# Move to Improve: Co‐Designing a Hospital‐Based Physical Activity Program for Children With Chronic Health Conditions

## TL;DR

This paper describes the co-design of a hospital-based physical activity program for children with chronic health conditions, emphasizing family-led and tailored approaches to support participation.

## Contribution

The study introduces a co-designed protocol for a hospital-based physical activity program tailored to children with chronic health conditions.

## Key findings

- Five themes emerged: family-led approaches, individualized design, enjoyment, confidence building, and transition support.
- A structured protocol was developed incorporating goal setting, skill building, and self-management education.
- The protocol is described as clinically relevant and scalable for hospital-based services.

## Abstract

Physical activity can support physical and mental health among children living with chronic health conditions; however, programmes must be tailored to their specific needs to support participation.

This study aimed to co‐design the protocol for Move to Improve, a hospital‐based clinical service at Perth Children's Hospital to support physical activity participation among children with chronic health conditions.

Four online co‐design workshops were conducted with children living with chronic health conditions and their parents, using a participatory and collaborative approach to inform programme development. Data were analysed using reflexive thematic analysis.

Five interrelated themes were identified, highlighting the importance of family‐led and goal‐oriented approaches, individualised programme design, enjoyment, confidence building and support for transition to community‐based physical activity. Together, these findings underscore the need for family‐centred and tailored programmes that support sustained engagement in physical activity.

The co‐design process informed the development of a structured protocol incorporating evidence‐based strategies aligned with families' priorities. These strategies included goal setting at the start of the programme, goal review at the end of the programme and tailoring of strategies such as skill building and education on self‐management of the condition across the duration of the programme. This protocol offers a clinically relevant and scalable model for supporting physical activity participation among children with chronic health conditions within hospital‐based services.

Children and parents of children living with chronic health conditions participated in co‐design workshops, and their input directly informed and shaped key elements of the Move to Improve protocol, including programme structure, content and delivery strategies.