“We Are an Active Family”: A Randomized Trial Protocol to Evaluate A Family-System Social Identity Intervention To Promote Child Physical Activity

“We Are an Active Family”: A Randomized Trial Protocol to Evaluate A Family-System Social Identity Intervention To Promote Child Physical Activity | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Study protocol “We Are an Active Family”: A Randomized Trial Protocol to Evaluate A Family-System Social Identity Intervention To Promote Child Physical Activity Evangeline Streight, Mark R. Beauchamp, Kurt Smith, Chris M. Blanchard, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4415668/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 27 Sep, 2024 Read the published version in BMC Public Health → Version 1 posted 4 You are reading this latest preprint version Abstract Background Regular engagement in moderate-to-vigorous physical activity (MVPA) during childhood yields a myriad of health benefits, and contributes to sustained MVPA behaviors into adulthood. Given the influence of parents on shaping their child’s MVPA behaviour, the family system represents a viable target for intervention. The purpose of this study is to compare the effects of two intervention conditions designed to increase child MVPA: 1) A standard education + planning intervention providing information about benefits, action planning, and coping planning; and 2) An augmented physical activity education + planning intervention that includes the components of the standard intervention, as well as a focus on family identity promotion and developing as an active member of the family. Methods A two-arm parallel single-blinded randomized trial will compare the two conditions over 6 months. Eligible families have at least one child aged 6–12 years who is not meeting the physical activity recommendations within the Canadian 24-Hour Movement Guidelines (i.e.,<60 minutes/day of MVPA). Intervention materials targeting family identity promotion will be delivered online via zoom following baseline assessment, with booster sessions at 6-weeks and 3-months. Child MVPA will be measured by wGT3X-BT Actigraph accelerometry at baseline, 6-weeks, 3-months, and 6-months as the primary outcome. At these same time points, parent cognition (e.g., attitudes, perceived control, behavioral regulation, habit, identity) and support behaviours, and parent-child co-activity will be assessed via questionnaire as secondary outcomes. Child-health fitness measures will be also administered through fitness testing at baseline and 6-months as secondary outcomes. Finally, upon completion of the trial’s 6-month measures, a follow-up end-of-trial interview will be conducted with parents to examine parents’ experiences with the intervention. Results So far, 30 families have been enrolled from the Southern Vancouver Island and Vancouver Lower Mainland area. Recruitment will be continuing through 2026 with a target of 148 families. Discussion This study will contribute to the understanding of effective strategies to increase child physical activity by comparing two intervention approaches. Both provide parents with education on physical activity benefits, action planning, and coping planning supports. However, one intervention also incorporates components focused on promoting an active family identity and involving all family members in physical activity together. The findings from this study have the potential to inform the design and implementation of public health initiatives aimed at improving physical activity participation in children and guide the development of more effective interventions that leverage the crucial role of parents and the family system in shaping children's physical activity behaviors. Trial Registration This trial was registered on clinicaltrials.gov in March 2nd, 2023. The last updated release being September 28th, 2023. Exercise self-regulation planning multi-process action control attitudes parental support Figures Figure 1 Figure 2 Figure 3 Introduction Children who engage in consistent moderate-to-vigorous physical activity (MVPA) are more likely to display positive health outcomes than their low active counterparts, such as better body composition, increased cardiorespiratory and musculoskeletal fitness, improved cardiovascular and metabolic health, positive emotional and behavioral regulation, and a reduced risk of chronic diseases [ 1 ]–[ 5 ] . Additionally, higher levels of childhood physical fitness have been associated with superior health and sustained physical activity (PA) participation in later adulthood [ 6 ] . Despite this overwhelming evidence, most children and youth (within the Western World) fail to adhere to international public health guidelines of 60 minutes per day of MVPA [ 7 ] . In Canada, over 80% of children are not active enough to reap the optimal benefits of MVPA (Roberts et al., 2017). Additional findings indicate that only 13% of 3–4-year-olds [ 9 ] and 17% of 5–17-year-olds meet the international guidelines for MVPA [ 8 ],[ 9 ] . Therefore, it is clear that promoting PA during childhood is a public health priority. Children spend considerable time within the care of their parents. Parents play an important role in establishing child PA behaviours; therefore, emphasizing the family system as a viable target for PA promotion initiatives [ 10 ] . In support of this contention, there is a consistent and medium-sized correlation between supportive PA parenting practices and child PA [ 11 ]–[ 13 ] . Parental support involves any actions (by parents) designed to meet the psychological, social, and physical needs of their children with the goal of promoting their child’s physical activity [ 14 ],[ 15 ] . These support behaviours may manifest as encouragement, logistical support (e.g., signing children up for recreation activities, transport to activities), and intergenerational PA behaviors (e.g., parent and child recreation activities together) [ 13 ],[ 16 ] . Despite support for the positive correlations between parental support practices and child PA in observational designs, interventions focused on family PA have been generally unsuccessful, particularly in terms of sustaining behavioral changes [ 12 ] . Specifically, interventions focused on increasing parental support of child PA have been found to result in some positive changes in children’s PA (Standard Mean Difference (SMD) = 0. 29; 95% Confidence Interval (CI) 0.14 to 0.45) in the first six-weeks [ 12 ] , but there is little evidence for sustained changes in the long-term. Previous randomized trials promoting family PA [ 15 ] and MVPA [ 14 ],[ 17 ] have reflected this evidence, showing that assisting parents with self-regulation skills (e.g., planning) can improve children’s MVPA over educational approaches (e.g., persuasive facts about the benefits of activity), yet, this approach also appears to wane in its effectiveness by 6-months post intervention [ 14 ] . In light of these outcomes, there is a need to focus on improving the effectiveness of family-based interventions for MVPA so that they may sustain initial behavioral changes. To address this, contemporary research in PA promotion has started to examine the effectiveness of behavior change interventions that specifically target long-term maintenance processes within the general population [ 18 ] , such as building habits and identity [ 19 ] . One of the most frequently applied frameworks within the PA domain with this focus on habit and identity is the multi-process action control framework (M-PAC) [ 20 ],[ 21 ] . The tenets of M-PAC suggest that sustained behaviour change is a function of three subsequent and overlapping processes. At the foundation of M-PAC are reflective processes (i.e., conscious expectations of behavioral consequences), such as attitudes and perceptions of control, which culminate in the formation of an intention to engage in PA. This framework is similar to the tenets of most intention-based social cognitive theories [ 22 ] . However, turning intention into behavior is dependent on regulation processes (e.g., planning, monitoring, regulating emotions), as people begin to use tactics to help translate positive intentions into action [ 23 ] . Finally, behavioral maintenance [ 19 ],[ 20 ] is developed through habit and identity formation, known as reflexive processes (i.e., stimulus-based motivation from learned associations and self-categorization). The M-PAC framework is backed by over 30 tests in the PA domain including observational evidence that the provision of parental support is predictive of child PA intentions [ 24 ]–[ 26 ] . While M-PAC is currently being utilized to investigate the role of parental support habits on children’s PA [ 27 ]–[ 29 ] , to our knowledge, there has not been a trial to explore this framework and the effectiveness of PA identity promotion in the family system. Previous observational research on predicting parental support for children’s PA [ 24 ] and reviews of PA identity processes [ 30 ]–[ 33 ] , suggest identity may be a potent mechanism for sustaining long term PA. Identity represents the meanings that individuals assign to the (multiple) roles they may play and the expectations that are associated with those roles [ 33 ] . This encompasses both self-identity and social identity. Self-identity involves the meanings and expectations a person attaches to a role based on their own internalized belief. For example, one’s self-identity as a physically active person, may include beliefs about the importance of regular exercise and seeing value in an active lifestyle. Social identity on the other hand reflects a person's self-concept derived from their perceived membership in various social groups [ 34 ] . For example, one’s social identity as a member of an active family would involve the family's shared views on the importance of physical activity and the expected behaviors of family members, such as regularly engaging in active outings together or supporting each other's fitness goals. Our self and social identities initiate a self-regulating system that increases our motivation and attention to sustain health behaviours, making them more resilient in the face of counter-stimuli or threats to the identity [ 31 ] . When an exercise identity is integrated into the self-concept, physical activity becomes an internalized value and pursuit. Moreover, identifying as a member of ‘an active group’ (e.g., family) can provides a sense of social support, establish social norms, and motivate identity-consistent behavior to affirm group membership [ 30 ],[ 35 ] . When this happens, behaviour can become habitual (translating positive intentions into behaviour), enabling greater attention to seize identity-affirming physical activity opportunities when they are presented [ 32 ] . In sum, grounding physical activity interventions in identity theory [ 33 ] and social identity theory [ 34 ] may provide a pathway for physical activity to become more congruent with one's self and social view and lasting behavior change. Helping participants to see their expectations and values attached to an active identity, along with the social influence of identifying with an active group, could help make regular physical activity an integral part of "who I am." Our research aims to test this possibility by exploring self and social identity-based strategies for promoting physical activity adoption and maintenance in families over time. Study Objectives and Hypotheses The primary objective of this study is to explore the effects of a theory-based intervention that targets family identity promotion (with education and planning) to promote child MVPA. For this study, we include the promotion of both self-identity of the parent (i.e., I am a parent supportive of child PA) [ 36 ] and social identity [ 34 ],[ 37 ] of the family (i.e., we are an active family) to better account for the family system [ 10 ] . Based off previous literature [ 17 ],[ 38 ]–[ 41 ] , it is hypothesized that the MVPA for children in the identity promotion condition will be higher in comparison to the MVPA for children in the standard PA education and planning condition at six months. Secondary objectives of the trial include the evaluation of children’s health-related fitness outcomes between the identity promotion condition and the education and planning condition at baseline and 6-months. It is hypothesized that child health-related fitness outcomes will be higher for the identity formation condition in comparison to the education and planning condition due to improved adherence. Specifically, in light of the anticipated superior adoption and maintenance of MVPA by children in the identity condition, we also anticipate that they will display better fitness than those randomized to the planning condition. Additionally, group differences among behavioural and health-related fitness outcomes will be examined by a mediation model. It is hypothesized that the effect of the assigned conditions (identity promotion vs. standard education and planning) on child MVPA will be mediated by parental support behaviors, and this mediation will be further explained by parents' identity as supportive of their child's physical activity (i.e., manipulation check). In turn, the covariance of parental support on health-related fitness outcomes is expected to be mediated by children's MVPA levels. In the case of null outcomes for the primary objective, outcomes will be explored with a prediction model of change in PA rather than a mediation model [ 41 ],[ 42 ] . Lastly, this study will explore intergenerational, seasonal, or sex differences across primary outcomes by assigned condition. Methods The design, conduct, and reporting of the trial follows the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) guidelines [ 43 ] and conforms to the Consolidated Standards of Reporting Trials (CONSORT) guidelines [ 44 ] . This study is approved by the University of Victoria (UVic) Human Research Ethics Board (HREB). Additionally, this study has harmonized ethics approval by the Research Ethics Board of BC (REBC) for multi-jurisdictional research with the University of British Columbia (UBC) and Vancouver Island University (VIU). The trial is registered with the Clinical Trials Registry maintained by the National Library of Medicine at the National Institutes of Health (ClinicalTrials.gov) Trial ID NCT05794789. The trial was registered on March 2nd of 2023, and last updated on September 28th, 2023. If modifications or amendments to the protocol are required, the Project Coordinator will submit the necessary paperwork to the Research and Information Systems (RISe) at UBC. Upon approval, the appropriate updates are made to the trial registration on the Clinical Trials Registry. Trial Design This study is a two-arm parallel single blinded randomized trial. After baseline assessment (fitness testing, MVPA, and questionnaire), participants are randomized to one of two groups: 1) physical activity education + planning + family identity promotion condition ; or 2) physical activity education + planning condition for six months (See Fig. 1 ). The objective of the trial is to evaluate the efficacy of the identity promotion condition , when compared to the education + planning condition, at the primary end-point of the trial (6 months) with secondary assessment time points at 6-weeks and 3-months. Sample Size Calculation A power calculation was conducted to estimate the required sample size. Power was set at 0.80 with four repeated assessments, one-between group factor, an alpha of .05, and a medium effect size (Cohen's f = .25), indicaed that 128 families are needed to show a significant condition by time effect for PA [ 12 ],[ 45 ],[ 46 ] . This effect size is consistent with previous studies examining physical activity interventions [ 47 ],[ 48 ] . With an expected attrition rate of 15% [ 14 ] , 148 families (74 children per condition) will therefore be recruited. Participants and Eligibility Participants are single or common law/married adult(s), with at least one child between the ages of six and twelve years. This age range has been shown to be the most effective for family-based intervention, as the influence of peer-relationships supercedes that of the parents by the teenage years. Families reside on Southern Vancouver Island spanning from Greater Victoria to the city of Nanaimo, British Columbia, Canada; as well as the Lower Mainland of British Columbia (Canada) encompassing Vancouver, Richmond, Surrey, Burnaby, Langley, and Coquitlam. Participants will be included if children participate in PA below Canadian recommendations of < 60 minutes/day of MVPA (screened by parental report through initial recruitment contact) [ 49 ] . To aid in the interpretation of this recommendation, our recruitment information includes examples of how one might accrue MVPA with an example schedule for the week. We also screen families based on child baseline accelerometry results (as a secondary assurance). If more than one child per family is eligible in this range, we randomly designate (via computer randomizer) a child as the target for analysis yet include all willing children within the study. If the child is not eligible due to meeting guidelines, the family is given the baseline honorarium, and removed from the study. The target parent(s) PA levels may be above or below the adult recommendations as they have no bearing on their eligibility to participate in the study. Consent and Permissions Participating parents are required to provide written consent and complete ParQ + Health Screening Questionnaire [ 50 ] to ensure they are physically healthy (i.e., no known episode of chest pain, dizziness, or joint problems after physical activity) to engage in MVPA before participating in this study. Parents are required to sign informed consent forms if they agree to participate as a family unit, with verbal assent also obtained from the participating children from each family. Recruitment Recruitment is conducted by the Behavioural Medicine Lab at the University of Victoria in British Columbia, Canada. Based on our extensive experience with prior family trials [ 14 ],[ 15 ],[ 17 ],[ 27 ],[ 28 ] , participants are recruited through a variety of avenues including (1) social media and online interest sites, (2) in-person markets and recruitment poster drops, and (3) community-based promotion and brand partnerships. The recruitment radius is stratified into three regions: Greater Victoria, Greater Nanaimo, and Greater Vancouver. Within each region, a complete list of schools, recreation centres, community centers, outdoor markets and health centers are approached to help facilitate recruitment, to maintain consistency along all regions of Southern Vancouver Island and Lower Mainland. Participants are recruited primarily through the social media platforms Facebook and Instagram. Facebook and Instagram posts are made bi-monthly by the Behavioural Medicine Lab Recruitment Officer on the Behavioural Medicine Lab Facebook page ( https://www.facebook.com/UVicBMED/ ) and Instagram account (@uvicbmed). These social media pages are linked, meaning a post made on Facebook is simultaneously shared on Instagram and vice versa. Posts are limited to 100 words or less and briefly describe the intent of the study and those eligible to partake, asking those interested to contact the Behavioural Medicine Lab through email or phone information provided in the post. Facebook posts are also shared to relevant Facebook groups (e.g., neighbourhood groups, young parent groups, homeschool group). Facebook posts are socially amplified by paying a small fee to have the post appear as an advertisement in a target demographic’s news feed. The target demographic is specified by selecting variables of age, location of residence, and other filters such as “parents”, and the advertisement typically run for 7 days. The Recruitment Officer also sets up a recruitment booth on average 2–3 times at local markets and festival events during the summer, and at community and recreation centers in the winter to engage with potential participants, answer questions, and collect contact information for interested families. Posters are put up or mailed out every 3–4 months by a Research Assistant and/or Recruitment Officer in all major recreation centers in the area, as well as shopping centers, health care centers, and schools. Word of mouth is also used as a recruitment strategy. We currently recruit approximately 3–5 interested families per week with this strategy. Additionally, we incorporated an incentive program to maximize recruitment interest. This program was set up through partnerships with local Universities (UVic, UBC, & VIU) as well as local businesses (Flying Squirrel, local gyms, apparel stores) to provide participants with draw prizes when screened to participate. Randomization Randomisation is performed by a Research Assistant assigned by the Research Coordinator to reduce bias using the Excel Sheet Randomization function. This is done with an allocation ratio of 1:1 to either the education + planning + identity promotion condition or education + planning condition . Participants are blind to their condition until the completion of the study, at which point they are informed of their group by the Project Coordinator and/or Research Assistant. Under no circumstance are participants informed of their condition while they are still enrolled in the study. Fitness testers are blind to each family’s condition as well, but the Research Coordinator and Research Assistants are aware of the condition to allow for correct delivery of intervention materials. Procedures and Protocol When interested parents contact the lab, the Recruitment Officer follows up with an email to schedule a phone conversation. If initial contact is a message through Instagram or Facebook, the Recruitment Officer privately replies asking the person to call/email the contact provided in recruitment material or follow the link in the post that allows them to provide