Willis C E, Reid S, Elliott C, Rosenberg M, Nyquist A, Jahnsen R, Girdler S
School of Sport Science, Exercise and Health, The University of Western Australia, M408 35 Stirling Hwy, Perth, WA, 6008, Australia.
Department of Paediatric Rehabilitation, Child and Adolescent Health Service, 37-39 Hay St, Perth, WA, 6008, Australia.
BMC Pediatr. 2018 Mar 15;18(1):113. doi: 10.1186/s12887-018-1089-8.
The need to identify strategies that facilitate involvement in physical activity for children and youth with disabilities is recognised as an urgent priority. This study aimed to describe the association between context, mechanisms and outcome(s) of a participation-focused physical activity intervention to understand what works, in what conditions, and how.
This study was designed as a realist evaluation. Participant recruitment occurred through purposive and theoretical sampling of children and parents participating in the Local Environment Model intervention at Beitostolen Healthsports Centre in Norway. Ethnographic methods comprising participant observation, interviews, and focus groups were employed over 15 weeks in the field. Data analysis was completed using the context-mechanism-outcome framework of realist evaluation. Context-mechanism-outcome connections were generated empirically from the data to create a model to indicate how the program activated mechanisms within the program context, to enable participation in physical activity.
Thirty one children with a range of disabilities (mean age 12y 6 m (SD 2y 2 m); 18 males) and their parents (n = 44; 26 mothers and 18 fathers) participated in the study. Following data synthesis, a refined program theory comprising four context themes, five mechanisms, and six outcomes, were identified. The mechanisms (choice, fun, friends, specialised health professionals, and time) were activated in a context that was safe, social, learning-based and family-centred, to elicit outcomes across all levels of the International Classification of Functioning, Disability and Health.
The interaction of mechanisms and context as a whole facilitated meaningful outcomes for children and youth with disabilities, and their parents. Whilst optimising participation in physical activity is a primary outcome of the Local Environment Model, the refined program theory suggests the participation-focused approach may act as a catalyst to promote a range of outcomes. Findings from this study may inform future interventions attempting to enable participation in physical activity for children and youth with disabilities.
识别促进残疾儿童和青少年参与体育活动的策略的需求被视为一项紧迫的优先事项。本研究旨在描述以参与为重点的体育活动干预的背景、机制和结果之间的关联，以了解什么有效、在什么条件下有效以及如何有效。
本研究设计为一项现实主义评价。通过对在挪威贝托斯托伦健康运动中心参与当地环境模式干预的儿童和家长进行目的抽样和理论抽样来招募参与者。在实地进行了为期15周的民族志研究方法，包括参与观察、访谈和焦点小组。使用现实主义评价的背景-机制-结果框架完成数据分析。从数据中实证生成背景-机制-结果联系，以创建一个模型，表明该项目如何在项目背景中激活机制，以促进参与体育活动。
31名患有各种残疾的儿童（平均年龄12岁6个月（标准差2岁2个月）；18名男性）及其家长（n = 44；26名母亲和18名父亲）参与了该研究。经过数据综合，确定了一个完善的项目理论，包括四个背景主题、五个机制和六个结果。这些机制（选择、乐趣、朋友、专业健康专业人员和时间）在一个安全、社交、基于学习且以家庭为中心的背景中被激活，以在《国际功能、残疾和健康分类》的各个层面产生结果。
机制与背景的整体相互作用为残疾儿童和青少年及其家长带来了有意义的结果。虽然优化体育活动参与是当地环境模式的主要结果，但完善的项目理论表明，以参与为重点的方法可能成为促进一系列结果的催化剂。本研究的结果可能为未来旨在使残疾儿童和青少年参与体育活动的干预措施提供参考。
