Identifying and prioritising strategies to optimise community gym participation for young adults with cerebral palsy: an e-Delphi study

Identify and prioritise strategies to optimise physical activity participation in the community gym setting for young adults with cerebral palsy. An e-Delphi method was implemented over three rounds with four stakeholder groups (young adults with cerebral palsy, their families, gym staff or exercise professionals, and health professionals). Strategies for change were identified by the stakeholders in round 1. In rounds 2 and 3, strategies for change were rated on the importance for implementation using a 7-point Likert scale (1 being lowest importance, 7 being highest). The consensus was achieved if ≥70% of participants identified a strategy as high importance. Seventy participants (20 young adults 10 family members, 21 health professionals, and 19 exercise professionals) identified 83 strategies for improving gym participation. Of these, 44 strategies met the consensus criteria. The highest priority strategies related to changing the physical environment, addressing cost barriers, gym staff training, and developing partnerships between sectors. Addressing physical accessibility, cost of attendance and the skills of gym staff were agreed upon by the stakeholder groups as priority areas for future resource allocation and research translation. Clinicians and community leisure facilities must work with consumers to implement strategies in their local contexts. The physical environment, gym staff training, and the cost of attendance are the priority areas for future interventions agreed on by key stakeholder groupsHealth professionals can facilitate community participation by partnering with the recreation and research sectors to create pathways to gym exerciseHealth professionals can play a role in developing the knowledge, skills and confidence of gym staff to support young people with cerebral palsy in the gymWhen implementing 1:1 social support in community gym settings, consider the preferences of young adults and the resources available The physical environment, gym staff training, and the cost of attendance are the priority areas for future interventions agreed on by key stakeholder groups Health professionals can facilitate community participation by partnering with the recreation and research sectors to create pathways to gym exercise Health professionals can play a role in developing the knowledge, skills and confidence of gym staff to support young people with cerebral palsy in the gym When implementing 1:1 social support in community gym settings, consider the preferences of young adults and the resources available

本研究旨在识别并优先排序针对脑瘫青年群体、优化其社区健身房体育参与度的相关策略。
研究采用三轮电子德尔菲法(e-Delphi method)，纳入四类利益相关者群体：脑瘫青年、其家属、健身房员工或运动专业人士，以及健康专业人士。
第一轮由利益相关者提出变革策略；第二、三轮则通过7点李克特量表(Likert scale)对变革策略的实施重要性进行评级（1分代表最低重要性，7分代表最高重要性）。当≥70%的参与者将某一策略评定为高重要性时，即视为达成共识。
本次研究共招募70名参与者（20名脑瘫青年、10名家属、21名健康专业人士及19名运动专业人士），共提出83项用于提升健身房体育参与度的策略，其中44项策略符合共识标准。
优先级最高的策略涉及改善物理环境、解决成本障碍、开展健身房员工培训，以及建立跨部门合作关系。四类利益相关者一致认为，改善物理无障碍条件、降低参与成本、提升健身房员工技能，是未来资源分配与研究转化的优先领域。
临床医生与社区休闲设施运营方需联合服务对象，在本地场景落地相关策略。物理环境优化、健身房员工培训与参与成本控制，是核心利益相关群体共识的未来干预优先领域；健康专业人士可通过与休闲及研究部门合作，搭建健身房运动参与通路，以促进脑瘫青年的社区体育参与；健康专业人士可助力提升健身房员工的专业知识、技能与服务信心，从而为在健身房活动的脑瘫青年提供支持；在社区健身房场景中开展1对1社会支持服务时，需充分考量脑瘫青年的个体偏好与可用资源。