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 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

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

本研究旨在确定并优先排序针对脑瘫（cerebral palsy）青年群体在社区健身房场景下优化体育活动参与度的相关策略。
研究采用三轮电子德尔菲法（e-Delphi），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。第一轮研究中，由利益相关者提出变革策略；第二、三轮研究中，采用7分李克特量表（Likert scale，1分代表最低重要性，7分代表最高重要性）对变革策略的实施重要性进行评级。若≥70%的参与者将某策略评定为高重要性，则视为该策略达成共识。
本次研究共纳入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项旨在优化健身房参与度的策略，其中44项策略符合共识标准。优先级最高的策略涉及改造物理环境、解决成本障碍、开展健身房员工培训，以及建立跨部门合作伙伴关系。
利益相关者群体一致认为，未来资源分配与研究转化的优先领域包括：解决物理可及性问题、降低参与成本，以及提升健身房员工技能。临床医生与社区休闲设施需与服务使用者协作，结合本地实际场景落地相关策略。

经核心利益相关者群体一致认可，物理环境改造、健身房员工培训及参与成本问题是未来干预措施的优先方向。
健康专业人士可通过与休闲及研究领域开展合作，搭建健身房运动参与路径，以推动社区体育活动参与。
健康专业人士可通过提升健身房员工的专业知识、技能与自信心，助力脑瘫青年在健身房开展活动。
在社区健身房场景中推行一对一社会支持时，需兼顾脑瘫青年的偏好与可用资源。

经核心利益相关者群体一致认可，物理环境改造、健身房员工培训及参与成本问题是未来干预措施的优先方向。
健康专业人士可通过与休闲及研究领域开展合作，搭建健身房运动参与路径，以推动社区体育活动参与。
健康专业人士可通过提升健身房员工的专业知识、技能与自信心，助力脑瘫青年在健身房开展活动。
在社区健身房场景中推行一对一社会支持时，需兼顾脑瘫青年的偏好与可用资源。