their contact information securely through an online form. An initial recruitment phone interview is set up with the Recruitment Officer, and families are screened using a parent-report of their child’s average physical activity per day as well as the ParQ + Health Screening Questionnaire [ 50 ] . If participants meet all eligibility criteria, the Recruitment officer advises the Project Coordinator, who then follows up with the family to schedule testing on site at our three satellite locations – UVic, UBC, or VIU. Once deemed eligible and enrolled, participants are scheduled for a baseline assessment. At the initial baseline session, the Fitness Tester obtains written consent from parents and verbal assent from children, and at the completion of the fitness testing, the Fitness Tester provides the participating parent(s) and child (ren) with a short training session on how to wear and use the accelerometers, before sending them home for a week of wear. Upon completion of this device-assessed PA measure, the accelerometers are received through mail-back packages or courier pick-up, and the child MVPA is checked against PA recommendations [ 49 ] as a secondary screening procedure to exclude those families with children meeting international PA guidelines from the trial. Families whose children do not meet those guidelines and therefore eligible to continue are then randomized into one of two intervention conditions and parents are asked to complete a baseline questionnaire. The Project Coordinator is responsible for guiding the two groups of participants through their respective interventions over the first 3 weeks after randomization. Both groups receive the same standard education + planning workshop in the first week. Then in weeks 2 and 3, each group receives two additional workshops relevant to their randomized intervention condition (i.e., education + planning , or education + planning + identity promotion ), with one workshop per week. At 6 weeks post initial intervention period, families are given follow-up online questionnaires to complete and accelerometers to wear and to return via mail or courier pick-up. Both groups will receive “booster” sessions administered by a research assistant delivered online via Zoom on the same material as their intervention designation (see Table 1 for Behaviour Change Techniques (BCTs) per condition). This process will be followed for the three-month time-period. Thus, two booster sessions at both 6 weeks and 3 months will be provided to the education + planning and education + planning + identity promotion groups. At 6 months, in addition to the questionnaires and accelerometry assessment, children will be asked to perform fitness tests once again, and parents will participate in a brief end-of-trial qualitative interview to evaluate the efficacy of the intervention. These semi-structured interviews will allow us to evaluate two key aspects of fidelity outlined by Dumas et al. [ 51 ] : content fidelity, which refers to "what is done" in the intervention, and process fidelity, which captures "how it is done". While measuring outcomes quantitatively will provide insight into the effectiveness of our intervention, it is also crucial to conduct a process evaluation through participant interviews. This qualitative approach will help determine whether the intervention program was delivered and carried out as intended. To assist study retention, we will offer monetary compensation across the study. Participants will receive an honorarium at baseline ( $ 30), 6 weeks ( $ 35), and 3 months ( $ 40), and 6 months ( $ 45) for a total of $ 150. Families only receive honoraria if they complete all the measures for the check point assessment (accelerometers, logbooks, questionnaires). Our experience with several past randomized control trials (RCTs) among families has shown that our protocol keeps attrition around or below 15% [ 14 ] . Interventions (see Table 1) Standard education + planning condition Participants in the standard education + planning condition will receive an initial baseline coaching session, designed exclusively for parents from a trained kinesiologist. Additionally, they will recieve an information-based series of worksheets that serve to standardize the delivery format of the material and provide a tangible knowledge translation (KT) product for the family after coaching. This is similar to our past family trials [ 14 ],[ 15 ],[ 27 ],[ 28 ] . The coaching session will consist of Canada’s 24-Hour Movement Guidelines for kids, which include recommendations of at least 60 minutes of MVPA a day [ 49 ] and a breakdown of ways for the parent to help their child achieve this PA, outlining three main types of parental support (encouragement, logistical support, and co-participation) [ 16 ] . The worksheet material is provided as prompts and suggestions, and contains questions that reinforce the benefits of PA for the child and family, as well as skill training content (how to plan for family PA). The material specifically includes a brainstorming exercise for parents where they list physical activities they think their children have found fun in the past. This list helps create a template for PA planning by contextualizing what the parents would like to do with their children. Additional activities within this material explore how the environment and use of rewards can enhance engagement in physical activity behavior. Discussions around the physical environment (access to recreational facilities, parks, pedestrian-friendly neighborhoods) and social environment (support from family/friends) highlight how supportive environments align with values like health, wellbeing, enjoyment, and social connections. Exploring environments and rewards can facilitate conversations around the values associated with physical activity, and help individuals and families identify the values that motivate their physical activity choices, fostering sustained motivation and turning it into a value-driven habit. The subsequent skill training material for planning is based on several streams of prior work in the adult PA literature [ 52 ]–[ 54 ] and our prior family trials [ 17 ],[ 55 ] . Aligned with the regulatory processes of M-PAC, families plan for their PA support based on skill training for forming implementation intentions which involve creating specific "if-then" plans linking situational cues to desired behaviors (e.g., "If it's Monday at 6 PM, then I will go for a 30-minute walk"), as well as action planning, coping planning and traditional goal setting [ 56 ]–[ 60 ] . Because the identity promotion condition has two additional workshops (when compared to the comparator intervention condition), the education + planning condition will also receive two additional workshops to compensate for time and attention, rather than content. The workshops will include education and planning material related to family healthy eating. This material will focus on the contents of the updated Canadian Food Guide [ 61 ] , with discussions on macronutrient education, meal planning, healthy food choice strategies, and food labels. They will also receive a digital screen saver for their computer or cellular device with graphics highlighting “Healthy Food Habits Start At Home”. Education/planning + identity condition The identity formation condition will receive the same content as the education + planning condition during the initial baseline workshop. However, it will augment this material by explicitly targeting, bolstering, and enhancing parents' "physical activity support identity" - that is, their self-categorization as a parent who actively supports their child's engagement in physical activity. This will be done through two additional coaching sessions focused on the behavior change principles of self-identity [ 31 ],[ 62 ],[ 63 ] and social identity theory [ 34 ] through two additional coaching sessions, as illustrated in Table 1. Specifically, the second workshop will involve only the parent(s) to focus on parental support identity and the content based on the behavior change principles of self-identity theory [ 31 ],[ 62 ],[ 63 ] . This session’s activities are based on our prior PA identity formation trials among adults [ 38 ],[ 39 ],[ 55 ],[ 64 ] and are adapted to parental support of child PA. These activities are also augmented by principles from social identity theorizing [ 65 ] designed to bolster a ‘sense of us’ (i.e., we as an active family). These principles are tailored for parents, and include (as per Steffens et al., [ 65 ] ): (a) identity entrepreneurship – when parents create a sense of shared social identity within the family, marked by a unique and compelling vision that distinguishes their supportive parental role from others; (b) identity prototypicality - when parents, in both action and perception, embody the values and ideals they aspire toward as active and supportive caregivers; (c) identity advancement - when parents prioritize their supportive roles as parents, and engage in activities that place the interests of their child above their own individual pursuits (as adults). This includes dedicating specific times in parents’ weekly schedule to support their child's physical activities, even at the expense of personal or occupational demands, and lastly; (d) identity impressarioship - occurs when parents create unconventional or novel strategies to optimize their supportive parental identity. An example might involve trying out a new activity that’s new for every member of the family. These principles are emphasized throughout the second workshop and through a worksheet shared by the Research Coordinator with the participating parent. This worksheet is as follows: * Activity #1: Workshop #2 begins with a review of parental support behaviours (ie. encouragement, logisitical support, and co-participation), and a reflection question, where parents are encouraged to reflect on their willingness to change their behaviors to better support their child's physical activity development. This reflection aligns with the concept of identity entrepreneurship [ 65 ] , as it helps parents establish a clear vision of their role as a supportive parent. * Activity #2 : Focuses on defining parental identity around physical activity engaging with the concepts of identity prototypicality and identity advancement [ 65 ] . Parents are prompted to consider the values and ideals they aspire to embody as supportive caregivers, list ways they can support their child's physical activity, and prioritize their child's physical activity over other responsibilities and pursuits. * Activity #3: Involves brainstorming family activities and explores the concept of identity impressarioship [ 65 ] . Parents are encouraged to explore unconventional or novel strategies to optimize their supportive parental identity. By brainstorming ways to make use of their environment, having convenient "grab and go" activities on hand, and adjusting their home setup to facilitate physical activity, parents develop innovative approaches to support their child's participation in PA. The self-reflection and planning tool in Activity 3 also allows parents recognize the enjoyment that PA provides for themselves and their family, and develop strategies to make it a priority. * Activity #4: Parents brainstorm ways to effectively communicate and deal with potential issues that may arise during the implementation of their family PA plan and being a supportive parent. By anticipating and navigating challenges, parents create a supportive and cohesive family environment that reinforces their shared social identity as a physically active family. This proactive approach to problem-solving and communication helps parents establish a distinct and compelling vision of their family identity, as well as their own identity as a parent, thus encourahing identity entrepreneurship [ 65 ] . The third workshop involves the parent(s) and their child(ren) with a focus on social identity within the family (i.e., collective categorizing that “We are an Active Family”). The intervention material is grounded in social identity theory [ 34 ] , self-categorization theory [ 36 ] , and group cohesion behaviour change techniques [ 66 ] , which emphasize the importance of group membership and shared identity in shaping behavior. *Workshop 3, Activity #1: The workshop begins with a discussion of the family's values and how physical activity can contribute to these values. This activity aims to highlight the importance of physical activity within the family context and foster a sense of shared purpose, thereby increasing identity salience the importance of the family's physical activity identity to the individual family members [ 67 ] . The BCT applied in this activity is framing/reframing [13.2] [ 68 ] . *Workshop 3, Activity #2: Next, the family engages in a creative activity designed to promote a sense of unity and shared identity, such as creating a family team name, family crest, or a family Instagram account focused on physical activity. This activity draws upon the BCTs of identity associated with changed behavior [13.5] and social support [3.1, 3.2, 3.3] [ 68 ] , fostering a sense of unity and distinctiveness around the family's physical activity identity. This activity encourages identity fit and contrast - the extent to which the family's physical activity identity distinguishes them from other families [ 36 ],[ 67 ] . *Workshop 3, Activity #3: The workshop then moves on to establishing standards for physical activity. The family discusses their expectations for physical activity, determines a reasonable amount of weekly family physical activity, and identifies activities to include in their family physical activity plan. This collaborative process employs the BCTs of discrepancy between current behavior and goal standard [1.6], goal setting (behavior) [1.1], and action planning [1.4] [ 68 ] , promoting a shared understanding of the family's physical activity goals and preferences, and promoting identity complementarity - the extent to which family members perceive themselves as similar to, and aligned with each other, in terms of their physical activity identity [ 69 ] . *Workshop 3, Activity #4: Problem-solving and brainstorming are then conducted to identify potential barriers to physical activity and develop strategies to overcome them. The family also discusses ways to support each other in changing the routine and recording their physical activity. This activity promotes a sense of shared responsibility and mutual support within the family, further enhancing identity salience. The BCTs applied in this activity are coping planning [1.2], social support [3.2, 3.3], and self-monitoring of behavior [2.3] [ 68 ] . *Workshop 3, Activity #5: The family then discusses the roles and responsibilities of each member in the physical activity program. They also identify individual and shared goals and explore ways to combine these goals to foster a sense of unity and family cohesion. The BCTs applied in this activity are goal setting (behavior) [1.1], action planning [1.4], and behavioral contract [1.8] [ 68 ] . *Workshop 3, Activity #6: Finally, the family are encouraged to envisions their possible selves as an active family at different time points in the future. This activity utilizes the BCTs of comparative imagining of future outcomes [9.3], framing/reframing [13.2], and identity associated with changed behavior [13.5] [ 68 ] , and is desiged to reinforces the family's shared vision and long-term commitment to an active lifestyle. When taken together, by focusing on the development of a shared family identity around PA, Workshop 3 aims to promote long-term adherence to an active lifestyle within the family context through the use of BCTs, the targeting of social identity constructs (that emphasizes a sense of ‘we-ness’ as an active family), and group discussion. In addition to these intervention materials, the participating parents in the identity promotion condition will receive a digital screen saver for their computer or cellular device with graphics highlighting “We Are an Active Family”. Given the use of phones/digital tools in day-to-day activity, the use of this media will be encouraged for the duration of the study as a prompt for continued engagement in research goals. Outcome measures Primary outcome measures Child MVPA is measured with wGT3X-BT Actigraph accelerometers, recognized as a widely accepted method for physical activity measurement in field settings [ 70 ] . These devices have several advantages over proxy-report subjective measures of PA. Accelerometers offer a more objective assessment of PA compared to parent or self-report measures, as they are less susceptible to reporting biases such as recall errors and social desirability [ 71 ] . Additionally, accelerometers have been shown to accurately record the short, intermittent bursts of activity that are characteristic of children's PA patterns, providing a more accurate representation of their true activity levels than subjective measures [ 71 ],[ 72 ] . Children will wear the devices during waking hours (~ 10 hours per day) on a belt around the waist for a for 7 consecutive days. The accelerometer is placed on an elastic belt, and participants are directed to wear it secured snugly around the waist with the device above the left iliac crest. Participants are instructed to remove the accelerometers for water-based activities as they are not waterproof, and a logbook is provided for participants, in most cases parents, to note when the devices were removed for water-based activity or any other reason. This includes noting the time the accelerometer was taken off for sleep, and the time it was put back on in the morning. Additionally, the logbook is to be used to provide other details of each day (e.g. if their routine was changed for any reason and/or what activities they participated in). This information can be used in parallel with the accelerometers to cross-reference the data it presents. ActiLife software (Version 6.11.9; ActiGraph LLC) will be used to initialize accelerometers, download data, and process the data. The accelerometers are initialized to collect pre-filtered data at a sample rate of 30 Hz for the children and their parents (see secondary outcomes below), and are downloaded into 15-second epochs for children to capture the sporadic nature of their PA [ 71 ],[ 72 ] , and 60-second epochs for parents, consistent with the methodology used by Troiano et al. [ 73 ] . For determining valid wear time, the Troiano algorithm is used which defines non-wear time as a period of at least 60 consecutive minutes of zero counts, with an allowance for one to two minutes of counts between 0 and 100. Measurements will take place at baseline, 6 weeks, 3 months, and 6 months (primary endpoint of interest), and MVPA will be evaluated as change from baseline. Child MVPA will be determined using the Evenson [ 74 ] cut points based off of recommendations from Trost et al. [ 72 ] . Evenson cut points define moderate activity as 2296–4011 counts per minute (CPM) and vigorous activity as ≥ 4012 CPM. Therefore, MVPA will be any activity ≥ 2296 CPM. The outcome variable will be average minutes per day of children’s MVPA. Secondary outcome measures (Fig. 2 ) Parental PA Parental PA will be measured using accelerometry and self-reported questionnaires at all assessment occasions (baseline, 6 weeks, 3 months and 6 months). Accelerometry will be measured in a similar fashion to the methods outlined above. Namely, parents are instructed to wear the Actigraph wGT3X-BT for 7 days a week (~ 10 hours per day), remove it at night and for water-based activities, and note the details of the wear in a logbook. Parental MVPA will be measured using Troiano adult protocol [ 73 ] . Activity will be assessed by measuring several variables, including duration (total minutes worn, total movement counts/day, total minutes of sedentary, light, moderate to vigorous day), frequency (bouts of sedentary, light moderate to vigorous/day), and intensity. Non-wear time will be determined using the algorithm from Troiano et al. (2008), and will be subtracted from total wear time. The MVPA of adults will be evaluated as change from baseline and determined using frequently applied cut points [ 75 ] validated for adults [ 73 ] which classify MVPA as 2020 counts per minutes (CPM) and above. As a secondary assessment, parents self-report physical activity using the Godin Leisure-Time Exercise Questionnaire [ 76 ],[ 77 ] at all time points. This questionnaire assesses the frequency of mild, moderate, and strenuous activity performed for at least 15 minutes during free time in a typical week. A total weekly MVPA score will be calculated by multiplying the frequency by the duration. Parent-child intergenerational activity Parent-child intergenerational activity will be measured using self-report with a modified Godin Leisure-Time Exercise Questionnaire (GLTEQ) [ 15 ] and accelerometry as discussed in the primary outcome above. Parent accelerometers will be tagged with the child’s accelerometer to assess coordinated activity. The wGT3X-BT accelerometer model has a Bluetooth proximity detection feature that can determine the presence (e.g., same room in a house, at the park together) or absence of close proximity between two accelerometers. The adult accelerometer is programmed to be the “beacon” device, and the child’s accelerometer is programmed as the “receiver”. In this method, “beacon” devices broadcast their serial number and “receiver” devices are set to search for the signal once per minute. The receivers then store a log of proximity detection information, recorded as a received signal strength indicator (RSSI). Every 60 seconds where the monitors are in close proximity will be “tagged” and recorded in the memory of the child’s monitor, which will be later linked to time-stamped data of the parent. According to ActiGraph [ 78 ] , accelerometers communicate via Bluetooth when in close proximity