postgraduate degree | 129 | 17.2 |
The frequencies of responses on the perceived importance of factors that might affect recruitment into a parenting course are presented in Table
2. In common with the qualitative data, practical constraints to attending were most important to parents. The single most important factors for parents was the timing of classes, with 89% of the sample reporting that this was very important. Over half of the respondents perceived that the time and dates of classes were very important when deciding whether to take part in a course. The provision of childcare was important to 62.9% of participants. The content of classes mattered to most parents with 56.9% reporting it was very important. Most parents were not concerned about who else would attend the group (75.5% not/not important at all) but rather with who would lead it (62.5% not/not important at all).
Table 2
Frequencies of responses on importance of factors affecting recruitment to physical activity parenting programme (n = 750)
Time of classes
| 665 | 88.7 | 80 | 10.7 | 4 | 0.5 | 1 | 0.1 |
Dates of classes
| 399 | 53.2 | 276 | 36.8 | 69 | 9.2 | 6 | 0.8 |
Knowing who will be leading the classes
| 116 | 15.5 | 358 | 47.7 | 251 | 33.5 | 25 | 3.3 |
Description of classes
| 427 | 56.9 | 313 | 41.7 | 9 | 1.2 | 1 | 0.1 |
Who else will be in the group
| 37 | 4.9 | 147 | 19.6 | 480 | 64.0 | 86 | 11.5 |
Who the classes are organised by
| 104 | 13.9 | 370 | 49.3 | 243 | 32.4 | 33 | 4.4 |
Childcare provision
| 225 | 30.0 | 247 | 32.9 | 214 | 28.5 | 64 | 8.5 |
The frequency of responses on the extent to which parents might pay attention to different recruitment methods are presented in Table
3. Over 90% of parents reported that they always pay attention to a letter home from school while over 80% of parents reported that they always or often pay attention to someone at school. Similarly, over 90% of parents reported that they always or often pay attention to “word of mouth”.
Table 3
Frequencies of responses on importance of salience of recruitment methods
School – letter home | 686 | 91.5 | 57 | 7.6 | 3 | 0.4 | 4 | 0.5 |
School – information on a board | 84 | 11.2 | 342 | 45.6 | 289 | 38.5 | 35 | 4.7 |
Someone at school (i.e. teacher or assistant) | 250 | 33.3 | 386 | 51.5 | 105 | 14.0 | 9 | 1.2 |
Posters/flyers in local places (i.e. church hall, sport centre) | 73 | 9.7 | 389 | 51.9 | 272 | 36.3 | 16 | 2.1 |
Health professional (i.e. nurse, community worker) | 112 | 14.9 | 291 | 38.8 | 283 | 37.7 | 64 | 8.5 |
Advert/feature in local paper | 88 | 11.7 | 371 | 49.5 | 254 | 33.9 | 37 | 4.9 |
Word of mouth | 268 | 35.7 | 436 | 58.1 | 41 | 5.5 | 5 | 0.7 |
The perceived value of possible options for participants assigned to a control group within a controlled trial of a PA parenting course are presented in Table
4. The most preferred option was the opportunity to attend the same course at a later date followed by a voucher for a local sports class. The two sources of data had good agreement, parents reported similar factors as important in both interviews and in an online questionnaire. A summary of the key findings from the two sources of data and the implications of those findings for the development of a PA/SV parenting intervention is presented in Table
5.
Table 4
Frequencies of responses on the value of control group provision for a parenting intervention
There was a chance to attend the same programme at a later date | 441 | 58.8 | 296 | 39.5 | 11 | 1.5 | 2 | 0.3 |
At the end of the programme there was the chance to attend 1 day programme instead | 173 | 23.1 | 447 | 59.6 | 118 | 15.7 | 12 | 1.6 |
At the end of the study all of the materials were provided but there were no classes | 114 | 15.2 | 309 | 41.2 | 277 | 36.9 | 50 | 6.7 |
At the end of the study a voucher for local sport classes was provided | 295 | 39.3 | 319 | 42.5 | 106 | 14.1 | 30 | 4.0 |
Table 5
Implications of the user-group engagement and developmental research findings for the design of a PA/SV parenting intervention
Facilitators and barriers
Childcare needs Timing - not afterschool - finding free time to attend Costs of travel to intervention sessions Social aspects of course - desire for group sessions - meeting friends on course - emotional support from group | Provision of free child care for parents attending intervention sessions Participants given option of attending daytime course while children are at school or evening course. Intervention delivered in multiple locations close to sampling area to minimise the need to travel Group-based course Focus on sharing experiences |
Recruitment
Programme expectations/marketing/description of sessions Time of sessions Location/methods - Schools - Known contact at child’s school - Face-to-face at schools - Coffee shops, leafleting etc. - Word of mouth | Recruitment materials (i.e., leaflets, posters, website, online advertising) designed to include key information reported to influence decision to enrol and aligned with the desired content as outlined below (e.g., social/group sessions, key topics covered and length of sessions). Varied and wide-reaching recruitment campaign including; letters to parents via schools, coffee mornings at schools and children’s centres, attendance at afterschool activities, family events, parent-toddler groups, stall at school fetes, meeting parents directly at schools, liaison with key community members, study website, posters and fliers in local venues and press releases. |
Intervention Content & learning methods
- what “counts” as exercise - ideas for active play/unstructured activity - ideas of where to go for free to be active - planning for PA - communicating about activity with children - encouraging child’s motivation | All desired content was incorporated in to the sessions. (e.g., Session 1: what counts as PA; Session 2: active play; Session 3: communication; Session 4 encouraging motivation; Session 7: Planning for PA - Dedicated time for parent feedback on parenting techniques attempted in the previous week - Significant time dedicated to practical advice. Take home guides on “putting it into practice” - Time given each week for parents to talk about their own experiences to support peer learning. |
Learning methods
- learning from other parents - professional advice - practical advice | - Development of an Activity Directory providing ideas of physical activity opportunities |