Co-designing a physical activity intervention for low-income mothers of preschool-aged children with community leaders: a qualitative study

Background: Young children from low-income families experience disparities in school readiness that impact short and long-term health. Family physical activity co-participation is an interactive activity that may promote positive health and academic outcomes. The purpose of this study is to describe the process and outcomes of engaging with community leaders to co-design the Families Moving Together intervention for low-income mothers and their preschool-aged children. Methods: Five action planning sessions were conducted with community leaders, experts in physical activity, early learning, or engaging low-income families (i.e., families receiving housing assistance). The PRACTical planning for Implementation and Scale-up (PRACTIS) guide provided a framework for each session to address implementation and sustainability barriers and facilitators. Qualitative data were analyzed using the Framework Analysis method with inductive and deductive coding. Results: Action planning participants (N = 19) were aged 50 ± 13.4 years, mostly female (89%), and worked across several community organizations serving low-income mothers and children in an urban city in central Kentucky. Three core themes were identified from analyzing the transcripts. First, participants held shared values, such as respect and equity, that informed the intervention design process. Second, these core values provided a foundation for creating collaborative and sustainable solutions to achieve outcomes. Finally, participants described program design elements to remove barriers and increase facilitators. Through the action planning process, participants co-designed the core components of Families Moving Together, which included leading free family movement programs in the community and engaging trusted community members to deliver the intervention. The goal of this 6-month community-level intervention is to increase school readiness and health by engaging families in physical activity together. Conclusions: Community experts and the research team used the PRACTIS guide to co-design strategies to increase physical activity and school readiness that they perceived would enhance the likelihood of implementation and sustainability in the community. Participants underscored the importance of the co-design process that centers community representation and collaborative approaches to create, implement, and sustain programs in the local community. Researchers and community leaders serving low-income mothers and children in other settings may be able to replicate the action planning process to facilitate equitable health outcomes.