indoors, which is a maximum of 10–20 meters, and close proximity outdoors, which is a maximum of 100 meters. Previous success has been demonstrated by the work of [ 79 ] showing 82% sensitivity and 81% specificity for determining the presence of close proximity between parents and preschoolers using the proximity feature [ 80 ] . The outcome variable will be average minutes per day parents and children were both engaging in physical activity at the same time while in close proximity. Child health-related fitness and body composition Child health-related fitness will assess the key components of body composition, aerobic fitness and musculoskeletal fitness. Body mass (kg), height (cm), body mass index, and waist circumference (cm; at the level of noticeable waist narrowing) will be measured according to standard procedures, and percentage body fat will be estimated using the Tanita TBF-300A scale. Cardiovascular fitness (i.e., predicted maximal aerobic power) will be assessed following protocol for the modified Canadian Aerobic Fitness Test (mCAFT) standardized in children. Heart rate and blood pressure (sphygmomanometer and a stethoscope) will be monitored at rest and during exercise. All participants will complete the mCAFT step test, which uses one or more 3-min submaximal stepping stage based on the participant’s heart rate response. Musculoskeletal fitness [i.e., muscular (grip) strength, muscular endurance (curl-ups and push-ups), power (vertical jump), and flexibility (sit-and-reach)] will be assessed according to standardized guideline [ 81 ] . All tests will be conducted by qualified exercise professionals following the Canadian Society for Exercise Physiology (CSEP) Protocol [ 82 ] . The total time required for the health-related physical fitness measurements will be approximately 45 min. Parental support and M-PAC Constructs Parental support measures are evaluated at all time points (baseline, 6 weeks, 3 months, 6 months) during the study. This includes main behavioral components such as encouragement, logistical support, and intergenerational PA behaviors [ 13 ] , as well as M-PAC constructs related to parental support of child physical activity [ 83 ] . MPAC constructs include parental support identity, habit, PA regulation (proactive, reactive, self-monitoring, social monitoring), perceived capability and opportunity, affective and instrumental attitude, and intention. Parental support for child physical activity is measured with an adapted 5-point Likert Scale (Strongly disagree Strongly agree) from [ 84 ] , to assess ways in which parents provide support for their child's PA. Parents respond to questions like "I go out of my way to enroll my child in sports and other activities that get him/her to be physically active (eg. After school programs, programs at the YMCA)..." and "I often drive or take my child to places where he/she can be active (e.g., parks, playground, sport games or practices).." The scores from this questionnaire have demonstrated good internal consistency reliability, with Cronbach's α ranging from 0.61 to 0.74 for the logistic support subscale and 0.69 to 0.75 for the modeling subscale [ 84 ] . Parent support identity (whether parents identify as being supportive of their child's physical activity) is measured via a Modified Exercise Identity Scale from Anderson and colleagues [ 85 ]–[ 87 ] . Parents are asked if they consider themselves a supportive parent for my child’s physical activity; if when they describe themselves to others, they include their involvement in supporting their child's physical activity; and if others see them as someone who regularly supports their child's PA. In prior studies, the modified scale scores assessing parent support identity have demonstrated evidence of internal consistency (e.g., Cronbach's α = 0.84) and convergent and predictive validity by correlating with measures of personal and family-based physical activity [ 24 ],[ 88 ] . Parent support of family physical activity identity is measured using a 4-item scale adapted from Doosje et al. [ 89 ] . Parents are asked to rate their agreement with the following statements on a 5-point Likert scale: “I identify as an active member of an active family”; “I see myself as an active member of an active family”; “I am pleased to be an active member of an active family”; and “I feel strong ties with my family members around being physically active” [ 89 ] . While the original scale by Doosje et al. [ 89 ] was designed to measure ingroup identification and has demonstrated good reliability for group identification (Study 1 = Cronbach's α = 0.83), the current study adapts this scale to measure identification with being part of an active family. As this is a newly adapted scale, reliability and validity data are not yet available. We plan to examine the internal consistency of the scale scores (Cronbach's α) in our sample, as well as explore the scale scores' associations with related constructs (e.g., family physical activity levels, parental support behaviors) as preliminary evidence of validity. Parental support of child physical activity habit is measured with an adapted Self-Reported Habit Strength Index (SRHI) [ 90 ] , which provides the opportunity to use the self-reported behavioural automaticity index subscale (SRBAI) [ 91 ] as well. Parents respond on a five-point scale to questions in the following format: "Regular support of my child's PA is something I do.... automatically, frequently, etc." The scores from the SRHI have demonstrated good internal consistency reliability (Cronbach's α = 0.91, p .80) and a strong convergent validity with the SRHI [ 91 ] . Physical activity regulation is measured via a modified Physical Activity Regulation Scale (PARS) from [ 92 ] . This instrument measures parent behaviours with regards to tracking and planning child's physical activity. Parents respond to statements in the following format: "to support my child I made a detailed plan regarding when to support my child's physical activity", "I avoid spending long periods of time in environments that do not allow me to support my child's physical activity" etc. Although this is a relatively new tool, initial evidence suggests that the scores from the PARS have good internal consistency reliability (Cronbach's α generally > .80) and predictive validity with measures of physical activity behavior [ 92 ] . Furthermore, an adapted perceived control measure from Lithopoulos et al. [ 93 ] evaluates measures of perceived capability and opportunity for parents to support child PA. This measure asks parents their level of agreement of how much control they have to regularly support their child’s physical activity over the next 6 weeks/3months. These are presented as statements in the following format: “I have the physical ability to support my child’s physical activity over the next…”; “I have enough skill to do the activities needed of me to support my child’s physical activity over…”; “I can handle the physical demands supporting my child’s physical activity over…” etc. The scores from this measure have demonstrated good internal consistency (Cronbach's α > .90) and test-retest reliability (Intraclass Correlation Coefficient (ICCs) of .79 for perceived opportunity and .82 for perceived capability). The measure also showed evidence of discriminant validity, distinguishing itself from related constructs like intentions and attitudes, as indicated by satisfactory model fit indices (Standardized Root Mean Square Residual (SRMR = 0.03); Root Mean Square Error of Approximation (RMSEA = 0.06)). Additionally, the measure exhibited predictive validity, with perceived capability and opportunity predicting intentions, and perceived capability predicting physical activity [ 93 ] . Attitudes toward engaging in supportive parenting behaviours of child PA are measured with items covering both affective and instrumental components [ 94 ],[ 95 ] . Using a modified 7-point scale this measure assesses to what degree parents find regular support of their child’s physical activity to be enjoyable, wise, exciting, beneficial, useful, and pleasant (eg., extremely unenjoyable extremely enjoyable, extremely unwise extremely wise, etc.). The scores from this affective and instrumental attitude measure show strong internal consistency (Cronbach’s alpha of > .84), and significant (p < .01) correlations of with intention and support child physical activity [ 24 ],[ 25 ] . Finally, parental support of child PA intention is assessed using Courneya’s recommendation for open-scaled measurement [ 96 ] . This instrument asks parents to respond on a 7-point scale from "Extremely Uncommitted" to "Extremely Committed" about how committed they are to regularly supporting their child's physical activity over the next 6 weeks, aligning with the open-scaled approach [ 96 ] , and exercise intention measures from Rhodes et al. [ 97 ] . They are also asked to quantify in times per week how often they intend to engage in supportive behaviors over the next 6 weeks, similar to measures in Rhodes, Berry, et al. [ 24 ] . These questions capture the distinction between decisional intention (direction) and intention strength (commitment) as recommended by [ 98 ] for improving measurement, theory testing and intervention practices related to physical activity intentions and behaviors. Sociodemographic variables A section of the baseline questionnaire assesses various demographic characteristics including gender, age, ethnicity, level of education, marital status, employment information, household income, and health background. Exit Interview Questions To evaluate participants' experience with the intervention and gather insights for potential improvements, semi-structured exit interviews are conducted with parents at the 6-month timepoint. The interviews, conducted via video chat by Research Assistants, aim to assess parents' overall experience, perceived benefits and barriers, satisfaction with the intervention materials and components, and any observed changes or consequences resulting from their participation. The interviews include common questions asked to all parents, as well as group-specific questions tailored to the respective intervention components. Common questions include: "What types of physical activities did you do over the course of the study and how often?", "Did you use any of the intervention materials/worksheets that were shared with you at these meetings?", "Were there any barriers to supporting your child's physical activity?", and "During the course of the study, did you notice any changes in regards to your relationship with your child, well-being or family functioning?". Group-specific questions for parents in the identity intervention group ask about how discussions on supportive parent identity and family identity as an active family influenced their motivation and commitment to supporting their child's physical activity. To control for attention, parents in the planning intervention group, had questions related to the Canadian Food Guide and were asked about how the shared information impacted their understanding and motivation to support healthy eating habits. These questions have proved useful in our prior evaluations [ 14 ] and are designed to provide a thorough illustration of the experience and impacts of the different intervention materials. Analysis strategy Quantitative Process Evaluation Data Analyses Recruitment and retention rates will be determined, after which the pattern of missing data will be determined [ 99 ] . Linear mixed models will then be conducted to determine if condition (0 = education + planning; 1 = education + planning + identity formation) has a differential impact on the children’s MVPA over time. Subsequent models will be conducted that center the linear trend at each time point to determine if a condition effect is also present at a given time point (e.g., at baseline, 6 weeks, 12 weeks or 24 weeks). These analyses will address primary objective 1. The same analytical approach will be used to determine whether there are condition effects on the secondary child fitness outcomes (secondary objective #1). For secondary objective #2, parental support and parental support identity will be treated as time varying covariates to examine their relationships with children’s MVPA over time. Next, if a condition effect is present for the children’s MVPA, analyses will be conducted to determine if the parental support / parental support identity variables mediate the condition / children’s MVPA relationship. Finally, exploratory analyses will be conducted to examine potential intergenerational, sex and seasonal influences on the children’s MVPA over time. Qualitative Process Evaluation Data Analyses Participants will be invited to participate in exit interviews designed to elicit in-depth information about the quality of processes embedded within the program [ 100 ] . This will draw from a qualitative social constructionist perspective [ 101 ] to understand in the parents’ own words, the beneficial features and any problematic components of the intervention. Data collected via the semi-structured interviews will be analyzed through use of inductive content analytic procedures [ 102 ] , through use of the NVivo software program, and themes will be identified that correspond to the strengths and limitations of the intervention program. The response themes will also be linked at the individual level, so post-hoc assessment of successful and unsuccessful interventions can be examined by these responses. Discussion This protocol describes the implementation of a randomized trial investigating the efficacy of planning and identity interventions aimed at increasing parent-child co-activity and parent support behaviours. This research is conceptually guided by the M-PAC framework [ 83 ] and has important implications for promoting children's physical activity. By explicitly targeting and fostering parents' "physical activity support identity" - their self-categorization as a parent who actively supports their child's physical activity engagement - this study addresses a key yet understudied influence on child physical activity behaviors in intervention research. If successful, the findings could inform the development of more effective family-based interventions that have the potential to create more sustainable changes in child physical activity behaviours and ultimately contribute to improved health outcomes. To date, we have obtained ethical approval, registered the trial, and have initiated recruitment and enrolledment efforts. Our recruitment strategies include targeted social media advertisements, distribution of flyers in community centers and schools, and outreach to local pediatricians and family health clinics. Through these efforts, we have generated interest from 50 families in the Greater Victoria region, 25 families in the Greater Vancouver region, and 14 families in the Greater Nanaimo region. From those expressing interest, 30 families have been assessed for eligibility based on our inclusion criteria of having a child aged 6–12 years old, being able to commit to the study requirements, and not having any medical conditions that would preclude participation in physical activity. Of these, 27 families have been deemed eligible and have completed all baseline measures, 25 are active families following two family drop-outs, and 12 are on a waitlist to begin baseline eligibility measures (see Fig. 3 for Participant Flow Diagram). The study is ongoing, and based on our current rate of recruitment, which averages 4 new interested families per week across all regions, we anticipate meeting our target sample size and completing recruitment by January 2026. We will continue to monitor recruitment progress and adjust our strategies as needed to ensure timely completion of the study. Our team has established scientific dissemination records and ongoing and long-standing knowledge exchange connections with international (e.g., International Society for Physical Activity and Health (ISPAH), International Society for Behavioral Nutrition and Physical Activity (ISBNPA), International Society of Behavioral Medicine (ISBM), WHO), national (e.g., ParticipACTION, Public Health Agency of Canada) and provincial (Ministry of Health, BC Healthy Living Alliance) organizations. Should our results support our hypotheses, we will leverage the relationships established through this network to establish a project advisory committee that includes the relevant policy-makers, child service providers and parents for the subsequent scale-up project and mobilization of study findings. This will ensure that our research findings are translated into practical recommendations and resources that can be integrated into existing programs and services to maximize their impact on child physical activity promotion. Abbreviations BCT - Behaviour Change Technique CI - Confidence Interval CONSORT - Consolidated Standards of Reporting Trials CPM - Counts per Minute CSEP - Canadian Society for Exercise Physiology GLTEQ - Godin Leisure-Time Exercise Questionnaire HREB - Human Research Ethics Board ICC - Intraclass Correlation Coefficient ISPAH - International Society for Physical Activity and Health ISBNPA - International Society for Behavioral Nutrition and Physical Activity ISBM - International Society of Behavioral Medicine KT - Knowledge Translation mCAFT – Modified Canadian Aerobic Fitness Test M-PAC - Multi-Process Action Control Framework MVPA - Moderate-to-Vigorous Physical Activity PARS - Physical Activity Regulation Scale ParQ+ - Physical Activity Readiness Questionnaire for Everyone REBC - Research Ethics Board of BC RISe - Research and Information Systems RMSEA - Root Mean Square Error of Approximation RSSI - Received Signal Strength Indicator SRBAI - Self-Reported Behavioural Automaticity Index SRHI - Self-Reported Habit Strength Index SRMR - Standardized Root Mean Square Residual SPIRIT - Standard Protocol Items: Recommendations for Interventional Trials UBC - University of British Columbia UVic - University of Victoria VIU - Vancouver Island University WHO - World Health Organization Declarations Ethics approval and consent to participate This study protocol was approved by the University of Victoria Human Research Ethics Board (Victoria, Canada) reference number 23-0022. Informed consent is obtained from all participants before study enrolment. Consent for publication Not applicable. Availability of data and materials The datasets generated and/or analysed during the current study are not publicly available as per ethical approval from HREB at the University of Victoria, which stipulates that the data will not accessed or analyzed by others. Competing interests The authors have no competing interests to declare. Funding This project is funded by Diabetes Canada Grant (OG-3-22-5649-RR). The funding body had no role in the design, data collection, or reporting associated with this study. Authors' contributions ES and RER contributed to the conception and design of the study. ES and RER drafted the manuscript. MB, KS, CM, VC, SS, LV, and SC reviewed the paper and approved the final submission. RER is responsible for project oversight. Acknowledgements Not applicable. References Ahn, J. V., Sera, F., Cummins, S. & Flouri, E. Associations between objectively measured physical activity and later mental health outcomes in children: findings from the UK Millennium Cohort Study. J. Epidemiol. Community Health 72 , 94–100 (2018). Biddle, S. J. H., Ciaccioni, S., Thomas, G. & Vergeer, I. Physical activity and mental health in children and adolescents: an updated review of reviews and an analysis of causality. Psychology of Sport and Exercise vol. 42 146–155 (2019). Donnelly, J. E. et al. Physical Activity, Fitness, Cognitive Function, and Academic Achievement in Children: A Systematic Review. Med. Sci. Sports Exerc. 48 , 1197–1222 (2016). Janssen, I. & LeBlanc, A. G. Systematic review of the health benefits of physical activity and fitness in school-aged children and youth. Int. J. Behav. Nutr. Phys. Act. 7 , 40 (2010). Poitras, V. J. et al. Systematic review of the relationships between objectively measured physical activity and health indicators in school-aged children and youth. Appl. Physiol. Nutr. Metab. Physiol. Appl. Nutr. Metab. 41 , S197-239 (2016). Jones, R. A., Hinkley, T., Okely, A. D. & Salmon, J. Tracking physical activity and sedentary behavior in childhood: a systematic review. Am. J. Prev. Med. 44 , 651–658 (2013). World Health Organization. Global Health Observatory (GHO) Data: Prevalence of Insufficient Physical Activity . https://www.who.int/data/gho/data/indicators/indicator-details/GHO/prevalence-of-insufficient-physical-activity-among-school-going-adolescents-aged-11-17-years (2016). Roberts, K. C. et al. Meeting the Canadian 24-Hour Movement Guidelines for Children and Youth. Health Rep. 28 , 3–7 (2017). Chaput, J.-P. et al. Proportion of preschool-aged children meeting the Canadian 24-Hour Movement Guidelines and associations with adiposity: results from the Canadian Health Measures Survey. BMC Public Health 17 , 147–154 (2017). Rhodes, R. E. et al. Development of a consensus statement on the role of the family in the physical activity, sedentary, and sleep behaviours of children and youth. Int. J. Behav. Nutr. Phys. Act. 17 , 74 (2020). Beets, M. W., Cardinal, B. J. & Alderman, B. L. Parental social support and the physical activity-related behaviors of youth: a review. Health Educ. Behav. Off. Publ. Soc. Public Health Educ. 37 , 621–644 (2010). Brown, H. E. et al. Family-based interventions to increase physical activity in children: a systematic review, meta-analysis and realist synthesis. Obes. Rev. Off. J. Int. Assoc. Study Obes. 17 , 345–360 (2016). Pyper, E., Harrington, D. & Manson, H. The impact of different types of parental support behaviours on child physical activity, healthy eating, and screen time: a cross-sectional study. BMC Public Health 16 , 568 (2016). Rhodes, R. E., Blanchard, C. M., Quinlan, A., Naylor, P.