Exploring physical literacy in chronic disease participants: development and effects of a pilot intervention

Aim of the study: Our study aimed to develop and assess the effect of a physical literacy intervention led by a physical educator, in medical center-setting, addressed to chronic disease participants.
Methods: This mixed-method study was composed of a qualitative and a quantitative part. The qualitative arm explored the feasibility of the intervention, by conducting 20 semi-structured interviews with chronic disease participants (10), health-care professionals (8) and external stakeholders (2). Sub-themes were highlighted and grouped into meaning units before qualitative analysis. The quantitative arm explored the effect of the physical literacy intervention (PL). Participants were referred to the program by doctors or physiotherapists of the medical center. The intervention consisted in an assessment and counselling session with a physical educator. Each session followed a motivational interviewing technique and consisted of (1) an anamnesis (2) a 40-item questionnaire PL assessment divided into the psychological, social and cognitive domain of PL; (3) 4 physical tests to assess the physical domain of PL; (4) a patient-centered discussion including feedback of the results and the setting of SMART individual goals.
Results: Analysis of the interviews highlighted the enthusiasm and conviction of the participants regarding the PL intervention, but also the importance of communication between PL stakeholders, medical center professionals and community members to promote PL in a broader perspective. A total of 108 patients with at least one chronic disease (71% female, 56±15 years) underwent one PL session with the physical educator, with 46 patients (74% female, 61±13 years) completing two sessions (46 days later on average). Significant improvements were demonstrated for the overall PL score (p<0,001) as well as the cognitive (p=0,001) and physical domains (p=0,032). No significant changes were found for the psychological and social domain. Additionally, no significant difference in changes were found based on age, sex or nature of the chronic disease.
Conclusion: The study indicates that physical literacy interventions, facilitated by a physical educator in a medical center setting, are both feasible and effective for chronic disease participants. These promising results suggest the potential for such interventions to positively impact health outcomes by expanding and promoting the role of physical educators in health-settings.