JMIR Publications

ABSTRACT

Background:

With rates of childhood obesity continually increasing, the need for effective physical activity (PA) and nutrition interventions are needed. Formative research is used to tailor interventions to different cultural and geographic contexts and can also be vital in adapting intervention strategies in the face of significant disruptive circumstances (like COVID-19).

Objective:

We conducted formative research among middle schoolers and parents to better understand barriers and facilitators to PA and fruit and vegetable (FV) consumption and inform the design of a large intervention for a low-income, urban setting in the U.S. Midwest.

Methods:

We conducted four qualitative focus groups with parents (n=20) and 6th-9th grade middle schoolers (n=22) before and during the COVID-19 pandemic. Focus groups were transcribed and thematically coded using Dedoose software.

Results:

Main facilitators to physical activity included the opportunity to have fun, peer influence, competition (for some), and incentives, which were similar pre-pandemic and amid the pandemic. Main barriers to physical activity were time constraints and social discomfort, yet lack of motivation and limited time spent outside of the home were additionally reported during the pandemic. In both time periods, main facilitators to eating FV included parental influence, preparation technique and convenience while barriers included dislike of vegetables, time constraints, and preparation or freshness. For some participants, the pandemic offered an opportunity to offer more FV to middle schoolers throughout the day.

Conclusions:

Some themes identified were common to those reported in previous studies, such as peer influence on PA and parental influence on FV consumption. Novel themes, such as lack of motivation to be active and limited time outside the home, helped improve intervention adaptation, specifically during the COVID-19 pandemic. The continuity of formative research after a major, unexpected change in intervention context can be essential in targeting areas of an intervention that can be retained and those that need to be adjusted.