-J. & Warburton, D. E. R. Family Physical Activity Planning and Child Physical Activity Outcomes: A Randomized Trial. Am. J. Prev. Med. 57 , 135–144 (2019). Rhodes, R. E., Naylor, P.-J. & McKay, H. A. Pilot study of a family physical activity planning intervention among parents and their children. J. Behav. Med. 33 , 91–100 (2010). Rhodes, R. E., Perdew, M. & Malli, S. Correlates of Parental Support of Child and Youth Physical Activity: a Systematic Review. Int. J. Behav. Med. 27 , 636–646 (2020). Rhodes, R. E. et al. Couple-Based Physical Activity Planning for New Parents: A Randomized Trial. Am. J. Prev. Med. 61 , 518–528 (2021). Dunton, G. F. et al. Towards consensus in conceptualizing and operationalizing physical activity maintenance. Psychol. Sport Exerc. 61 , 102214 (2022). Rhodes, R. E. & Sui, W. Physical Activity Maintenance: A Critical Narrative Review and Directions for Future Research. Front. Psychol. 12 , 725671 (2021). Rhodes, R. E. Multi-process action control in physical activity: a primer. Front. Psychol. 12 , 797484 (2021). Rhodes, R. E., Janssen, I., Bredin, S. S. D., Warburton, D. E. R. & Bauman, A. Physical activity: Health impact, prevalence, correlates and interventions. Psychol. Health 32 , 942–975 (2017). Conner, M. & Norman, P. Predicting and changing health behaviour: A social cognition approach. Predict. Chang. Health Behav. Res. Pract. Soc. Cogn. Models 3 , 1–29 (2015). Rhodes, R. E. & Yao, C. A. Models accounting for intention-behavior discordance in the physical activity domain: a user’s guide, content overview, and review of current evidence. Int. J. Behav. Nutr. Phys. Act. 12 , 9 (2015). Rhodes, R. E. et al. Application of the Multi-Process Action Control Framework to Understand Parental Support of Child and Youth Physical Activity, Sleep, and Screen Time Behaviours. Appl. Psychol. Health Well-Being 11 , 223–239 (2019). Rhodes, R. E. et al. Understanding action control of parental support behavior for child physical activity. Health Psychol. Off. J. Div. Health Psychol. Am. Psychol. Assoc. 35 , 131–140 (2016). Tanna, S., Arbour-Nicitopoulos, K., Rhodes, R. E. & Bassett-Gunter, R. A pilot study exploring the use of a telephone-assisted planning intervention to promote parental support for physical activity among children and youth with disabilities. Psychol. Sport Exerc. 32 , 25–33 (2017). Grant, S. J. et al. Parents and children active together: a randomized trial protocol examining motivational, regulatory, and habitual intervention approaches. BMC Public Health 20 , 1436 (2020). Medd, E. R. et al. Family-based habit intervention to promote parent support for child physical activity in Canada: protocol for a randomised trial. BMJ Open 10 , e033732 (2020). Quinlan, A., Rhodes, R. E., Blanchard, C. M., Naylor, P.-J. & Warburton, D. E. R. Family planning to promote physical activity: a randomized controlled trial protocol. BMC Public Health 15 , 1011 (2015). Beauchamp, M. R. Promoting Exercise Adherence Through Groups: A Self-Categorization Theory Perspective. Exerc. Sport Sci. Rev. 47 , 54–61 (2019). J. Burke, P. & E. Stets, J. Identity Theory . (Oxford University Press USA, 2009). Rhodes, R. E. et al. Enacting physical activity intention: Multi-process action control. Self-Regul. Motiv. Sport Exerc. Oxon UK Taylor Francis (2020). Stryker, S. & Burke, P. J. The past, present, and future of identity theory. Soc. Psychol. Q. 63 , 284–297 (2000). Tajfel, H. & Turner, J.C. The Social Identity Theory of Intergroup Behavior. in Psychology of Intergroup Relation (eds. Worchel, S. & Austin, W. G.) 7–24 (Hall Publishers, Chicago, 1986). Rees, T., Alexander Haslam, S., Coffee, P. & Lavallee, D. A social identity approach to sport psychology: Principles, practice, and prospects. Sports Med. 45 , 1083–1096 (2015). Turner, J. C., Hogg, M. A., Oakes, P. J., Reicher, S. D. & Wetherell, M. S. Rediscovering the Social Group: A Self-Categorization Theory. (basil Blackwell, 1987). Abrams, D. & Hogg, M. A. Social Identifications: A Social Psychology of Intergroup Relations and Group Processes . (Routledge, 2006). Hollman, H., Sui, W. & Rhodes, R. E. A feasibility randomized controlled trial of a multi-process action control web-based intervention that targets physical activity in mothers. Women Health 62 , 384–401 (2022). Husband, C. J., Wharf-Higgins, J. & Rhodes, R. E. A feasibility randomized trial of an identity-based physical activity intervention among university students. Health Psychol. Behav. Med. 7 , 128–146 (2019). McEwan, D., Rhodes, R. E. & Beauchamp, M. R. What happens when the party is over?: sustaining physical activity behaviors after intervention cessation. Behav. Med. 48 , 1–9 (2022). Rhodes, R. E. et al. Predicting the physical activity of new parents who participated in a physical activity intervention. Soc. Sci. Med. 284 , 114221 (2021). Rhodes, R. E., Quinlan, A., Naylor, P.-J., Warburton, D. E. & Blanchard, C. M. Predicting personal physical activity of parents during participation in a family intervention targeting their children. J. Behav. Med. 43 , 209–224 (2020). Chan, A.-W. et al. SPIRIT 2013 statement: defining standard protocol items for clinical trials. Ann. Intern. Med. 158 , 200–207 (2013). Schulz, K. F., Altman, D. G. & Moher, D. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. J. Pharmacol. Pharmacother. 1 , 100–107 (2010). Rhodes, R. E., Wierts, C., Kullman, S., Magel, E. & Strachan, S. M. Experimental manipulations of physical activity identity: A systematic review and meta-analysis. Health Psychol. Rev. (In press). Wright, C. E., Rhodes, R. E., Ruggiero, E. W. & Sheeran, P. Benchmarking the effectiveness of interventions to promote physical activity: A metasynthesis. Health Psychol. Off. J. Div. Health Psychol. Am. Psychol. Assoc. 40 , 811–821 (2021). Rhodes, R. E. Translating physical activity intentions into regular behavior is a consequence of reflective, regulatory, and reflexive processes. Exerc. Sport Sci. Rev. 52 , 13–22 (2024). Yao, C. A. & Rhodes, R. E. Parental correlates in child and adolescent physical activity: a meta-analysis. Int. J. Behav. Nutr. Phys. Act. 12 , 10 (2015). Tremblay, M. S. et al. Canadian 24-Hour Movement Guidelines for Children and Youth: An Integration of Physical Activity, Sedentary Behaviour, and Sleep. Appl. Physiol. Nutr. Metab. 41 , S311–S327 (2016). Warburton, D. E., Jamnik, V. K., Bredin, S. S. & Gledhill, N. The physical activity readiness questionnaire for everyone (PAR-Q+) and electronic physical activity readiness medical examination (ePARmed-X+). Health Fit. J. Can. 4 , 3–17 (2011). Dumas, J. E., Lynch, A. M., Laughlin, J. E., Smith, E. P. & Prinz, R. J. Promoting intervention fidelity: Conceptual issues, methods, and preliminary results from the EARLY ALLIANCE prevention trial. Am. J. Prev. Med. 20 , 38–47 (2001). Hagger, M.S et al. Implementation intention and planning interventions in Health Psychology: Recommendations from the Synergy Expert Group for research and practice. Psychol. Health 31 , (2016). Rhodes, R. E., Grant, S. & de Bruijn, G.-J. Planning and implementation intention interventions. in The handbook of behavior change. 572–585 (Cambridge University Press, New York, NY, US, 2020). doi:10.1017/9781108677318.039. Schwarzer, R. Modeling Health Behavior Change: How to Predict and Modify the Adoption and Maintenance of Health Behaviors. Appl. Psychol. 57 , 1–29 (2008). Sui, W., Hollman, H., Magel, E. & Rhodes, R. E. Increasing physical activity among adults affected by COVID-19 social distancing restrictions: A feasibility trial of an online intervention. J. Behav. Med. ((In press)). Locke, E. A. & Latham, G. P. A Theory of Goal Setting & Task Performance. (Prentice-Hall, Inc, 1990). Prestwich, A., Lawton, R. & Conner, M. The use of implementation intentions and the decision balance sheet in promoting exercise behaviour. Psychol. Health 18 , 707–721 (2003). Sniehotta, F. F., Scholz, U. & Schwarzer, R. Bridging the intention–behaviour gap: Planning, self-efficacy, and action control in the adoption and maintenance of physical exercise. Psychol. Health 20 , 143–160 (2005). Sniehotta, F. F., Scholz, U. & Schwarzer, R. Action plans and coping plans for physical exercise: A longitudinal intervention study in cardiac rehabilitation. Br. J. Health Psychol. 11 , 23–37 (2006). Strecher, V. J. et al. Goal setting as a strategy for health behavior change. Health Educ. Q. 22 , 190–200 (1995). Health Canada. Canada’s food guide: Healthy eating resources. https://food-guide.canada.ca/en/healthy-eating-resources/ (2024). Burke, P. J. Identity change. Soc. Psychol. Q. 69 , 81–96 (2006). Kendzierski, D. & Morganstein, M. S. Test, revision, and cross-validation of the physical activity self-definition model. J. Sport Exerc. Psychol. 31 , 484–504 (2009). Cox, A. & Rhodes, R. Increasing physical activity in empty nest and retired populations online: a randomized feasibility trial protocol. Int. J. Environ. Res. Public. Health 17 , 3544 (2020). Steffens, N. K., Fransen, K. & Haslam, S. A. Leadership. in The new psychology of sport and exercise: the social identity approach 41–58 (Sage: Thousand Oaks., 2020). Carron, A. V., Widmeyer, W. N. & Brawley, L. R. The Development of an Instrument to Assess Cohesion in Sport Teams: The Group Environment Questionnaire. J. Sport Psychol. 7 , 244–266 (1985). Oakes, P. J., Haslam, S. A. & Turner, J. C. Stereotyping and Social Reality. (Blackwell Publishing, 1994). Michie, S. et al. The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions. Ann. Behav. Med. 46 , 81–95 (2013). Haslam, S. A., Oakes, P. J. & Turner, J. C. Social identity, self-categorization, and the perceived homogeneity of ingroups and outgroups: The interaction between social motivation and cognition. (1996). Esliger, D. W. & Tremblay, M. S. Physical activity and inactivity profiling: the next generation. Appl. Physiol. Nutr. Metab. 32 , S195–S207 (2007). Cain, K. L., Sallis, J. F., Conway, T. L., Van Dyck, D. & Calhoon, L. Using accelerometers in youth physical activity studies: a review of methods. J. Phys. Act. Health 10 , 437–450 (2013). Trost, S. G., McIver, K. L. & Pate, R. R. Conducting Accelerometer-Based Activity Assessments in Field-Based Research. Med. Sci. Sports Exerc. 37 , (2005). Troiano, R. P. et al. Physical activity in the United States measured by accelerometer. Med. Sci. Sports Exerc. 40 , 181 (2008). Evenson, K. R., Catellier, D. J., Gill, K., Ondrak, K. S. & McMurray, R. G. Calibration of two objective measures of physical activity for children. J. Sports Sci. 26 , 1557–1565 (2008). Migueles, J. H. et al. Accelerometer data collection and processing criteria to assess physical activity and other outcomes: a systematic review and practical considerations. Sports Med. 47 , 1821–1845 (2017). Godin, G., Jobin, J. & Bouillon, J. Assessment of leisure time exercise behavior by self-report: a concurrent validity study. Can. J. Public Health Rev. Can. Sante Publique 77 , 359–362 (1986). Godin, G. & Shephard, R. J. A simple method to assess exercise behavior in the community. Can. J. Appl. Sport Sci. J. Can. Sci. Appl. Au Sport 10 , 141–146 (1985). Actigraph. ActiGraph Launches New Generation of Bluetooth® Smart Activity Monitors. Actigraph https://www.actigraphcorp.com/press-release/actigraph-launches-new-generation-of-bluetooth-smart-activity-monitors/ (2013). Kuzik, N. & Carson, V. Accelerometer Bluetooth proximity validation in parents and early years children. Meas. Phys. Educ. Exerc. Sci. 22 , 287–293 (2018). Dlugonski, D., Wood, A. P., DuBose, K. D., Rider, P. & Schoemann, A. M. Validity and reliability of proximity detection with Bluetooth-enabled accelerometers among adults. Meas. Phys. Educ. Exerc. Sci. 23 , 272–279 (2019). Gledhill, N. & Jamnik, V. K. Canadian Physical Activity, Fitness and Lifestyle Approach. (Canadian Society for Exercise Physiology, 2003). Canadian Society for Exercise Physiology (CSEP). The Canadian Physical Activity, Fitness and Lifestyle Approach (CPAFLA) . (Canadian Society for Exercise Physiology, 2003). Rhodes, R. E. The evolving understanding of physical activity behavior: A multi-process action control approach. in Advances in motivation science vol. 4 171–205 (Elsevier, 2017). Davison, K. K., Cutting, T. M. & Birch, L. L. Parents’ activity-related parenting practices predict girls’ physical activity. Med. Sci. Sports Exerc. 35 , 1589 (2003). Anderson, D. F., Cychosz, C. M. & Franke, W. D. Association of exercise identity with measures of exercise commitment and physiological indicators of fitness in a law enforcement cohort. J. Sport Behav. 21 , 233–241 (1998). Anderson, D. F. & Cychosz, C. M. Development of an exercise identity scale. Percept. Mot. Skills 78 , 747–751 (1994). Anderson, D. F. & Cychosz, C. M. Exploration of the relationship between exercise behavior and exercise identity. J. Sport Behav. 18 , 159–166 (1995). Wilson, P. M. & Muon, S. Psychometric properties of the Exercise Identity Scale in a university sample. Int. J. Sport Exerc. Psychol. 6 , 115–131 (2008). Doosje, B., Ellemers, N. & Spears, R. Perceived intragroup variability as a function of group status and identification. J. Exp. Soc. Psychol. 31 , 410–436 (1995). Verplanken, B. & Orbell, S. Reflections on Past Behavior: A Self‐Report Index of Habit Strength. J. Appl. Soc. Psychol. 33 , 1313–1330 (2003). Gardner, B., Abraham, C., Lally, P. & de Bruijn, G.-J. Towards parsimony in habit measurement: Testing the convergent and predictive validity of an automaticity subscale of the Self-Report Habit Index. Int. J. Behav. Nutr. Phys. Act. 9 , 102 (2012). Rhodes, R. E. & Lithopoulos, A. The Physical Activity Regulation Scale: Development and validity testing. Health Psychol. 42 , 378 (2023). Lithopoulos, A., Zhang, C.-Q., Williams, D. M. & Rhodes, R. E. Development and validation of a two-component perceived control measure. Ann. Behav. Med. 57 , 175–184 (2023). Ajzen, I. The theory of planned behavior. Theor. Cogn. Self-Regul. 50 , 179–211 (1991). Rhodes, R. E. & Courneya, K. S. Investigating multiple components of attitude, subjective norm, and perceived control: An examination of the theory of planned behaviour in the exercise domain. Br. J. Soc. Psychol. 42 , 129–146 (2003). Courneya, K. S. Predicting repeated behavior from intention: The issue of scale correspondence. J. Appl. Soc. Psychol. 24 , 580–594 (1994). Rhodes, R. E., Blanchard, C. M. & Matheson, D. H. A multicomponent model of the theory of planned behaviour. Br. J. Health Psychol. 11 , 119–137 (2006). Rhodes, R. E. & Rebar, A. L. Conceptualizing and Defining the Intention Construct for Future Physical Activity Research. Exerc. Sport Sci. Rev. 45 , 209–216 (2017). Allison, P. Missing Data . (Thousand Oaks, California, 2002). doi:10.4135/9781412985079. Creswell, J. W. Qualitative Inquiry and Research Design: Choosing among Five Traditions. xv, 403 (Sage Publications, Inc, Thousand Oaks, CA, US, 1998). Schwandt, T. A. Three epistemological stances for qualitative inquiry: Interpretivism, hermeneutics, and social constructionism. in Handbook of qualitative research 189–213 (SAGE Publishing, 2000). Maykut, P. & Morehouse, R. Beginning Qualitative Research: A Philosophical and Practical Guide . (Routledge, 2002). Table 1 Table 1 is available in the Supplementary Files section. Additional Declarations No competing interests reported. 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2","display":"","copyAsset":false,"role":"figure","size":708028,"visible":true,"origin":"","legend":"\u003cp\u003eFlow Diagram of Outcomes Assessed Throughout the Trial\u003c/p\u003e","description":"","filename":"Figure2.png","url":"https://assets-eu.researchsquare.com/files/rs-4415668/v1/baf3748064beae093c215f5f.png"},{"id":58076711,"identity":"e41e7455-499b-4281-bab2-c70a8ffaf16f","added_by":"auto","created_at":"2024-06-10 22:21:51","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":124832,"visible":true,"origin":"","legend":"\u003cp\u003eFlow Diagram of Participant Recruitment\u003c/p\u003e","description":"","filename":"Figure3.png","url":"https://assets-eu.researchsquare.com/files/rs-4415668/v1/9b72f0ac5dc7c8001a04834b.png"},{"id":65627139,"identity":"52bd0f35-0e7e-401d-839b-746010aec1b1","added_by":"auto","created_at":"2024-09-30 16:12:25","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1799984,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4415668/v1/b2e7ff24-99fc-41b0-80e4-8f76fcb27f55.pdf"},{"id":58076713,"identity":"7ceafb2f-4a93-4825-9142-2cec42eecaaf","added_by":"auto","created_at":"2024-06-10 22:21:51","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":621934,"visible":true,"origin":"","legend":"","description":"","filename":"Table1.docx","url":"https://assets-eu.researchsquare.com/files/rs-4415668/v1/5acf6be9ce8a6a763996545e.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"“We Are an Active Family”: A Randomized Trial Protocol to Evaluate A Family-System Social Identity Intervention To Promote Child Physical Activity","fulltext":[{"header":"Introduction","content":"\u003cp\u003eChildren who engage in consistent moderate-to-vigorous physical activity (MVPA) are more likely to display positive health outcomes than their low active counterparts, such as better body composition, increased cardiorespiratory and musculoskeletal fitness, improved cardiovascular and metabolic health, positive emotional and behavioral regulation, and a reduced risk of chronic diseases \u003csup\u003e[\u003cspan additionalcitationids=\"CR2 CR3 CR4\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u0026ndash;[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003e. Additionally, higher levels of childhood physical fitness have been associated with superior health and sustained physical activity (PA) participation in later adulthood \u003csup\u003e[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eDespite this overwhelming evidence, most children and youth (within the Western World) fail to adhere to international public health guidelines of 60 minutes per day of MVPA \u003csup\u003e[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]\u003c/sup\u003e. In Canada, over 80% of children are not active enough to reap the optimal benefits of MVPA (Roberts et al., 2017). Additional findings indicate that only 13% of 3\u0026ndash;4-year-olds \u003csup\u003e[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/sup\u003e and 17% of 5\u0026ndash;17-year-olds meet the international guidelines for MVPA \u003csup\u003e[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e],[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/sup\u003e. Therefore, it is clear that promoting PA during childhood is a public health priority.\u003c/p\u003e \u003cp\u003eChildren spend considerable time within the care of their parents. Parents play an important role in establishing child PA behaviours; therefore, emphasizing the family system as a viable target for PA promotion initiatives \u003csup\u003e[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]\u003c/sup\u003e. In support of this contention, there is a consistent and medium-sized correlation between supportive PA parenting practices and child PA \u003csup\u003e[\u003cspan additionalcitationids=\"CR12\" citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]\u0026ndash;[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]\u003c/sup\u003e. Parental support involves any actions (by parents) designed to meet the psychological, social, and physical needs of their children with the goal of promoting their child\u0026rsquo;s physical activity \u003csup\u003e[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e],[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]\u003c/sup\u003e. These support behaviours may manifest as encouragement, logistical support (e.g., signing children up for recreation activities, transport to activities), and intergenerational PA behaviors (e.g., parent and child recreation activities together) \u003csup\u003e[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e],[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eDespite support for the positive correlations between parental support practices and child PA in observational designs, interventions focused on family PA have been generally unsuccessful, particularly in terms of sustaining behavioral changes \u003csup\u003e[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/sup\u003e. Specifically, interventions focused on increasing parental support of child PA have been found to result in some positive changes in children\u0026rsquo;s PA (Standard Mean Difference (SMD)\u0026thinsp;=\u0026thinsp;0. 29; 95% Confidence Interval (CI) 0.14 to 0.45) in the first six-weeks \u003csup\u003e[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/sup\u003e, but there is little evidence for sustained changes in the long-term. Previous randomized trials promoting family PA \u003csup\u003e[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]\u003c/sup\u003e and MVPA \u003csup\u003e[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e],[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]\u003c/sup\u003e have reflected this evidence, showing that assisting parents with self-regulation skills (e.g., planning) can improve children\u0026rsquo;s MVPA over educational approaches (e.g., persuasive facts about the benefits of activity), yet, this approach also appears to wane in its effectiveness by 6-months post intervention \u003csup\u003e[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/sup\u003e. In light of these outcomes, there is a need to focus on improving the effectiveness of family-based interventions for MVPA so that they may sustain initial behavioral changes.