Effect and acceptability of co-created interventions linking public rehabilitation programs with civil society involvement for physical activity engagement - a convergent mixed methods pilot study

BackgroundPublic physical activity programs are time-limited and often lacking sufficient support for citizens to maintain physical activity engagement. In this project, municipal stakeholders; civil society organizations; citizens with type 2 diabetes (T2D), cardiovascular diseases (CVD), and/or obesity; and researchers were involved in the co-creation and implementation of interventions to support citizens in continuing physical activity engagement following a municipal rehabilitation program. The primary aim of this study was to investigate the effect of these interventions on physical activity engagement in civil society sports organizations. Secondary aims were to investigate acceptability and effect of these interventions on physical and mental health, and organizational development and collaboration. MethodsThis was a convergent mixed methods study using a quantitative prospective intervention study with a historic control group, and a qualitative descriptive study. These were analyzed separately and then integrated. Quantitative data from citizens were collected before; and 0, 3 and 6 months after ending their rehabilitation program. Outcomes included physical activity engagement in civil society organizations; and changes in objectively measured physical activity, physical and mental health. Qualitative data were collected among citizens, civil society, and municipal representatives. Themes included physical activity engagement, acceptability, and organizational development and collaboration. ResultsAmong the 33 included citizens (58% women, median (25th; 75th percentile) age of 67.6 (63.9; 74.1) years), six lived with T2D; nine with CVD; and 18 were obese. Of the 21 citizens who were not engaged in physical activities in civil society organizations before entering the rehabilitation program, 67% started and remained active at 6-month follow-up--significantly more than in the historic control group. Light physical activity increased by a mean (95% confidence interval) of 15.4 (2.3; 28.5) min/day from 0 to 6 months after the rehabilitation program; all other outcomes remained unchanged. This was assisted by experienced high acceptability of the linking interventions and strengthened collaboration between the municipal health center and civil society organizations. ConclusionsThe co-created interventions led to increased physical activity engagement in civil society organizations. This supports co-creation as a method to link municipal rehabilitation programs with physical activities in civil society organizations. Trial registrationClinicalTrials.gov: NCT05493345, 2022-08-05