Ethics
Ethical approval for this study was granted by the Cambridge Psychology Research Ethics Committee (University of Cambridge, Application No: Pre.2013.119). All subsequent study amendments were reviewed and approved. Written (parental) consent was obtained for all participants, and child participants provided written assent.
Pilot
A pilot focus group, using a convenience sample, was conducted to refine the study protocol. All procedures from recruitment through to data analysis were tested; pilot participants provided feedback, which was then used to improve each process. Data obtained in the pilot focus group was not included in the final study sample.
Recruitment
Families (including a ‘target’ child aged between 8 and 11 years, their primary caregiver(s) (hereafter referred to as ‘parents’), siblings, and others involved in their care) were recruited through schools and community groups (e.g., scout/guide groups) in the wider Cambridgeshire area. Particular effort was made to contact schools and community groups (through which to deliver recruitment materials) that were located in areas representing all levels of socio-economic status. Initial letters and posters invited families to contact the study team to express their interest in participation. The study co-ordinator spoke with parents on the telephone, answered any questions, and obtained a postal and/or email addresses for further correspondence. Recruitment packets were then sent to families via their preferred method (i.e., postal or email), containing (i) a personalised cover letter, (ii) full study information with a list of frequently asked questions, (iii) written consent forms, and (iv) a brief data collection form. Personalised letters have been shown to elicit greater initial response [10], and therefore children’s, parent’s and sibling’s names were included in all correspondence. Once consent had been provided, appointments were scheduled to include all family members.
Data collection procedures
Basic demographic and anthropometric data (age, sex, height, and weight) of those agreeing to participate were collected using the brief data collection form.
Focus groups were conducted in participants’ homes, mostly during the evening (to ensure all family members were available to participate). A semi-structured interview approach was used. An introductory activity was used as an ‘ice-breaker; participants were asked to share their favourite physical and non-physical activities. This encouraged each family member, along with researchers, to build rapport and ensured participants felt comfortable contributing to the discussion.
Families were then asked to order cards listing the possible benefits of, and the barriers to, being involved in physical activity research. These cards were used as prompts only (developed using feedback from our pilot focus group), and were not designed to provide an exhaustive list. They were asked to highlight the items they consider most relevant, and suggest additional items. Health, social, and educational benefits were listed, as well as the provision of child care, connection with other families, and incentives. Barriers included increased time commitment and/or scheduling clashes, difficulties with transport, financial commitment, and a lack of interest or perceived benefit. Participants were asked to explain their choices (i.e., items highlighted as being of most importance), discuss conflicting opinions, and supplement the list with additional items relevant to their family. Follow-up probes were used by the facilitator (HEB) to encourage further discussion. A second researcher (AS) recorded participant responses (particularly when ordering the cards) and noted family interactions. At the end of the session, AS provided families with a summary of the discussion, offering them a chance to elaborate or add to previous answers. Two digital voice recorders were used to record the session.
Follow-up
All individual participants were provided with a £5 gift voucher and were contacted later with individual feedback on their session, and some interim results.
Data analysis
Demographic data were recorded from the participant questionnaires. The postcode of each family home was used to classify according to socio-economic deprivation. Families were ranked according to social deprivation percentile (those ranked in the higher percentiles represent families of higher socio-economic status compared with the rest of the UK) [11].
Interviews were transcribed verbatim and anonymised by an external data transcription service. Data was then analysed thematically; two members of the study team (HEB and AS) independently read transcripts to identify emerging themes and develop a coding framework [12]. Once complete, the coding frame was provisionally tested with a 10 % sample of transcripts. Discrepancies were discussed, and the coding frame refined (on the basis of both theoretical issues guiding the research questions, and salient issues arising from the transcripts) [12]. Quotations were then clustered around broader themes and these themes were merged or altered where appropriate. Additionally, observer notes (recorded during the focus groups) were coded, and a quantitative count of the ‘card order’ (i.e., the order in which facilitators and barriers were listed by participants) was noted.
All data from the focus groups was recorded and considered, but the main aim of the present analysis was to identify effective recruitment and retention strategies for engaging families in physical activity interventions. Given the complexity of family context and relationships, family case studies were also written (combining demographic information, coded interview transcripts, and observer notes). This more detailed narrative aimed to offer further insight into the potential incentives for and barriers to research participation.