\u003c/p\u003e \u003cp\u003eTo address this, contemporary research in PA promotion has started to examine the effectiveness of behavior change interventions that specifically target long-term maintenance processes within the general population \u003csup\u003e[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]\u003c/sup\u003e, such as building habits and identity \u003csup\u003e[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]\u003c/sup\u003e. One of the most frequently applied frameworks within the PA domain with this focus on habit and identity is the multi-process action control framework (M-PAC) \u003csup\u003e[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e],[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]\u003c/sup\u003e. The tenets of M-PAC suggest that sustained behaviour change is a function of three subsequent and overlapping processes. At the foundation of M-PAC are reflective processes (i.e., conscious expectations of behavioral consequences), such as attitudes and perceptions of control, which culminate in the formation of an intention to engage in PA. This framework is similar to the tenets of most intention-based social cognitive theories \u003csup\u003e[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]\u003c/sup\u003e. However, turning intention into behavior is dependent on regulation processes (e.g., planning, monitoring, regulating emotions), as people begin to use tactics to help translate positive intentions into action \u003csup\u003e[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]\u003c/sup\u003e. Finally, behavioral maintenance \u003csup\u003e[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e],[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]\u003c/sup\u003e is developed through habit and identity formation, known as reflexive processes (i.e., stimulus-based motivation from learned associations and self-categorization).\u003c/p\u003e \u003cp\u003eThe M-PAC framework is backed by over 30 tests in the PA domain including observational evidence that the provision of parental support is predictive of child PA intentions \u003csup\u003e[\u003cspan additionalcitationids=\"CR25\" citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]\u0026ndash;[\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]\u003c/sup\u003e. While M-PAC is currently being utilized to investigate the role of parental support habits on children\u0026rsquo;s PA \u003csup\u003e[\u003cspan additionalcitationids=\"CR28\" citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]\u0026ndash;[\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]\u003c/sup\u003e, to our knowledge, there has not been a trial to explore this framework and the effectiveness of PA identity promotion in the family system. Previous observational research on predicting parental support for children\u0026rsquo;s PA \u003csup\u003e[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]\u003c/sup\u003e and reviews of PA identity processes \u003csup\u003e[\u003cspan additionalcitationids=\"CR31 CR32\" citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]\u0026ndash;[\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]\u003c/sup\u003e, suggest identity may be a potent mechanism for sustaining long term PA.\u003c/p\u003e \u003cp\u003eIdentity represents the meanings that individuals assign to the (multiple) roles they may play and the expectations that are associated with those roles \u003csup\u003e[\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]\u003c/sup\u003e. This encompasses both self-identity and social identity. Self-identity involves the meanings and expectations a person attaches to a role based on their own internalized belief. For example, one\u0026rsquo;s self-identity as a physically active person, may include beliefs about the importance of regular exercise and seeing value in an active lifestyle. Social identity on the other hand reflects a person's self-concept derived from their perceived membership in various social groups \u003csup\u003e[\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]\u003c/sup\u003e. For example, one\u0026rsquo;s social identity as a member of an active family would involve the family's shared views on the importance of physical activity and the expected behaviors of family members, such as regularly engaging in active outings together or supporting each other's fitness goals.\u003c/p\u003e \u003cp\u003eOur self and social identities initiate a self-regulating system that increases our motivation and attention to sustain health behaviours, making them more resilient in the face of counter-stimuli or threats to the identity \u003csup\u003e[\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]\u003c/sup\u003e. When an exercise identity is integrated into the self-concept, physical activity becomes an internalized value and pursuit. Moreover, identifying as a member of \u0026lsquo;an active group\u0026rsquo; (e.g., family) can provides a sense of social support, establish social norms, and motivate identity-consistent behavior to affirm group membership \u003csup\u003e[\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e],[\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]\u003c/sup\u003e. When this happens, behaviour can become habitual (translating positive intentions into behaviour), enabling greater attention to seize identity-affirming physical activity opportunities when they are presented \u003csup\u003e[\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eIn sum, grounding physical activity interventions in identity theory \u003csup\u003e[\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]\u003c/sup\u003e and social identity theory \u003csup\u003e[\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]\u003c/sup\u003e may provide a pathway for physical activity to become more congruent with one's self and social view and lasting behavior change. Helping participants to see their expectations and values attached to an active identity, along with the social influence of identifying with an active group, could help make regular physical activity an integral part of \"who I am.\" Our research aims to test this possibility by exploring self and social identity-based strategies for promoting physical activity adoption and maintenance in families over time.\u003c/p\u003e \u003cdiv id=\"Sec2\" class=\"Section2\"\u003e \u003ch2\u003eStudy Objectives and Hypotheses\u003c/h2\u003e \u003cp\u003eThe primary objective of this study is to explore the effects of a theory-based intervention that targets family identity promotion (with education and planning) to promote child MVPA. For this study, we include the promotion of both self-identity of the parent (i.e., I am a parent supportive of child PA) \u003csup\u003e[\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]\u003c/sup\u003e and social identity \u003csup\u003e[\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e],[\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]\u003c/sup\u003e of the family (i.e., we are an active family) to better account for the family system \u003csup\u003e[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]\u003c/sup\u003e. Based off previous literature \u003csup\u003e[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e],[\u003cspan additionalcitationids=\"CR39 CR40\" citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]\u0026ndash;[\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e]\u003c/sup\u003e, it is hypothesized that the MVPA for children in the identity promotion condition will be higher in comparison to the MVPA for children in the standard PA education and planning condition at six months.\u003c/p\u003e \u003cp\u003eSecondary objectives of the trial include the evaluation of children\u0026rsquo;s health-related fitness outcomes between the identity promotion condition and the education and planning condition at baseline and 6-months. It is hypothesized that child health-related fitness outcomes will be higher for the identity formation condition in comparison to the education and planning condition due to improved adherence. Specifically, in light of the anticipated superior adoption and maintenance of MVPA by children in the identity condition, we also anticipate that they will display better fitness than those randomized to the planning condition.\u003c/p\u003e \u003cp\u003eAdditionally, group differences among behavioural and health-related fitness outcomes will be examined by a mediation model. It is hypothesized that the effect of the assigned conditions (identity promotion vs. standard education and planning) on child MVPA will be mediated by parental support behaviors, and this mediation will be further explained by parents' identity as supportive of their child's physical activity (i.e., manipulation check). In turn, the covariance of parental support on health-related fitness outcomes is expected to be mediated by children's MVPA levels. In the case of null outcomes for the primary objective, outcomes will be explored with a prediction model of change in PA rather than a mediation model \u003csup\u003e[\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e],[\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]\u003c/sup\u003e. Lastly, this study will explore intergenerational, seasonal, or sex differences across primary outcomes by assigned condition.\u003c/p\u003e \u003c/div\u003e"},{"header":"Methods","content":"\u003cp\u003eThe design, conduct, and reporting of the trial follows the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) guidelines \u003csup\u003e[\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e]\u003c/sup\u003e and conforms to the Consolidated Standards of Reporting Trials (CONSORT) guidelines \u003csup\u003e[\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e]\u003c/sup\u003e. This study is approved by the University of Victoria (UVic) Human Research Ethics Board (HREB). Additionally, this study has harmonized ethics approval by the Research Ethics Board of BC (REBC) for multi-jurisdictional research with the University of British Columbia (UBC) and Vancouver Island University (VIU). The trial is registered with the Clinical Trials Registry maintained by the National Library of Medicine at the National Institutes of Health (ClinicalTrials.gov) Trial ID NCT05794789. The trial was registered on March 2nd of 2023, and last updated on September 28th, 2023.\u003c/p\u003e \u003cp\u003eIf modifications or amendments to the protocol are required, the Project Coordinator will submit the necessary paperwork to the Research and Information Systems (RISe) at UBC. Upon approval, the appropriate updates are made to the trial registration on the Clinical Trials Registry.\u003c/p\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eTrial Design\u003c/h2\u003e \u003cp\u003eThis study is a two-arm parallel single blinded randomized trial. After baseline assessment (fitness testing, MVPA, and questionnaire), participants are randomized to one of two groups: 1) \u003cem\u003ephysical activity education\u0026thinsp;+\u0026thinsp;planning\u0026thinsp;+\u0026thinsp;family identity promotion condition\u003c/em\u003e; or 2) \u003cem\u003ephysical activity education\u0026thinsp;+\u0026thinsp;planning\u003c/em\u003e condition for six months (See Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). The objective of the trial is to evaluate the efficacy of the \u003cem\u003eidentity promotion condition\u003c/em\u003e, when compared to the \u003cem\u003eeducation\u0026thinsp;+\u0026thinsp;planning\u003c/em\u003e condition, at the primary end-point of the trial (6 months) with secondary assessment time points at 6-weeks and 3-months.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eSample Size Calculation\u003c/h2\u003e \u003cp\u003eA power calculation was conducted to estimate the required sample size. Power was set at 0.80 with four repeated assessments, one-between group factor, an alpha of .05, and a medium effect size (Cohen's f\u0026thinsp;=\u0026thinsp;.25), indicaed that 128 families are needed to show a significant condition by time effect for PA \u003csup\u003e[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e],[\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e],[\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e]\u003c/sup\u003e. This effect size is consistent with previous studies examining physical activity interventions \u003csup\u003e[\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e],[\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e]\u003c/sup\u003e. With an expected attrition rate of 15% \u003csup\u003e[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/sup\u003e, 148 families (74 children per condition) will therefore be recruited.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eParticipants and Eligibility\u003c/h2\u003e \u003cp\u003eParticipants are single or common law/married adult(s), with at least one child between the ages of six and twelve years. This age range has been shown to be the most effective for family-based intervention, as the influence of peer-relationships supercedes that of the parents by the teenage years. Families reside on Southern Vancouver Island spanning from Greater Victoria to the city of Nanaimo, British Columbia, Canada; as well as the Lower Mainland of British Columbia (Canada) encompassing Vancouver, Richmond, Surrey, Burnaby, Langley, and Coquitlam. Participants will be included if children participate in PA below Canadian recommendations of \u0026lt;\u0026thinsp;60 minutes/day of MVPA (screened by parental report through initial recruitment contact) \u003csup\u003e[\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e]\u003c/sup\u003e. To aid in the interpretation of this recommendation, our recruitment information includes examples of how one might accrue MVPA with an example schedule for the week. We also screen families based on child baseline accelerometry results (as a secondary assurance). If more than one child per family is eligible in this range, we randomly designate (via computer randomizer) a child as the target for analysis yet include all willing children within the study. If the child is not eligible due to meeting guidelines, the family is given the baseline honorarium, and removed from the study. The target parent(s) PA levels may be above or below the adult recommendations as they have no bearing on their eligibility to participate in the study.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eConsent and Permissions\u003c/h2\u003e \u003cp\u003e Participating parents are required to provide written consent and complete\u003c/p\u003e \u003cp\u003eParQ\u0026thinsp;+\u0026thinsp;Health Screening Questionnaire \u003csup\u003e[\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e]\u003c/sup\u003e to ensure they are physically healthy (i.e., no known episode of chest pain, dizziness, or joint problems after physical activity) to engage in MVPA before participating in this study. Parents are required to sign informed consent forms if they agree to participate as a family unit, with verbal assent also obtained from the participating children from each family.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eRecruitment\u003c/h2\u003e \u003cp\u003eRecruitment is conducted by the Behavioural Medicine Lab at the University of Victoria in British Columbia, Canada. Based on our extensive experience with prior family trials \u003csup\u003e[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e],[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e],[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e],[\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e],[\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]\u003c/sup\u003e, participants are recruited through a variety of avenues including (1) social media and online interest sites, (2) in-person markets and recruitment poster drops, and (3) community-based promotion and brand partnerships. The recruitment radius is stratified into three regions: Greater Victoria, Greater Nanaimo, and Greater Vancouver. Within each region, a complete list of schools, recreation centres, community centers, outdoor markets and health centers are approached to help facilitate recruitment, to maintain consistency along all regions of Southern Vancouver Island and Lower Mainland.\u003c/p\u003e \u003cp\u003eParticipants are recruited primarily through the social media platforms Facebook and Instagram. Facebook and Instagram posts are made bi-monthly by the Behavioural Medicine Lab Recruitment Officer on the Behavioural Medicine Lab Facebook page (\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.facebook.com/UVicBMED/\u003c/span\u003e\u003cspan address=\"https://www.facebook.com/UVicBMED/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e) and Instagram account (@uvicbmed). These social media pages are linked, meaning a post made on Facebook is simultaneously shared on Instagram and vice versa. Posts are limited to 100 words or less and briefly describe the intent of the study and those eligible to partake, asking those interested to contact the Behavioural Medicine Lab through email or phone information provided in the post. Facebook posts are also shared to relevant Facebook groups (e.g., neighbourhood groups, young parent groups, homeschool group). Facebook posts are socially amplified by paying a small fee to have the post appear as an advertisement in a target demographic\u0026rsquo;s news feed. The target demographic is specified by selecting variables of age, location of residence, and other filters such as \u0026ldquo;parents\u0026rdquo;, and the advertisement typically run for 7 days.\u003c/p\u003e \u003cp\u003eThe Recruitment Officer also sets up a recruitment booth on average 2\u0026ndash;3 times at local markets and festival events during the summer, and at community and recreation centers in the winter to engage with potential participants, answer questions, and collect contact information for interested families. Posters are put up or mailed out every 3\u0026ndash;4 months by a Research Assistant and/or Recruitment Officer in all major recreation centers in the area, as well as shopping centers, health care centers, and schools. Word of mouth is also used as a recruitment strategy. We currently recruit approximately 3\u0026ndash;5 interested families per week with this strategy.\u003c/p\u003e \u003cp\u003eAdditionally, we incorporated an incentive program to maximize recruitment interest. This program was set up through partnerships with local Universities (UVic, UBC, \u0026amp; VIU) as well as local businesses (Flying Squirrel, local gyms, apparel stores) to provide participants with draw prizes when screened to participate.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eRandomization\u003c/h2\u003e \u003cp\u003eRandomisation is performed by a Research Assistant assigned by the Research Coordinator to reduce bias using the Excel Sheet Randomization function. This is done with an allocation ratio of 1:1 to either the \u003cem\u003eeducation\u0026thinsp;+\u0026thinsp;planning\u0026thinsp;+\u0026thinsp;identity promotion condition\u003c/em\u003e or \u003cem\u003eeducation\u0026thinsp;+\u0026thinsp;planning condition\u003c/em\u003e. Participants are blind to their condition until the completion of the study, at which point they are informed of their group by the Project Coordinator and/or Research Assistant. Under no circumstance are participants informed of their condition while they are still enrolled in the study. Fitness testers are blind to each family\u0026rsquo;s condition as well, but the Research Coordinator and Research Assistants are aware of the condition to allow for correct delivery of intervention materials.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eProcedures and Protocol\u003c/h2\u003e \u003cp\u003eWhen interested parents contact the lab, the Recruitment Officer follows up with an email to schedule a phone conversation. If initial contact is a message through Instagram or Facebook, the Recruitment Officer privately replies asking the person to call/email the contact provided in recruitment material or follow the link in the post that allows them to provide their contact information securely through an online form. An initial recruitment phone interview is set up with the Recruitment Officer, and families are screened using a parent-report of their child\u0026rsquo;s average physical activity per day as well as the ParQ\u0026thinsp;+\u0026thinsp;Health Screening Questionnaire \u003csup\u003e[\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e]\u003c/sup\u003e. If participants meet all eligibility criteria, the Recruitment officer advises the Project Coordinator, who then follows up with the family to schedule testing on site at our three satellite locations \u0026ndash; UVic, UBC, or VIU.\u003c/p\u003e \u003cp\u003eOnce deemed eligible and enrolled, participants are scheduled for a baseline assessment. At the initial baseline session, the Fitness Tester obtains written consent from parents and verbal assent from children, and at the completion of the fitness testing, the Fitness Tester provides the participating parent(s) and child (ren) with a short training session on how to wear and use the accelerometers, before sending them home for a week of wear. Upon completion of this device-assessed PA measure, the accelerometers are received through mail-back packages or courier pick-up, and the child MVPA is checked against PA recommendations \u003csup\u003e[\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e]\u003c/sup\u003e as a secondary screening procedure to exclude those families with children meeting international PA guidelines from the trial. Families whose children do not meet those guidelines and therefore eligible to continue are then randomized into one of two intervention conditions and parents are asked to complete a baseline questionnaire.\u003c/p\u003e \u003cp\u003eThe Project Coordinator is responsible for guiding the two groups of participants through their respective interventions over the first 3 weeks after randomization. Both groups receive the same \u003cem\u003estandard education\u0026thinsp;+\u0026thinsp;planning\u003c/em\u003e workshop in the first week. Then in weeks 2 and 3, each group receives two additional workshops relevant to their randomized intervention condition (i.e., \u003cem\u003eeducation\u0026thinsp;+\u0026thinsp;planning\u003c/em\u003e, or \u003cem\u003eeducation\u0026thinsp;+\u0026thinsp;planning\u0026thinsp;+\u0026thinsp;identity promotion\u003c/em\u003e), with one workshop per week.