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It’s Not Just What You Do but the Way You Do It: A Systematic Review of Process Evaluation of Interventions to Improve Gross Motor Competence

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Abstract

Background

Motor competence is an important predictor of health behaviours. However, levels of motor competence are low in children and adolescents. Many interventions have improved motor competence, yet intervention effects were highly variable. Potential causes of such variations are not fully understood. Process evaluation can assist with the understanding of why an intervention worked or not, but its application and reporting in motor competence interventions has received little attention.

Objectives

The primary aim of this review was to investigate whether process evaluations have been reported in interventions to improve motor competence and, if reported, which process evaluation measures have been used. A secondary aim was to explore the association of intervention characteristics and process evaluation findings (outcomes of process evaluation measures) with intervention outcomes, in a search for what process evaluation measures may impact on intervention functioning and outcomes.

Methods

The process of conducting and reporting this review adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The review protocol was registered with PROSPERO (CRD42019124412). A systematic search of seven electronic databases (i.e. MEDLINE [via EBSCOhost], Cochrane Central Register of Controlled Trials [CENTRAL], CINAHL, Academic Search Complete, Education Database, SPORTDiscus and Scopus) was conducted with no date restrictions. Eligibility criteria included the following: (1) a study sample of typically developing children and adolescents aged 5–18 years, (2) an intervention aimed to improve motor competence, (3) an intervention included a control group, (4) a report of motor competence outcome at both pre- and post-intervention. Only original articles published in English in peer-reviewed journals were considered. Process evaluation measures and findings were extracted using the UK Medical Research Council’s process evaluation framework in order to provide overarching descriptions on the implementation, mechanism of change and context of interventions. Univariable meta-regressions were performed to ascertain whether selected study-level covariates moderated the improvement in motor competence outcomes in interventions.

Results

The search identified 60 intervention studies. Only 30 studies (50%) reported process evaluation measures. No studies reported (or employed) theoretical frameworks to guide process evaluation. Process evaluation measures relating to implementation were most commonly reported, with the most prevalent aspect being fidelity. This was followed by reporting on measures relating to mechanism of change and context of the intervention. Meta-analysis results suggested intervention duration, dose, inclusion of process evaluation aim, provision of lesson plans, sample size and sex as potential moderators.

Conclusions

Reporting of process evaluation measures may help build our understanding of the optimal characteristics of motor competence interventions. However, process evaluation is under-used and/or under-reported. This review serves as a call for more process evaluations and better reporting in motor competence interventions.

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Authors and Affiliations

  1. Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry, UK

    Jiani Ma, Emma L. J. Eyre, Inimfon A. Essiet & Michael J. Duncan

  2. School of Health and Social Development, Deakin University, Geelong, VIC, Australia

    Jiani Ma, Lisa M. Barnett & Inimfon A. Essiet

  3. School of Arts and Education, Deakin University, Geelong, VIC, Australia

    Natalie Lander

  4. Institute of Physical Activity and Nutrition, School of Health and Social Development, Deakin University, Geelong, VIC, Australia

    Lisa M. Barnett

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  1. Jiani Ma
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  2. Natalie Lander
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  4. Lisa M. Barnett
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Correspondence to Jiani Ma.

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Funding

Jiani Ma is supported by a Cotutelle Doctoral Studentship of Coventry University and Deakin University. Natalie Lander is funded by an Alfred Deakin Postdoctoral Fellowship. Inimfon Essiet is supported by a Cotutelle Doctoral Studentship from Deakin University, Australia and Coventry University, United Kingdom.

Conflicts of Interest

Jiani Ma, Natalie Lander, Emma Eyre, Lisa Barnett, Inimfon Essiet and Michael Duncan have no conflicts of interest relevant to the content of this review.

Data Availability

All data generated or analysed during this study are included in Tables S3 and S4 in the ESM.

Code Availability

R codes used for meta-regressions available upon request from the first author.

Author contributions

JM conceived the review, designed the review methods, wrote and edited the manuscript, ran the literature search, screened all identified titles and abstracts, assisted with the full-text screening and the risk-of-bias assessment, led the data extraction and ran the meta-analyses. NL advised on and assisted with the data analysis and revised and edited the manuscript. EE advised on the full-text screening and data analysis and revised and edited the manuscript. LMB advised on the data analysis and revised and edited the manuscript. IAE assisted with the full-text screening, data extraction and revising the manuscript. MD assisted with the risk-of-bias assessment, advised on the data analysis and revised and edited the manuscript. All authors read and approved the final manuscript.

Acknowledgements

The authors thank Sharon Davison and Chris Bark, both of Coventry University, for the initial library and information search support.

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Ma, J., Lander, N., Eyre, E.L.J. et al. It’s Not Just What You Do but the Way You Do It: A Systematic Review of Process Evaluation of Interventions to Improve Gross Motor Competence. Sports Med 51, 2547–2569 (2021). https://doi.org/10.1007/s40279-021-01519-5

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