Feasibility of an acceptance and commitment therapy-based intervention for the promotion of physical activity in parents with young children
Date
2025
Authors
Barton, Joe
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Abstract
Background: Parents with children under the age of six experience lower levels of physical activity (PA) compared to the general population. The transition to parenthood brings with it an increase in incidental affect such as fatigue and anxiety, as well as an increased workload. Acceptance and Commitment Therapy (ACT) has been shown to improve the initiation and maintenance of physical activity. However, no research has applied ACT to PA promotion in parents with children under six.
Purpose: This study aimed to evaluate the feasibility of a 6-week mobile app PA intervention based on ACT for parents with children under six, compared to an active control group, receiving health information about PA. The Multi-Process Action Control (M-PAC) framework was used to further guide the structure and components of the mobile app. Primary outcomes were recruitment, retention, and acceptability of the intervention. Secondary outcomes explored changes in PA, ACT constructs (PA-related experiential acceptance, cognitive defusion, and valued living), and M-PAC constructs (affective and instrumental attitudes towards PA, perceived opportunity for and perceived capability over PA, PA identity, and habit of PA).
Methods: A mixed-methods, randomized feasibility trial was conducted with parents with a child under the age of six who engaged in a 6-week ACT-based mHealth intervention. Participants were randomized (1:1) to the intervention or control group. The intervention group completed 7 app modules, with accompanying worksheets, based on ACT. The control group received the Canadian 24-Hour Movement guidelines. Measurement was taken at baseline and at 6-week follow-up using a modified Godin Leisure-Time Exercise Questionnaire (GLTEQ), the M-PAC battery, PA Acceptance Questionnaire (PAAQ), Drexel Defusion Scale (DDS), and Valuing Questionnaire (VQ). The intervention group also completed the mHealth Satisfaction Questionnaire (MSQ), mHealth App Usability Questionnaire (MAUQ), and exit interviews at 6- week follow-up. Independent samples t-tests and one-way ANCOVAs were used for the quantitative analysis, and reflexive thematic analysis of exit interviews was conducted for the qualitative analysis.
Results: The study met progression criteria for retention (78.46%) and engagement (71.43%), but not recruitment (22.87%). MSQ and MAUQ scores indicated adequate acceptability (M = 3.43/5; M = 4.29/7). Qualitative findings showed overall enjoyment of the intervention, with some recommendations for change, such as incorporating the worksheets into the app. There was no difference in PA (partial eta-squared = 0.00). Most effect sizes for ACT and M-PAC constructs were small or negligible, with medium effects trending towards the control for affective attitude towards PA (partial eta-squared = 0.07) and trending towards the intervention for habit of PA (partial eta-squared = 0.06).
Conclusion: Feasibility outcomes were positive and suggest a full-scale trial is feasible with a longer study period and minor changes to the intervention content (e.g., more in-depth content, increased M-PAC focus, incorporation of social/environmental components) and delivery (e.g., integrating worksheets within the app, adding a second check-in meeting, adding module release reminders) to improve engagement and retention.
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Keywords
Acceptance and commitment therapy, Physical activity, mHealth, Feasibility