Move to Improve: Co-Designing a Hospital-Based Physical Activity Program for Children With Chronic Health Conditions.

Five interrelated themes were identified from co-design workshops with children with chronic health conditions and their parents.

• Themes highlighted the importance of family-led and goal-oriented approaches, individualised programme design, enjoyment, confidence building, and support for transition to community-based physical activity.
• Data were analysed using reflexive thematic analysis.
• Four online co-design workshops were conducted using a participatory and collaborative approach.
• Participants included children living with chronic health conditions and their parents.

The co-design process informed the development of a structured protocol incorporating evidence-based strategies aligned with families' priorities.

• Strategies included goal setting at the start of the programme and goal review at the end of the programme.
• Additional strategies included skill building and education on self-management of the condition across the duration of the programme.
• The protocol was developed for the Move to Improve clinical service at Perth Children's Hospital.
• The protocol is described as 'a clinically relevant and scalable model for supporting physical activity participation among children with chronic health conditions within hospital-based services.'

Family-centred and tailored programme design was identified as essential to support sustained engagement in physical activity among children with chronic health conditions.

• Findings 'underscore the need for family-centred and tailored programmes that support sustained engagement in physical activity.'
• Family-led approaches and individualised programme design were among the five key themes identified.
• Children and parents' input 'directly informed and shaped key elements of the Move to Improve protocol, including programme structure, content and delivery strategies.'

Support for transition to community-based physical activity was identified as an important component of the programme.

• Transition support was one of five interrelated themes identified through reflexive thematic analysis.
• The programme was designed as a hospital-based service at Perth Children's Hospital, with community transition as an explicit programme goal.
• The protocol addresses the need to move children from hospital-based to community-based physical activity participation.

Physical activity programmes for children with chronic health conditions must be tailored to their specific needs to support participation.

• Physical activity can support both physical and mental health among children living with chronic health conditions.
• The study was motivated by the need for programmes tailored to the specific needs of this population.
• An online co-design methodology was chosen to engage children with chronic health conditions and their parents in programme development.