\u003c/p\u003e \u003cp\u003eAt 6 weeks post initial intervention period, families are given follow-up online questionnaires to complete and accelerometers to wear and to return via mail or courier pick-up. Both groups will receive \u0026ldquo;booster\u0026rdquo; sessions administered by a research assistant delivered online via Zoom on the same material as their intervention designation (see Table\u0026nbsp;1 for Behaviour Change Techniques (BCTs) per condition). This process will be followed for the three-month time-period. Thus, two booster sessions at both 6 weeks and 3 months will be provided to the \u003cem\u003eeducation\u0026thinsp;+\u0026thinsp;planning\u003c/em\u003e and \u003cem\u003eeducation\u0026thinsp;+\u0026thinsp;planning\u0026thinsp;+\u0026thinsp;identity promotion\u003c/em\u003e groups.\u003c/p\u003e \u003cp\u003eAt 6 months, in addition to the questionnaires and accelerometry assessment, children will be asked to perform fitness tests once again, and parents will participate in a brief end-of-trial qualitative interview to evaluate the efficacy of the intervention. These semi-structured interviews will allow us to evaluate two key aspects of fidelity outlined by Dumas et al.\u003csup\u003e[\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e]\u003c/sup\u003e: content fidelity, which refers to \"what is done\" in the intervention, and process fidelity, which captures \"how it is done\". While measuring outcomes quantitatively will provide insight into the effectiveness of our intervention, it is also crucial to conduct a process evaluation through participant interviews. This qualitative approach will help determine whether the intervention program was delivered and carried out as intended. To assist study retention, we will offer monetary compensation across the study. Participants will receive an honorarium at baseline (\u003cspan\u003e$\u003c/span\u003e30), 6 weeks (\u003cspan\u003e$\u003c/span\u003e35), and 3 months (\u003cspan\u003e$\u003c/span\u003e40), and 6 months (\u003cspan\u003e$\u003c/span\u003e45) for a total of \u003cspan\u003e$\u003c/span\u003e150. Families only receive honoraria if they complete all the measures for the check point assessment (accelerometers, logbooks, questionnaires). Our experience with several past randomized control trials (RCTs) among families has shown that our protocol keeps attrition around or below 15% \u003csup\u003e[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eInterventions (see Table\u0026nbsp;1)\u003c/h2\u003e \u003cdiv id=\"Sec12\" class=\"Section3\"\u003e \u003ch2\u003eStandard education\u0026thinsp;+\u0026thinsp;planning condition\u003c/h2\u003e \u003cp\u003eParticipants in the \u003cem\u003estandard education\u0026thinsp;+\u0026thinsp;planning condition\u003c/em\u003e will receive an initial baseline coaching session, designed exclusively for parents from a trained kinesiologist. Additionally, they will recieve an information-based series of worksheets that serve to standardize the delivery format of the material and provide a tangible knowledge translation (KT) product for the family after coaching. This is similar to our past family trials \u003csup\u003e[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e],[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e],[\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e],[\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]\u003c/sup\u003e. The coaching session will consist of Canada\u0026rsquo;s 24-Hour Movement Guidelines for kids, which include recommendations of at least 60 minutes of MVPA a day \u003csup\u003e[\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e]\u003c/sup\u003e and a breakdown of ways for the parent to help their child achieve this PA, outlining three main types of parental support (encouragement, logistical support, and co-participation) \u003csup\u003e[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]\u003c/sup\u003e. The worksheet material is provided as prompts and suggestions, and contains questions that reinforce the benefits of PA for the child and family, as well as skill training content (how to plan for family PA). The material specifically includes a brainstorming exercise for parents where they list physical activities they think their children have found fun in the past. This list helps create a template for PA planning by contextualizing what the parents would like to do with their children.\u003c/p\u003e \u003cp\u003eAdditional activities within this material explore how the environment and use of rewards can enhance engagement in physical activity behavior. Discussions around the physical environment (access to recreational facilities, parks, pedestrian-friendly neighborhoods) and social environment (support from family/friends) highlight how supportive environments align with values like health, wellbeing, enjoyment, and social connections. Exploring environments and rewards can facilitate conversations around the values associated with physical activity, and help individuals and families identify the values that motivate their physical activity choices, fostering sustained motivation and turning it into a value-driven habit. The subsequent skill training material for planning is based on several streams of prior work in the adult PA literature \u003csup\u003e[\u003cspan additionalcitationids=\"CR53\" citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e]\u0026ndash;[\u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e]\u003c/sup\u003e and our prior family trials \u003csup\u003e[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e],[\u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e]\u003c/sup\u003e. Aligned with the regulatory processes of M-PAC, families plan for their PA support based on skill training for forming implementation intentions which involve creating specific \"if-then\" plans linking situational cues to desired behaviors (e.g., \"If it's Monday at 6 PM, then I will go for a 30-minute walk\"), as well as action planning, coping planning and traditional goal setting \u003csup\u003e[\u003cspan additionalcitationids=\"CR57 CR58 CR59\" citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e]\u0026ndash;[\u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e60\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eBecause the \u003cem\u003eidentity promotion condition\u003c/em\u003e has two additional workshops (when compared to the comparator intervention condition), the \u003cem\u003eeducation\u0026thinsp;+\u0026thinsp;planning condition\u003c/em\u003e will also receive two additional workshops to compensate for time and attention, rather than content. The workshops will include education and planning material related to family healthy eating. This material will focus on the contents of the updated Canadian Food Guide \u003csup\u003e[\u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e61\u003c/span\u003e]\u003c/sup\u003e, with discussions on macronutrient education, meal planning, healthy food choice strategies, and food labels. They will also receive a digital screen saver for their computer or cellular device with graphics highlighting \u0026ldquo;Healthy Food Habits Start At Home\u0026rdquo;.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eEducation/planning\u0026thinsp;+\u0026thinsp;identity condition\u003c/h2\u003e \u003cp\u003eThe identity formation condition will receive the same content as the \u003cem\u003eeducation\u0026thinsp;+\u0026thinsp;planning condition\u003c/em\u003e during the initial baseline workshop. However, it will augment this material by explicitly targeting, bolstering, and enhancing parents' \"physical activity support identity\" - that is, their self-categorization as a parent who actively supports their child's engagement in physical activity. This will be done through two additional coaching sessions focused on the behavior change principles of self-identity \u003csup\u003e[\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e],[\u003cspan citationid=\"CR62\" class=\"CitationRef\"\u003e62\u003c/span\u003e],[\u003cspan citationid=\"CR63\" class=\"CitationRef\"\u003e63\u003c/span\u003e]\u003c/sup\u003e and social identity theory \u003csup\u003e[\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]\u003c/sup\u003e through two additional coaching sessions, as illustrated in Table\u0026nbsp;1.\u003c/p\u003e \u003cp\u003eSpecifically, the second workshop will involve only the parent(s) to focus on parental support identity and the content based on the behavior change principles of self-identity theory \u003csup\u003e[\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e],[\u003cspan citationid=\"CR62\" class=\"CitationRef\"\u003e62\u003c/span\u003e],[\u003cspan citationid=\"CR63\" class=\"CitationRef\"\u003e63\u003c/span\u003e]\u003c/sup\u003e. This session\u0026rsquo;s activities are based on our prior PA identity formation trials among adults \u003csup\u003e[\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e],[\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e],[\u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e],[\u003cspan citationid=\"CR64\" class=\"CitationRef\"\u003e64\u003c/span\u003e]\u003c/sup\u003e and are adapted to parental support of child PA. These activities are also augmented by principles from social identity theorizing \u003csup\u003e[\u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e65\u003c/span\u003e]\u003c/sup\u003e designed to bolster a \u0026lsquo;sense of us\u0026rsquo; (i.e., we as an active family). These principles are tailored for parents, and include (as per Steffens et al.,\u003csup\u003e[\u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e65\u003c/span\u003e]\u003c/sup\u003e): (a) \u003cem\u003eidentity entrepreneurship\u003c/em\u003e \u0026ndash; when parents create a sense of shared social identity within the family, marked by a unique and compelling vision that distinguishes their supportive parental role from others; (b) \u003cem\u003eidentity prototypicality\u003c/em\u003e - when parents, in both action and perception, embody the values and ideals they aspire toward as active and supportive caregivers; (c) \u003cem\u003eidentity advancement -\u003c/em\u003e when parents prioritize their supportive roles as parents, and engage in activities that place the interests of their child above their own individual pursuits (as adults). This includes dedicating specific times in parents\u0026rsquo; weekly schedule to support their child's physical activities, even at the expense of personal or occupational demands, and lastly; (d) \u003cem\u003eidentity impressarioship\u003c/em\u003e - occurs when parents create unconventional or novel strategies to optimize their supportive parental identity. An example might involve trying out a new activity that\u0026rsquo;s new for every member of the family. These principles are emphasized throughout the second workshop and through a worksheet shared by the Research Coordinator with the participating parent. This worksheet is as follows:\u003c/p\u003e \u003cp\u003e* Activity #1: Workshop #2 begins with a review of parental support behaviours (ie. encouragement, logisitical support, and co-participation), and a reflection question, where parents are encouraged to reflect on their willingness to change their behaviors to better support their child's physical activity development. This reflection aligns with the concept of \u003cem\u003eidentity entrepreneurship\u003c/em\u003e \u003csup\u003e[\u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e65\u003c/span\u003e]\u003c/sup\u003e, as it helps parents establish a clear vision of their role as a supportive parent.\u003c/p\u003e \u003cp\u003e* Activity #2 : Focuses on defining parental identity around physical activity engaging with the concepts of \u003cem\u003eidentity prototypicality\u003c/em\u003e and \u003cem\u003eidentity advancement\u003c/em\u003e\u003csup\u003e[\u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e65\u003c/span\u003e]\u003c/sup\u003e. Parents are prompted to consider the values and ideals they aspire to embody as supportive caregivers, list ways they can support their child's physical activity, and prioritize their child's physical activity over other responsibilities and pursuits.\u003c/p\u003e \u003cp\u003e* Activity #3: Involves brainstorming family activities and explores the concept of \u003cem\u003eidentity impressarioship\u003c/em\u003e\u003csup\u003e[\u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e65\u003c/span\u003e]\u003c/sup\u003e. Parents are encouraged to explore unconventional or novel strategies to optimize their supportive parental identity. By brainstorming ways to make use of their environment, having convenient \"grab and go\" activities on hand, and adjusting their home setup to facilitate physical activity, parents develop innovative approaches to support their child's participation in PA. The self-reflection and planning tool in Activity 3 also allows parents recognize the enjoyment that PA provides for themselves and their family, and develop strategies to make it a priority.\u003c/p\u003e \u003cp\u003e * Activity #4: Parents brainstorm ways to effectively communicate and deal with potential issues that may arise during the implementation of their family PA plan and being a supportive parent. By anticipating and navigating challenges, parents create a supportive and cohesive family environment that reinforces their shared social identity as a physically active family. This proactive approach to problem-solving and communication helps parents establish a distinct and compelling vision of their family identity, as well as their own identity as a parent, thus encourahing \u003cem\u003eidentity entrepreneurship\u003c/em\u003e\u003csup\u003e[\u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e65\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThe third workshop involves the parent(s) and their child(ren) with a focus on social identity within the family (i.e., collective categorizing that \u0026ldquo;We are an Active Family\u0026rdquo;). The intervention material is grounded in social identity theory \u003csup\u003e[\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]\u003c/sup\u003e, self-categorization theory \u003csup\u003e[\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]\u003c/sup\u003e, and group cohesion behaviour change techniques \u003csup\u003e[\u003cspan citationid=\"CR66\" class=\"CitationRef\"\u003e66\u003c/span\u003e]\u003c/sup\u003e, which emphasize the importance of group membership and shared identity in shaping behavior.\u003c/p\u003e \u003cp\u003e*Workshop 3, Activity #1: The workshop begins with a discussion of the family's values and how physical activity can contribute to these values. This activity aims to highlight the importance of physical activity within the family context and foster a sense of shared purpose, thereby increasing \u003cem\u003eidentity salience\u003c/em\u003e the importance of the family's physical activity identity to the individual family members \u003csup\u003e[\u003cspan citationid=\"CR67\" class=\"CitationRef\"\u003e67\u003c/span\u003e]\u003c/sup\u003e. The BCT applied in this activity is framing/reframing [13.2] \u003csup\u003e[\u003cspan citationid=\"CR68\" class=\"CitationRef\"\u003e68\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003e*Workshop 3, Activity #2: Next, the family engages in a creative activity designed to promote a sense of unity and shared identity, such as creating a family team name, family crest, or a family Instagram account focused on physical activity. This activity draws upon the BCTs of identity associated with changed behavior [13.5] and social support [3.1, 3.2, 3.3] \u003csup\u003e[\u003cspan citationid=\"CR68\" class=\"CitationRef\"\u003e68\u003c/span\u003e]\u003c/sup\u003e, fostering a sense of unity and distinctiveness around the family's physical activity identity. This activity encourages \u003cem\u003eidentity fit and contrast\u003c/em\u003e - the extent to which the family's physical activity identity distinguishes them from other families \u003csup\u003e[\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e],[\u003cspan citationid=\"CR67\" class=\"CitationRef\"\u003e67\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003e*Workshop 3, Activity #3: The workshop then moves on to establishing standards for physical activity. The family discusses their expectations for physical activity, determines a reasonable amount of weekly family physical activity, and identifies activities to include in their family physical activity plan. This collaborative process employs the BCTs of discrepancy between current behavior and goal standard [1.6], goal setting (behavior) [1.1], and action planning [1.4] \u003csup\u003e[\u003cspan citationid=\"CR68\" class=\"CitationRef\"\u003e68\u003c/span\u003e]\u003c/sup\u003e, promoting a shared understanding of the family's physical activity goals and preferences, and promoting \u003cem\u003eidentity complementarity\u003c/em\u003e - the extent to which family members perceive themselves as similar to, and aligned with each other, in terms of their physical activity identity \u003csup\u003e[\u003cspan citationid=\"CR69\" class=\"CitationRef\"\u003e69\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003e*Workshop 3, Activity #4: Problem-solving and brainstorming are then conducted to identify potential barriers to physical activity and develop strategies to overcome them. The family also discusses ways to support each other in changing the routine and recording their physical activity. This activity promotes a sense of shared responsibility and mutual support within the family, further enhancing \u003cem\u003eidentity salience.\u003c/em\u003e The BCTs applied in this activity are coping planning [1.2], social support [3.2, 3.3], and self-monitoring of behavior [2.3] \u003csup\u003e[\u003cspan citationid=\"CR68\" class=\"CitationRef\"\u003e68\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003e*Workshop 3, Activity #5: The family then discusses the roles and responsibilities of each member in the physical activity program. They also identify individual and shared goals and explore ways to combine these goals to foster a sense of unity and family cohesion. The BCTs applied in this activity are goal setting (behavior) [1.1], action planning [1.4], and behavioral contract [1.8] \u003csup\u003e[\u003cspan citationid=\"CR68\" class=\"CitationRef\"\u003e68\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003e*Workshop 3, Activity #6: Finally, the family are encouraged to envisions their possible selves as an active family at different time points in the future. This activity utilizes the BCTs of comparative imagining of future outcomes [9.3], framing/reframing [13.2], and identity associated with changed behavior [13.5] \u003csup\u003e[\u003cspan citationid=\"CR68\" class=\"CitationRef\"\u003e68\u003c/span\u003e]\u003c/sup\u003e, and is desiged to reinforces the family's shared vision and long-term commitment to an active lifestyle. When taken together, by focusing on the development of a shared family identity around PA, Workshop 3 aims to promote long-term adherence to an active lifestyle within the family context through the use of BCTs, the targeting of social identity constructs (that emphasizes a sense of \u0026lsquo;we-ness\u0026rsquo; as an active family), and group discussion.\u003c/p\u003e \u003cp\u003e In addition to these intervention materials, the participating parents in the identity promotion condition will receive a digital screen saver for their computer or cellular device with graphics highlighting \u0026ldquo;We Are an Active Family\u0026rdquo;. Given the use of phones/digital tools in day-to-day activity, the use of this media will be encouraged for the duration of the study as a prompt for continued engagement in research goals.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eOutcome measures\u003c/h2\u003e \u003cdiv id=\"Sec15\" class=\"Section3\"\u003e \u003ch2\u003ePrimary outcome measures\u003c/h2\u003e \u003cp\u003eChild MVPA is measured with wGT3X-BT Actigraph accelerometers, recognized as a widely accepted method for physical activity measurement in field settings \u003csup\u003e[\u003cspan citationid=\"CR70\" class=\"CitationRef\"\u003e70\u003c/span\u003e]\u003c/sup\u003e. These devices have several advantages over proxy-report subjective measures of PA. Accelerometers offer a more objective assessment of PA compared to parent or self-report measures, as they are less susceptible to reporting biases such as recall errors and social desirability \u003csup\u003e[\u003cspan citationid=\"CR71\" class=\"CitationRef\"\u003e71\u003c/span\u003e]\u003c/sup\u003e. Additionally, accelerometers have been shown to accurately record the short, intermittent bursts of activity that are characteristic of children's PA patterns, providing a more accurate representation of their true activity levels than subjective measures \u003csup\u003e[\u003cspan citationid=\"CR71\" class=\"CitationRef\"\u003e71\u003c/span\u003e],[\u003cspan citationid=\"CR72\" class=\"CitationRef\"\u003e72\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eChildren will wear the devices during waking hours (~\u0026thinsp;10 hours per day) on a belt around the waist for a for 7 consecutive days. The accelerometer is placed on an elastic belt, and participants are directed to wear it secured snugly around the waist with the device above the left iliac crest. Participants are instructed to remove the accelerometers for water-based activities as they are not waterproof, and a logbook is provided for participants, in most cases parents, to note when the devices were removed for water-based activity or any other reason. This includes noting the time the accelerometer was taken off for sleep, and the time it was put back on in the morning. Additionally, the logbook is to be used to provide other details of each day (e.g. if their routine was changed for any reason and/or what activities they participated in). This information can be used in parallel with the accelerometers to cross-reference the data it presents.