Free Time 4 Wellness - SUMMARY Physical inactivity is a significant contributor to risk of chronic diseases and poor health. This relationship is particularly salient for women of low socioeconomic position in the US, for which >60% do not reach the recommended guidelines of at least 150 minutes of moderate physical activity each week. Prior research has documented barriers to physical activity for this population, including individual factors (e.g., limited time, insufficient funds for gym memberships or daycare) and community-level factors (e.g., traditional gender roles, limited access to recreation space). Prior attempts to increase physical activity have generally targeted individuals, with only modest results. To increase physical activity among mothers living in low-resourced communities, innovative research to identify a multilevel intervention that is easily implemented at the community level and appropriate for mothers with little time is urgently needed. The increasing demands on mothers' time in a new pandemic era makes freely accessible childcare an attractive option. We successfully designed and piloted an innovative intervention to increase physical activity among mothers by combining fitness classes with free childcare and technology to connect and support mothers at the community level. This project will evaluate the effectiveness of our multilevel intervention, the Free Time for Wellness (FT4W) program. The conceptual framework for the FT4W program is based on social cognitive theory and the NIMHD Minority Health and Health Disparities Research Framework. The intervention includes: 1) free childcare at free fitness classes, and 2) peer support activities including group play dates and group volunteer activities. No prior health intervention has included these components that we hypothesize, separately or in combination, will increase physical activity, based on prior theory and pilot work. We will test the FT4W program as a mixed method, cluster randomized controlled trial conducted in community-based health centers serving racially minoritized and socioeconomically disadvantaged populations. Participants will be randomized to one of three arms: a control arm, a childcare only arm, or a childcare + peer support arm. The trial will evaluate: (1) the ability of FT4W to increase physical activity within 12 weeks as confirmed by accelerometers; (2) the potential mechanisms by which the FT4W program facilitates physical activity (e.g., environmental resources, social cohesion); and (3) potential differences in the magnitude of effect across intersecting social stratification parameters including race/ethnicity, socioeconomic position, and migration status. At the completion of our study, we will make the FT4W protocol freely available and work to scale the program in low-socioeconomic areas. The proposed project thus aims to introduce an effective multilevel intervention that is easily implemented in communities and appropriate for mothers with little time. This scalable intervention will help reduce the barriers that prevent mothers from participating in physical activity, preventing future high rates of chronic diseases associated with inactivity.
