Increasing participation in resistance training using outdoor gyms: A study protocol for the ecofit type III hybrid effectiveness implementation trial

Anna K Jansson; David R Lubans; Mitch J Duncan; Jordan J Smith; Adrian Bauman; John Attia; Sara L Robards; Emily R Cox; Sam Beacroft; Ronald C Plotnikoff

doi:10.1016/j.conctc.2024.101358

Increasing participation in resistance training using outdoor gyms: A study protocol for the ecofit type III hybrid effectiveness implementation trial

Contemp Clin Trials Commun. 2024 Aug 24:41:101358. doi: 10.1016/j.conctc.2024.101358. eCollection 2024 Oct.

Authors

Anna K Jansson^{1

2}, David R Lubans^{1

2

3}, Mitch J Duncan^{1

2

4}, Jordan J Smith^{1

2}, Adrian Bauman⁵, John Attia⁴, Sara L Robards¹, Emily R Cox^{1

2

6}, Sam Beacroft¹, Ronald C Plotnikoff^{1

2}

Affiliations

¹ Centre for Active Living and Learning, School of Education, University of Newcastle, Callaghan, NSW, Australia.
² Active Living and Learning Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.
³ Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
⁴ School of Medicine and Public Health, University of Newcastle, Callaghan, Australia.
⁵ School of Public Health, University of Sydney, Camperdown, NSW, Australia.
⁶ School of Biomedical Sciences and Pharmacy, University of Newcastle, NSW, Australia.

Abstract

Background: In this paper we outline the protocol for an implementation-effectiveness trial of ecofit, a multi-component mHealth intervention aimed at increasing participation in resistance and aerobic physical activity using the outdoor built environment (i.e., outdoor gyms) and social support. We have previously demonstrated the efficacy and effectiveness of the ecofit program in insufficiently active people with (or at risk of) type 2 diabetes and community-dwelling adults, respectively. The objective of this trial is to compare the effects of two implementation support models (i.e., 'Low' versus 'Moderate') on the reach (primary outcome), uptake, dose received, impact and fidelity of the ecofit program.

Research design and methods: This hybrid type III implementation-effectiveness study will be evaluated using a two-arm randomized controlled trial, including 16 outdoor gym locations in two large regional municipalities in New South Wales, Australia. Outdoor gym locations will be pair-matched, based on an established socio-economic status consensus-based index (high versus low), and randomized to the 'Low' (i.e., ecofit app only) or 'Moderate' (i.e., ecofit app, face-to-face workout sessions and QR codes) implementation support group. The primary outcome of 'reach' will be measured using a modified version of the 'System for Observing Play and Recreation in Communities', capturing outdoor gym use amongst community members.

Conclusion: This implementation-effectiveness trial will evaluate the effects of different levels of implementation support on participation in resistance-focused physical activity using mHealth and outdoor gyms across the broader community. This may guide widespread dissemination for councils (municipalities) nation-wide wanting to promote outdoor gym usage.

Trial registry: This trial was preregistered with the Australian and New Zealand Clinical Trial Registry (ACTRN12624000261516).

Keywords: Outdoor gym; Physical activity; Resistance training; mhealth.