Feasibility of integrating an exercise specialist supported by mHealth technology to increase exercise and physical activity adherence in a Complications from Excess Weight Service: MOTIVATE-CEW

Introduction: To address the increasing prevalence of childhood obesity NHS England has established 21 Complications of Excess Weight (CEW) services. Despite physical activity (PA) and exercise forming cornerstones of successful weight management programmes CEW services do not include specialists in the delivery of PA or exercise. Aim: To assess the feasibility of embedding an mHealth supported PA and exercise intervention, led by an exercise specialist, to a CEW service. Methods: A 12-week feasibility, parallel group, randomised control trial was conducted in 23 obese adolescents receiving care from the Alder Hey Children’s Hospital (AHCH) CEW service. Participants randomised to usual care continued with the CEW service and the MOTIVATE-CEW group received usual care alongside an mHealth supported exercise and PA intervention. A process evaluation assessed reach, dose and fidelity and preliminary effectiveness was measured (health related quality of life (HRQOL), body composition and cardiovascular disease risk factors). Results: 45% of eligible participants were recruited and 87% completed post-intervention assessments. Recruited participants shared similar demographics to the AHCH CEW service cohort in terms of age, sex and deprivation. Large effect sizes favouring MOTIVATE-CEW were shown for device derived number of exercise session (d=1.02) and mean time spent exercising (d= 0.97). Data availability for in-clinic outcomes was good (≥85%), but adherence to wear time criteria for PA (GENEActiv 43%, ActivPAL 41%) and flash glucose (35%) monitors was poor. Conclusion: The MOTIVATE-CEW intervention showed promising effects on exercise behaviour. Good reach and data availability suggests the study design could be feasible within future trials