\u003c/p\u003e \u003cp\u003eActiLife software (Version 6.11.9; ActiGraph LLC) will be used to initialize accelerometers, download data, and process the data. The accelerometers are initialized to collect pre-filtered data at a sample rate of 30 Hz for the children and their parents (see secondary outcomes below), and are downloaded into 15-second epochs for children to capture the sporadic nature of their PA \u003csup\u003e[\u003cspan citationid=\"CR71\" class=\"CitationRef\"\u003e71\u003c/span\u003e],[\u003cspan citationid=\"CR72\" class=\"CitationRef\"\u003e72\u003c/span\u003e]\u003c/sup\u003e, and 60-second epochs for parents, consistent with the methodology used by Troiano et al.\u003csup\u003e[\u003cspan citationid=\"CR73\" class=\"CitationRef\"\u003e73\u003c/span\u003e]\u003c/sup\u003e. For determining valid wear time, the Troiano algorithm is used which defines non-wear time as a period of at least 60 consecutive minutes of zero counts, with an allowance for one to two minutes of counts between 0 and 100. Measurements will take place at baseline, 6 weeks, 3 months, and 6 months (primary endpoint of interest), and MVPA will be evaluated as change from baseline.\u003c/p\u003e \u003cp\u003eChild MVPA will be determined using the Evenson \u003csup\u003e[\u003cspan citationid=\"CR74\" class=\"CitationRef\"\u003e74\u003c/span\u003e]\u003c/sup\u003e cut points based off of recommendations from Trost et al.\u003csup\u003e[\u003cspan citationid=\"CR72\" class=\"CitationRef\"\u003e72\u003c/span\u003e]\u003c/sup\u003e. Evenson cut points define moderate activity as 2296\u0026ndash;4011 counts per minute (CPM) and vigorous activity as \u0026ge;\u0026thinsp;4012 CPM. Therefore, MVPA will be any activity\u0026thinsp;\u0026ge;\u0026thinsp;2296 CPM. The outcome variable will be average minutes per day of children\u0026rsquo;s MVPA.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eSecondary outcome measures (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e2\u003c/span\u003e)\u003c/h2\u003e \u003cdiv id=\"Sec17\" class=\"Section3\"\u003e \u003ch2\u003eParental PA\u003c/h2\u003e \u003cp\u003eParental PA will be measured using accelerometry and self-reported questionnaires at all assessment occasions (baseline, 6 weeks, 3 months and 6 months). Accelerometry will be measured in a similar fashion to the methods outlined above. Namely, parents are instructed to wear the Actigraph wGT3X-BT for 7 days a week (~\u0026thinsp;10 hours per day), remove it at night and for water-based activities, and note the details of the wear in a logbook. Parental MVPA will be measured using Troiano adult protocol \u003csup\u003e[\u003cspan citationid=\"CR73\" class=\"CitationRef\"\u003e73\u003c/span\u003e]\u003c/sup\u003e. Activity will be assessed by measuring several variables, including duration (total minutes worn, total movement counts/day, total minutes of sedentary, light, moderate to vigorous day), frequency (bouts of sedentary, light moderate to vigorous/day), and intensity. Non-wear time will be determined using the algorithm from Troiano et al. (2008), and will be subtracted from total wear time. The MVPA of adults will be evaluated as change from baseline and determined using frequently applied cut points \u003csup\u003e[\u003cspan citationid=\"CR75\" class=\"CitationRef\"\u003e75\u003c/span\u003e]\u003c/sup\u003e validated for adults \u003csup\u003e[\u003cspan citationid=\"CR73\" class=\"CitationRef\"\u003e73\u003c/span\u003e]\u003c/sup\u003e which classify MVPA as 2020 counts per minutes (CPM) and above.\u003c/p\u003e \u003cp\u003eAs a secondary assessment, parents self-report physical activity using the Godin Leisure-Time Exercise Questionnaire \u003csup\u003e[\u003cspan citationid=\"CR76\" class=\"CitationRef\"\u003e76\u003c/span\u003e],[\u003cspan citationid=\"CR77\" class=\"CitationRef\"\u003e77\u003c/span\u003e]\u003c/sup\u003e at all time points. This questionnaire assesses the frequency of mild, moderate, and strenuous activity performed for at least 15 minutes during free time in a typical week. A total weekly MVPA score will be calculated by multiplying the frequency by the duration.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eParent-child intergenerational activity\u003c/h2\u003e \u003cp\u003eParent-child intergenerational activity will be measured using self-report with a modified Godin Leisure-Time Exercise Questionnaire (GLTEQ) \u003csup\u003e[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]\u003c/sup\u003e and accelerometry as discussed in the primary outcome above. Parent accelerometers will be tagged with the child\u0026rsquo;s accelerometer to assess coordinated activity. The wGT3X-BT accelerometer model has a Bluetooth proximity detection feature that can determine the presence (e.g., same room in a house, at the park together) or absence of close proximity between two accelerometers. The adult accelerometer is programmed to be the \u0026ldquo;beacon\u0026rdquo; device, and the child\u0026rsquo;s accelerometer is programmed as the \u0026ldquo;receiver\u0026rdquo;. In this method, \u0026ldquo;beacon\u0026rdquo; devices broadcast their serial number and \u0026ldquo;receiver\u0026rdquo; devices are set to search for the signal once per minute. The receivers then store a log of proximity detection information, recorded as a received signal strength indicator (RSSI). Every 60 seconds where the monitors are in close proximity will be \u0026ldquo;tagged\u0026rdquo; and recorded in the memory of the child\u0026rsquo;s monitor, which will be later linked to time-stamped data of the parent. According to ActiGraph \u003csup\u003e[\u003cspan citationid=\"CR78\" class=\"CitationRef\"\u003e78\u003c/span\u003e]\u003c/sup\u003e, accelerometers communicate via Bluetooth when in close proximity indoors, which is a maximum of 10\u0026ndash;20 meters, and close proximity outdoors, which is a maximum of 100 meters. Previous success has been demonstrated by the work of \u003csup\u003e[\u003cspan citationid=\"CR79\" class=\"CitationRef\"\u003e79\u003c/span\u003e]\u003c/sup\u003e showing 82% sensitivity and 81% specificity for determining the presence of close proximity between parents and preschoolers using the proximity feature \u003csup\u003e[\u003cspan citationid=\"CR80\" class=\"CitationRef\"\u003e80\u003c/span\u003e]\u003c/sup\u003e. The outcome variable will be average minutes per day parents and children were both engaging in physical activity at the same time while in close proximity.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003eChild health-related fitness and body composition\u003c/h2\u003e \u003cp\u003eChild health-related fitness will assess the key components of body composition, aerobic fitness and musculoskeletal fitness. Body mass (kg), height (cm), body mass index, and waist circumference (cm; at the level of noticeable waist narrowing) will be measured according to standard procedures, and percentage body fat will be estimated using the Tanita TBF-300A scale. Cardiovascular fitness (i.e., predicted maximal aerobic power) will be assessed following protocol for the modified Canadian Aerobic Fitness Test (mCAFT) standardized in children. Heart rate and blood pressure (sphygmomanometer and a stethoscope) will be monitored at rest and during exercise. All participants will complete the mCAFT step test, which uses one or more 3-min submaximal stepping stage based on the participant\u0026rsquo;s heart rate response. Musculoskeletal fitness [i.e., muscular (grip) strength, muscular endurance (curl-ups and push-ups), power (vertical jump), and flexibility (sit-and-reach)] will be assessed according to standardized guideline \u003csup\u003e[\u003cspan citationid=\"CR81\" class=\"CitationRef\"\u003e81\u003c/span\u003e]\u003c/sup\u003e. All tests will be conducted by qualified exercise professionals following the Canadian Society for Exercise Physiology (CSEP) Protocol \u003csup\u003e[\u003cspan citationid=\"CR82\" class=\"CitationRef\"\u003e82\u003c/span\u003e]\u003c/sup\u003e. The total time required for the health-related physical fitness measurements will be approximately 45 min.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003eParental support and M-PAC Constructs\u003c/h2\u003e \u003cp\u003eParental support measures are evaluated at all time points (baseline, 6 weeks, 3 months, 6 months) during the study. This includes main behavioral components such as encouragement, logistical support, and intergenerational PA behaviors \u003csup\u003e[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]\u003c/sup\u003e, as well as M-PAC constructs related to parental support of child physical activity \u003csup\u003e[\u003cspan citationid=\"CR83\" class=\"CitationRef\"\u003e83\u003c/span\u003e]\u003c/sup\u003e. MPAC constructs include parental support identity, habit, PA regulation (proactive, reactive, self-monitoring, social monitoring), perceived capability and opportunity, affective and instrumental attitude, and intention.\u003c/p\u003e \u003cp\u003eParental support for child physical activity is measured with an adapted 5-point Likert Scale (Strongly disagree \u0026lt;-\u0026gt; Strongly agree) from \u003csup\u003e[\u003cspan citationid=\"CR84\" class=\"CitationRef\"\u003e84\u003c/span\u003e]\u003c/sup\u003e, to assess ways in which parents provide support for their child's PA. Parents respond to questions like \"I go out of my way to enroll my child in sports and other activities that get him/her to be physically active (eg. After school programs, programs at the YMCA)...\" and \"I often drive or take my child to places where he/she can be active (e.g., parks, playground, sport games or practices)..\" The scores from this questionnaire have demonstrated good internal consistency reliability, with Cronbach's α ranging from 0.61 to 0.74 for the logistic support subscale and 0.69 to 0.75 for the modeling subscale \u003csup\u003e[\u003cspan citationid=\"CR84\" class=\"CitationRef\"\u003e84\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eParent support identity (whether parents identify as being supportive of their child's physical activity) is measured via a Modified Exercise Identity Scale from Anderson and colleagues \u003csup\u003e[\u003cspan additionalcitationids=\"CR86\" citationid=\"CR85\" class=\"CitationRef\"\u003e85\u003c/span\u003e]\u0026ndash;[\u003cspan citationid=\"CR87\" class=\"CitationRef\"\u003e87\u003c/span\u003e]\u003c/sup\u003e. Parents are asked if they consider themselves a supportive parent for my child\u0026rsquo;s physical activity; if when they describe themselves to others, they include their involvement in supporting their child's physical activity; and if others see them as someone who regularly supports their child's PA. In prior studies, the modified scale scores assessing parent support identity have demonstrated evidence of internal consistency (e.g., Cronbach's α\u0026thinsp;=\u0026thinsp;0.84) and convergent and predictive validity by correlating with measures of personal and family-based physical activity \u003csup\u003e[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e],[\u003cspan citationid=\"CR88\" class=\"CitationRef\"\u003e88\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eParent support of family physical activity identity is measured using a 4-item scale adapted from Doosje et al.\u003csup\u003e[\u003cspan citationid=\"CR89\" class=\"CitationRef\"\u003e89\u003c/span\u003e]\u003c/sup\u003e. Parents are asked to rate their agreement with the following statements on a 5-point Likert scale: \u0026ldquo;I identify as an active member of an active family\u0026rdquo;; \u0026ldquo;I see myself as an active member of an active family\u0026rdquo;; \u0026ldquo;I am pleased to be an active member of an active family\u0026rdquo;; and \u0026ldquo;I feel strong ties with my family members around being physically active\u0026rdquo; \u003csup\u003e[\u003cspan citationid=\"CR89\" class=\"CitationRef\"\u003e89\u003c/span\u003e]\u003c/sup\u003e. While the original scale by Doosje et al.\u003csup\u003e[\u003cspan citationid=\"CR89\" class=\"CitationRef\"\u003e89\u003c/span\u003e]\u003c/sup\u003e was designed to measure ingroup identification and has demonstrated good reliability for group identification (Study 1\u0026thinsp;=\u0026thinsp;Cronbach's α\u0026thinsp;=\u0026thinsp;0.83), the current study adapts this scale to measure identification with being part of an active family. As this is a newly adapted scale, reliability and validity data are not yet available. We plan to examine the internal consistency of the scale scores (Cronbach's α) in our sample, as well as explore the scale scores' associations with related constructs (e.g., family physical activity levels, parental support behaviors) as preliminary evidence of validity.\u003c/p\u003e \u003cp\u003eParental support of child physical activity habit is measured with an adapted Self-Reported Habit Strength Index (SRHI) \u003csup\u003e[\u003cspan citationid=\"CR90\" class=\"CitationRef\"\u003e90\u003c/span\u003e]\u003c/sup\u003e, which provides the opportunity to use the self-reported behavioural automaticity index subscale (SRBAI) \u003csup\u003e[\u003cspan citationid=\"CR91\" class=\"CitationRef\"\u003e91\u003c/span\u003e]\u003c/sup\u003e as well. Parents respond on a five-point scale to questions in the following format: \"Regular support of my child's PA is something I do.... automatically, frequently, etc.\" The scores from the SRHI have demonstrated good internal consistency reliability (Cronbach's α\u0026thinsp;=\u0026thinsp;0.91, p\u0026thinsp;\u0026lt;\u0026thinsp;.001) and convergent validity with measures of past behavior and behavioral frequency \u003csup\u003e[\u003cspan citationid=\"CR90\" class=\"CitationRef\"\u003e90\u003c/span\u003e]\u003c/sup\u003e. The SRBAI subscale has also shown good internal consistency reliability (Cronbach's α generally\u0026thinsp;\u0026gt;\u0026thinsp;.80) and a strong convergent validity with the SRHI \u003csup\u003e[\u003cspan citationid=\"CR91\" class=\"CitationRef\"\u003e91\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003ePhysical activity regulation is measured via a modified Physical Activity Regulation Scale (PARS) from \u003csup\u003e[\u003cspan citationid=\"CR92\" class=\"CitationRef\"\u003e92\u003c/span\u003e]\u003c/sup\u003e. This instrument measures parent behaviours with regards to tracking and planning child's physical activity. Parents respond to statements in the following format: \"to support my child I made a detailed plan regarding when to support my child's physical activity\", \"I avoid spending long periods of time in environments that do not allow me to support my child's physical activity\" etc. Although this is a relatively new tool, initial evidence suggests that the scores from the PARS have good internal consistency reliability (Cronbach's α generally\u0026thinsp;\u0026gt;\u0026thinsp;.80) and predictive validity with measures of physical activity behavior \u003csup\u003e[\u003cspan citationid=\"CR92\" class=\"CitationRef\"\u003e92\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eFurthermore, an adapted perceived control measure from Lithopoulos et al. \u003csup\u003e[\u003cspan citationid=\"CR93\" class=\"CitationRef\"\u003e93\u003c/span\u003e]\u003c/sup\u003e evaluates measures of perceived capability and opportunity for parents to support child PA. This measure asks parents their level of agreement of how much control they have to regularly support their child\u0026rsquo;s physical activity over the next 6 weeks/3months. These are presented as statements in the following format: \u0026ldquo;I have the physical ability to support my child\u0026rsquo;s physical activity over the next\u0026hellip;\u0026rdquo;; \u0026ldquo;I have enough skill to do the activities needed of me to support my child\u0026rsquo;s physical activity over\u0026hellip;\u0026rdquo;; \u0026ldquo;I can handle the physical demands supporting my child\u0026rsquo;s physical activity over\u0026hellip;\u0026rdquo; etc. The scores from this measure have demonstrated good internal consistency (Cronbach's α\u0026thinsp;\u0026gt;\u0026thinsp;.90) and test-retest reliability (Intraclass Correlation Coefficient (ICCs) of .79 for perceived opportunity and .82 for perceived capability). The measure also showed evidence of discriminant validity, distinguishing itself from related constructs like intentions and attitudes, as indicated by satisfactory model fit indices (Standardized Root Mean Square Residual (SRMR\u0026thinsp;=\u0026thinsp;0.03); Root Mean Square Error of Approximation (RMSEA\u0026thinsp;=\u0026thinsp;0.06)). Additionally, the measure exhibited predictive validity, with perceived capability and opportunity predicting intentions, and perceived capability predicting physical activity \u003csup\u003e[\u003cspan citationid=\"CR93\" class=\"CitationRef\"\u003e93\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eAttitudes toward engaging in supportive parenting behaviours of child PA are measured with items covering both affective and instrumental components \u003csup\u003e[\u003cspan citationid=\"CR94\" class=\"CitationRef\"\u003e94\u003c/span\u003e],[\u003cspan citationid=\"CR95\" class=\"CitationRef\"\u003e95\u003c/span\u003e]\u003c/sup\u003e. Using a modified 7-point scale this measure assesses to what degree parents find regular support of their child\u0026rsquo;s physical activity to be enjoyable, wise, exciting, beneficial, useful, and pleasant (eg., extremely unenjoyable \u0026lt;-\u0026gt; extremely enjoyable, extremely unwise \u0026lt;-\u0026gt; extremely wise, etc.). The scores from this affective and instrumental attitude measure show strong internal consistency (Cronbach\u0026rsquo;s alpha of \u0026gt;\u0026thinsp;.84), and significant (p\u0026thinsp;\u0026lt;\u0026thinsp;.01) correlations of with intention and support child physical activity \u003csup\u003e[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e],[\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eFinally, parental support of child PA intention is assessed using Courneya\u0026rsquo;s recommendation for open-scaled measurement \u003csup\u003e[\u003cspan citationid=\"CR96\" class=\"CitationRef\"\u003e96\u003c/span\u003e]\u003c/sup\u003e. This instrument asks parents to respond on a 7-point scale from \"Extremely Uncommitted\" to \"Extremely Committed\" about how committed they are to regularly supporting their child's physical activity over the next 6 weeks, aligning with the open-scaled approach \u003csup\u003e[\u003cspan citationid=\"CR96\" class=\"CitationRef\"\u003e96\u003c/span\u003e]\u003c/sup\u003e, and exercise intention measures from Rhodes et al.\u003csup\u003e[\u003cspan citationid=\"CR97\" class=\"CitationRef\"\u003e97\u003c/span\u003e]\u003c/sup\u003e. They are also asked to quantify in times per week how often they intend to engage in supportive behaviors over the next 6 weeks, similar to measures in Rhodes, Berry, et al.\u003csup\u003e[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]\u003c/sup\u003e. These questions capture the distinction between decisional intention (direction) and intention strength (commitment) as recommended by \u003csup\u003e[\u003cspan citationid=\"CR98\" class=\"CitationRef\"\u003e98\u003c/span\u003e]\u003c/sup\u003e for improving measurement, theory testing and intervention practices related to physical activity intentions and behaviors.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec21\" class=\"Section2\"\u003e \u003ch2\u003eSociodemographic variables\u003c/h2\u003e \u003cp\u003eA section of the baseline questionnaire assesses various demographic characteristics including gender, age, ethnicity, level of education, marital status, employment information, household income, and health background.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec22\" class=\"Section2\"\u003e \u003ch2\u003eExit Interview Questions\u003c/h2\u003e \u003cp\u003eTo evaluate participants' experience with the intervention and gather insights for potential improvements, semi-structured exit interviews are conducted with parents at the 6-month timepoint. The interviews, conducted via video chat by Research Assistants, aim to assess parents' overall experience, perceived benefits and barriers, satisfaction with the intervention materials and components, and any observed changes or consequences resulting from their participation. The interviews include common questions asked to all parents, as well as group-specific questions tailored to the respective intervention components. Common questions include: \"What types of physical activities did you do over the course of the study and how often?\", \"Did you use any of the intervention materials/worksheets that were shared with you at these meetings?\", \"Were there any barriers to supporting your child's physical activity?\", and \"During the course of the study, did you notice any changes in regards to your relationship with your child, well-being or family functioning?\". Group-specific questions for parents in the identity intervention group ask about how discussions on supportive parent identity and family identity as an active family influenced their motivation and commitment to supporting their child's physical activity. To control for attention, parents in the planning intervention group, had questions related to the Canadian Food Guide and were asked about how the shared information impacted their understanding and motivation to support healthy eating habits. These questions have proved useful in our prior evaluations \u003csup\u003e[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/sup\u003e and are designed to provide a thorough illustration of the experience and impacts of the different intervention materials.\u003c/p\u003e \u003cdiv id=\"Sec23\" class=\"Section3\"\u003e \u003ch2\u003eAnalysis strategy\u003c/h2\u003e \u003cp\u003e \u003cstrong\u003eQuantitative Process Evaluation Data Analyses\u003c/strong\u003e \u003cp\u003eRecruitment and retention rates will be determined, after which the pattern of missing data will be determined \u003csup\u003e[\u003cspan citationid=\"CR99\" class=\"CitationRef\"\u003e99\u003c/span\u003e]\u003c/sup\u003e. Linear mixed models will then be conducted to determine if condition (0\u0026thinsp;=\u0026thinsp;education\u0026thinsp;+\u0026thinsp;planning; 1\u0026thinsp;=\u0026thinsp;education\u0026thinsp;+\u0026thinsp;planning\u0026thinsp;+\u0026thinsp;identity formation) has a differential impact on the children\u0026rsquo;s MVPA over time. Subsequent models will be conducted that center the linear trend at each time point to determine if a condition effect is also present at a given time point (e.g., at baseline, 6 weeks, 12 weeks or 24 weeks). These analyses will address primary objective 1. The same analytical approach will be used to determine whether there are condition effects on the secondary child fitness outcomes (secondary objective #1). For secondary objective #2, parental support and parental support identity will be treated as time varying covariates to examine their relationships with children\u0026rsquo;s MVPA over time. Next, if a condition effect is present for the children\u0026rsquo;s MVPA, analyses will be conducted to determine if the parental support / parental support identity variables mediate the condition / children\u0026rsquo;s MVPA relationship. Finally, exploratory analyses will be conducted to examine potential intergenerational, sex and seasonal influences on the children\u0026rsquo;s MVPA over time.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eQualitative Process Evaluation Data Analyses\u003c/strong\u003e \u003cp\u003eParticipants will be invited to participate in exit interviews designed to elicit \u003cem\u003ein-depth\u003c/em\u003e information about the quality of processes embedded within the program \u003csup\u003e[\u003cspan citationid=\"CR100\" class=\"CitationRef\"\u003e100\u003c/span\u003e]\u003c/sup\u003e. This will draw from a qualitative \u003cem\u003esocial constructionist\u003c/em\u003e perspective \u003csup\u003e[\u003cspan citationid=\"CR101\" class=\"CitationRef\"\u003e101\u003c/span\u003e]\u003c/sup\u003e to understand in the parents\u0026rsquo; own words, the beneficial features and any problematic components of the intervention. Data collected via the semi-structured interviews will be analyzed through use of inductive content analytic procedures \u003csup\u003e[\u003cspan citationid=\"CR102\" class=\"CitationRef\"\u003e102\u003c/span\u003e]\u003c/sup\u003e, through use of the NVivo software program, and themes will be identified that correspond to the strengths and limitations of the intervention program. The response themes will also be linked at the individual level, so post-hoc assessment of successful and unsuccessful interventions can be examined by these responses.\u003c/p\u003e \u003c/p\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis protocol describes the implementation of a randomized trial investigating the efficacy of planning and identity interventions aimed at increasing parent-child co-activity and parent support behaviours. This research is conceptually guided by the M-PAC framework \u003csup\u003e[\u003cspan citationid=\"CR83\" class=\"CitationRef\"\u003e83\u003c/span\u003e]\u003c/sup\u003e and has important implications for promoting children's physical activity. By explicitly targeting and fostering parents' \"physical activity support identity\" - their self-categorization as a parent who actively supports their child's physical activity engagement - this study addresses a key yet understudied influence on child physical activity behaviors in intervention research. If successful, the findings could inform the development of more effective family-based interventions that have the potential to create more sustainable changes in child physical activity behaviours and ultimately contribute to improved health outcomes.\u003c/p\u003e \u003cp\u003e To date, we have obtained ethical approval, registered the trial, and have initiated recruitment and enrolledment efforts. Our recruitment strategies include targeted social media advertisements, distribution of flyers in community centers and schools, and outreach to local pediatricians and family health clinics. Through these efforts, we have generated interest from 50 families in the Greater Victoria region, 25 families in the Greater Vancouver region, and 14 families in the Greater Nanaimo region. From those expressing interest, 30 families have been assessed for eligibility based on our inclusion criteria of having a child aged 6\u0026ndash;12 years old, being able to commit to the study requirements, and not having any medical conditions that would preclude participation in physical activity. Of these, 27 families have been deemed eligible and have completed all baseline measures, 25 are active families following two family drop-outs, and 12 are on a waitlist to begin baseline eligibility measures (see Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e3\u003c/span\u003e for Participant Flow Diagram). The study is ongoing, and based on our current rate of recruitment, which averages 4 new interested families per week across all regions, we anticipate meeting our target sample size and completing recruitment by January 2026. We will continue to monitor recruitment progress and adjust our strategies as needed to ensure timely completion of the study.\u003c/p\u003e \u003cp\u003eOur team has established scientific dissemination records and ongoing and long-standing knowledge exchange connections with international (e.g., International Society for Physical Activity and Health (ISPAH), International Society for Behavioral Nutrition and Physical Activity (ISBNPA), International Society of Behavioral Medicine (ISBM), WHO), national (e.g., ParticipACTION, Public Health Agency of Canada) and provincial (Ministry of Health, BC Healthy Living Alliance) organizations. Should our results support our hypotheses, we will leverage the relationships established through this network to establish a project advisory committee that includes the relevant policy-makers, child service providers and parents for the subsequent scale-up project and mobilization of study findings. This will ensure that our research findings are translated into practical recommendations and resources that can be integrated into existing programs and services to maximize their impact on child physical activity promotion.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eBCT - Behaviour Change Technique\u003c/p\u003e\n\u003cp\u003eCI - Confidence Interval\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eCONSORT - Consolidated Standards of Reporting Trials\u003c/p\u003e\n\u003cp\u003eCPM - Counts per Minute\u003c/p\u003e\n\u003cp\u003eCSEP - Canadian Society for Exercise Physiology\u003c/p\u003e\n\u003cp\u003eGLTEQ - Godin Leisure-Time Exercise Questionnaire\u003c/p\u003e\n\u003cp\u003eHREB - Human Research Ethics Board\u003c/p\u003e\n\u003cp\u003eICC - Intraclass Correlation Coefficient\u003c/p\u003e\n\u003cp\u003eISPAH - International Society for Physical Activity and Health\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eISBNPA - International Society for Behavioral Nutrition and Physical Activity\u003c/p\u003e\n\u003cp\u003eISBM - International Society of Behavioral Medicine\u003c/p\u003e\n\u003cp\u003eKT - Knowledge Translation\u003c/p\u003e\n\u003cp\u003emCAFT \u0026ndash; Modified Canadian Aerobic Fitness Test\u003c/p\u003e\n\u003cp\u003eM-PAC - Multi-Process Action Control Framework\u003c/p\u003e\n\u003cp\u003eMVPA - Moderate-to-Vigorous Physical Activity\u003c/p\u003e\n\u003cp\u003ePARS - Physical Activity Regulation Scale\u003c/p\u003e\n\u003cp\u003eParQ+ - Physical Activity Readiness Questionnaire for Everyone\u003c/p\u003e\n\u003cp\u003eREBC - Research Ethics Board of BC\u003c/p\u003e\n\u003cp\u003eRISe - Research and Information Systems\u003c/p\u003e\n\u003cp\u003eRMSEA - Root Mean Square Error of Approximation\u003c/p\u003e\n\u003cp\u003eRSSI - Received Signal Strength Indicator \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSRBAI - Self-Reported Behavioural Automaticity Index\u003c/p\u003e\n\u003cp\u003eSRHI - Self-Reported Habit Strength Index\u003c/p\u003e\n\u003cp\u003eSRMR - Standardized Root Mean Square Residual\u003c/p\u003e\n\u003cp\u003eSPIRIT - Standard Protocol Items: Recommendations for Interventional Trials\u003c/p\u003e\n\u003cp\u003eUBC - University of British Columbia\u003c/p\u003e\n\u003cp\u003eUVic - University of Victoria\u003c/p\u003e\n\u003cp\u003eVIU - Vancouver Island University\u003c/p\u003e\n\u003cp\u003eWHO - World Health Organization\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study protocol was approved by\u0026nbsp;the University of Victoria Human Research Ethics Board (Victoria, Canada) reference number 23-0022. Informed consent is obtained from all participants before study enrolment.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;The datasets generated and/or analysed during the current study are not publicly available as per ethical approval from HREB at the University of Victoria, which stipulates that the data will not accessed or analyzed by others.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no competing interests to declare.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis project is funded by Diabetes Canada\u0026nbsp;Grant (OG-3-22-5649-RR).\u0026nbsp;The funding body had no role in the design, data collection, or reporting associated with this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eES and RER contributed to the conception and design of the study. ES and RER drafted the manuscript. MB, KS, CM, VC, SS, LV, and SC reviewed the paper and approved the final submission. RER is responsible for project oversight.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAhn, J. V., Sera, F., Cummins, S. \u0026amp; Flouri, E. Associations between objectively measured physical activity and later mental health outcomes in children: findings from the UK Millennium Cohort Study. \u003cem\u003eJ. Epidemiol. Community Health\u003c/em\u003e \u003cstrong\u003e72\u003c/strong\u003e, 94\u0026ndash;100 (2018).\u003c/li\u003e\n\u003cli\u003eBiddle, S. J. H., Ciaccioni, S., Thomas, G. \u0026amp; Vergeer, I. Physical activity and mental health in children and adolescents: an updated review of reviews and an analysis of causality. \u003cem\u003ePsychology of Sport and Exercise\u003c/em\u003e vol. 42 146\u0026ndash;155 (2019).\u003c/li\u003e\n\u003cli\u003eDonnelly, J. E. \u003cem\u003eet al.\u003c/em\u003e Physical Activity, Fitness, Cognitive Function, and Academic Achievement in Children: A Systematic Review. \u003cem\u003eMed. Sci. Sports Exerc.\u003c/em\u003e \u003cstrong\u003e48\u003c/strong\u003e, 1197\u0026ndash;1222 (2016).\u003c/li\u003e\n\u003cli\u003eJanssen, I. \u0026amp; LeBlanc, A. G. Systematic review of the health benefits of physical activity and fitness in school-aged children and youth. \u003cem\u003eInt. J. Behav. Nutr. Phys. Act.\u003c/em\u003e \u003cstrong\u003e7\u003c/strong\u003e, 40 (2010).\u003c/li\u003e\n\u003cli\u003ePoitras, V. J. \u003cem\u003eet al.\u003c/em\u003e Systematic review of the relationships between objectively measured physical activity and health indicators in school-aged children and youth. \u003cem\u003eAppl. Physiol. Nutr. Metab. Physiol. Appl. Nutr. Metab.\u003c/em\u003e \u003cstrong\u003e41\u003c/strong\u003e, S197-239 (2016).\u003c/li\u003e\n\u003cli\u003eJones, R. A., Hinkley, T., Okely, A. D. \u0026amp; Salmon, J. Tracking physical activity and sedentary behavior in childhood: a systematic review. \u003cem\u003eAm. J. Prev. Med.\u003c/em\u003e \u003cstrong\u003e44\u003c/strong\u003e, 651\u0026ndash;658 (2013).\u003c/li\u003e\n\u003cli\u003eWorld Health Organization. \u003cem\u003eGlobal Health Observatory (GHO) Data: Prevalence of Insufficient Physical Activity\u003c/em\u003e. https://www.who.int/data/gho/data/indicators/indicator-details/GHO/prevalence-of-insufficient-physical-activity-among-school-going-adolescents-aged-11-17-years (2016).\u003c/li\u003e\n\u003cli\u003eRoberts, K. C. \u003cem\u003eet al.\u003c/em\u003e Meeting the Canadian 24-Hour Movement Guidelines for Children and Youth. \u003cem\u003eHealth Rep.\u003c/em\u003e \u003cstrong\u003e28\u003c/strong\u003e, 3\u0026ndash;7 (2017).\u003c/li\u003e\n\u003cli\u003eChaput, J.-P. \u003cem\u003eet al.\u003c/em\u003e Proportion of preschool-aged children meeting the Canadian 24-Hour Movement Guidelines and associations with adiposity: results from the Canadian Health Measures Survey. \u003cem\u003eBMC Public Health\u003c/em\u003e \u003cstrong\u003e17\u003c/strong\u003e, 147\u0026ndash;154 (2017).\u003c/li\u003e\n\u003cli\u003eRhodes, R. E. \u003cem\u003eet al.\u003c/em\u003e Development of a consensus statement on the role of the family in the physical activity, sedentary, and sleep behaviours of children and youth. \u003cem\u003eInt. J. Behav. Nutr. Phys. Act.\u003c/em\u003e \u003cstrong\u003e17\u003c/strong\u003e, 74 (2020).\u003c/li\u003e\n\u003cli\u003eBeets, M. W., Cardinal, B. J. \u0026amp; Alderman, B. L. Parental social support and the physical activity-related behaviors of youth: a review. \u003cem\u003eHealth Educ. Behav. Off. Publ. Soc. Public Health Educ.\u003c/em\u003e \u003cstrong\u003e37\u003c/strong\u003e, 621\u0026ndash;644 (2010).\u003c/li\u003e\n\u003cli\u003eBrown, H. E. \u003cem\u003eet al.\u003c/em\u003e Family-based interventions to increase physical activity in children: a systematic review, meta-analysis and realist synthesis. \u003cem\u003eObes. Rev. Off. J. Int. Assoc. Study Obes.\u003c/em\u003e \u003cstrong\u003e17\u003c/strong\u003e, 345\u0026ndash;360 (2016).\u003c/li\u003e\n\u003cli\u003ePyper, E., Harrington, D. \u0026amp; Manson, H. The impact of different types of parental support behaviours on child physical activity, healthy eating, and screen time: a cross-sectional study. \u003cem\u003eBMC Public Health\u003c/em\u003e \u003cstrong\u003e16\u003c/strong\u003e, 568 (2016).\u003c/li\u003e\n\u003cli\u003eRhodes, R. E., Blanchard, C. M., Quinlan, A., Naylor, P.-J. \u0026amp; Warburton, D. E. R. Family Physical Activity Planning and Child Physical Activity Outcomes: A Randomized Trial. \u003cem\u003eAm. J. Prev. Med.\u003c/em\u003e \u003cstrong\u003e57\u003c/strong\u003e, 135\u0026ndash;144 (2019).\u003c/li\u003e\n\u003cli\u003eRhodes, R. E., Naylor, P.-J. \u0026amp; McKay, H. A. Pilot study of a family physical activity planning intervention among parents and their children. \u003cem\u003eJ. Behav. Med.\u003c/em\u003e \u003cstrong\u003e33\u003c/strong\u003e, 91\u0026ndash;100 (2010).\u003c/li\u003e\n\u003cli\u003eRhodes, R. E., Perdew, M. \u0026amp; Malli, S. Correlates of Parental Support of Child and Youth Physical Activity: a Systematic Review. \u003cem\u003eInt. J. Behav. Med.\u003c/em\u003e \u003cstrong\u003e27\u003c/strong\u003e, 636\u0026ndash;646 (2020).\u003c/li\u003e\n\u003cli\u003eRhodes, R. E. \u003cem\u003eet al.\u003c/em\u003e Couple-Based Physical Activity Planning for New Parents: A Randomized Trial. \u003cem\u003eAm. J. Prev. Med.\u003c/em\u003e \u003cstrong\u003e61\u003c/strong\u003e, 518\u0026ndash;528 (2021).\u003c/li\u003e\n\u003cli\u003eDunton, G. F. \u003cem\u003eet al.\u003c/em\u003e Towards consensus in conceptualizing and operationalizing physical activity maintenance. \u003cem\u003ePsychol. Sport Exerc.\u003c/em\u003e \u003cstrong\u003e61\u003c/strong\u003e, 102214 (2022).\u003c/li\u003e\n\u003cli\u003eRhodes, R. E. \u0026amp; Sui, W. Physical Activity Maintenance: A Critical Narrative Review and Directions for Future Research. \u003cem\u003eFront. Psychol.\u003c/em\u003e \u003cstrong\u003e12\u003c/strong\u003e, 725671 (2021).\u003c/li\u003e\n\u003cli\u003eRhodes, R. E. Multi-process action control in physical activity: a primer. \u003cem\u003eFront. Psychol.\u003c/em\u003e \u003cstrong\u003e12\u003c/strong\u003e, 797484 (2021).\u003c/li\u003e\n\u003cli\u003eRhodes, R. E., Janssen, I., Bredin, S. S. D., Warburton, D. E. R. \u0026amp; Bauman, A. Physical activity: Health impact, prevalence, correlates and interventions. \u003cem\u003ePsychol. Health\u003c/em\u003e \u003cstrong\u003e32\u003c/strong\u003e, 942\u0026ndash;975 (2017).\u003c/li\u003e\n\u003cli\u003eConner, M. \u0026amp; Norman, P. Predicting and changing health behaviour: A social cognition approach. \u003cem\u003ePredict. Chang. Health Behav. Res. Pract. Soc. Cogn. Models\u003c/em\u003e \u003cstrong\u003e3\u003c/strong\u003e, 1\u0026ndash;29 (2015).\u003c/li\u003e\n\u003cli\u003eRhodes, R. E. \u0026amp; Yao, C. A. Models accounting for intention-behavior discordance in the physical activity domain: a user\u0026rsquo;s guide, content overview, and review of current evidence. \u003cem\u003eInt. J. Behav. Nutr. Phys. Act.\u003c/em\u003e \u003cstrong\u003e12\u003c/strong\u003e, 9 (2015).\u003c/li\u003e\n\u003cli\u003eRhodes, R. E. \u003cem\u003eet al.\u003c/em\u003e Application of the Multi-Process Action Control Framework to Understand Parental Support of Child and Youth Physical Activity, Sleep, and Screen Time Behaviours. \u003cem\u003eAppl. Psychol. Health Well-Being\u003c/em\u003e \u003cstrong\u003e11\u003c/strong\u003e, 223\u0026ndash;239 (2019).\u003c/li\u003e\n\u003cli\u003eRhodes, R. E. \u003cem\u003eet al.\u003c/em\u003e Understanding action control of parental support behavior for child physical activity. \u003cem\u003eHealth Psychol. Off. J. Div. Health Psychol. Am. Psychol. Assoc.\u003c/em\u003e \u003cstrong\u003e35\u003c/strong\u003e, 131\u0026ndash;140 (2016).\u003c/li\u003e\n\u003cli\u003eTanna, S., Arbour-Nicitopoulos, K., Rhodes, R. E. \u0026amp; Bassett-Gunter, R. A pilot study exploring the use of a telephone-assisted planning intervention to promote parental support for physical activity among children and youth with disabilities. \u003cem\u003ePsychol. Sport Exerc.\u003c/em\u003e \u003cstrong\u003e32\u003c/strong\u003e, 25\u0026ndash;33 (2017).\u003c/li\u003e\n\u003cli\u003eGrant, S. J. \u003cem\u003eet al.\u003c/em\u003e Parents and children active together: a randomized trial protocol examining motivational, regulatory, and habitual intervention approaches. \u003cem\u003eBMC Public Health\u003c/em\u003e \u003cstrong\u003e20\u003c/strong\u003e, 1436 (2020).\u003c/li\u003e\n\u003cli\u003eMedd, E. R. \u003cem\u003eet al.\u003c/em\u003e Family-based habit intervention to promote parent support for child physical activity in Canada: protocol for a randomised trial. \u003cem\u003eBMJ Open\u003c/em\u003e \u003cstrong\u003e10\u003c/strong\u003e, e033732 (2020).\u003c/li\u003e\n\u003cli\u003eQuinlan, A., Rhodes, R. E., Blanchard, C. M., Naylor, P.-J. \u0026amp; Warburton, D. E. R. Family planning to promote physical activity: a randomized controlled trial protocol. \u003cem\u003eBMC Public Health\u003c/em\u003e \u003cstrong\u003e15\u003c/strong\u003e, 1011 (2015).\u003c/li\u003e\n\u003cli\u003eBeauchamp, M. R. Promoting Exercise Adherence Through Groups: A Self-Categorization Theory Perspective. \u003cem\u003eExerc. Sport Sci. Rev.\u003c/em\u003e \u003cstrong\u003e47\u003c/strong\u003e, 54\u0026ndash;61 (2019).\u003c/li\u003e\n\u003cli\u003eJ. Burke, P. \u0026amp; E. Stets, J. \u003cem\u003eIdentity Theory\u003c/em\u003e. (Oxford University Press USA, 2009).\u003c/li\u003e\n\u003cli\u003eRhodes, R. E. \u003cem\u003eet al.\u003c/em\u003e Enacting physical activity intention: Multi-process action control. \u003cem\u003eSelf-Regul. Motiv. Sport Exerc. Oxon UK Taylor Francis\u003c/em\u003e (2020).\u003c/li\u003e\n\u003cli\u003eStryker, S. \u0026amp; Burke, P. J. The past, present, and future of identity theory. \u003cem\u003eSoc. Psychol. Q.\u003c/em\u003e \u003cstrong\u003e63\u003c/strong\u003e, 284\u0026ndash;297 (2000).\u003c/li\u003e\n\u003cli\u003eTajfel, H. \u0026amp; Turner, J.C. The Social Identity Theory of Intergroup Behavior. in \u003cem\u003ePsychology of Intergroup Relation\u003c/em\u003e (eds. Worchel, S. \u0026amp; Austin, W. G.) 7\u0026ndash;24 (Hall Publishers, Chicago, 1986).\u003c/li\u003e\n\u003cli\u003eRees, T., Alexander Haslam, S., Coffee, P. \u0026amp; Lavallee, D. A social identity approach to sport psychology: Principles, practice, and prospects. \u003cem\u003eSports Med.\u003c/em\u003e \u003cstrong\u003e45\u003c/strong\u003e, 1083\u0026ndash;1096 (2015).\u003c/li\u003e\n\u003cli\u003eTurner, J. C., Hogg, M. A., Oakes, P. J., Reicher, S. D. \u0026amp; Wetherell, M. S. \u003cem\u003eRediscovering the Social Group: A Self-Categorization Theory.\u003c/em\u003e (basil Blackwell, 1987).\u003c/li\u003e\n\u003cli\u003eAbrams, D. \u0026amp; Hogg, M. A. \u003cem\u003eSocial Identifications: A Social Psychology of Intergroup Relations and Group Processes\u003c/em\u003e. (Routledge, 2006).\u003c/li\u003e\n\u003cli\u003eHollman, H., Sui, W. \u0026amp; Rhodes, R. E. A feasibility randomized controlled trial of a multi-process action control web-based intervention that targets physical activity in mothers. \u003cem\u003eWomen Health\u003c/em\u003e \u003cstrong\u003e62\u003c/strong\u003e, 384\u0026ndash;401 (2022).\u003c/li\u003e\n\u003cli\u003eHusband, C. J., Wharf-Higgins, J. \u0026amp; Rhodes, R. E. A feasibility randomized trial of an identity-based physical activity intervention among university students. \u003cem\u003eHealth Psychol. Behav. Med.\u003c/em\u003e \u003cstrong\u003e7\u003c/strong\u003e, 128\u0026ndash;146 (2019).\u003c/li\u003e\n\u003cli\u003eMcEwan, D., Rhodes, R. E. \u0026amp; Beauchamp, M. R. What happens when the party is over?: sustaining physical activity behaviors after intervention cessation. \u003cem\u003eBehav. Med.\u003c/em\u003e \u003cstrong\u003e48\u003c/strong\u003e, 1\u0026ndash;9 (2022).\u003c/li\u003e\n\u003cli\u003eRhodes, R. E. \u003cem\u003eet al.\u003c/em\u003e Predicting the physical activity of new parents who participated in a physical activity intervention. \u003cem\u003eSoc. Sci. Med.\u003c/em\u003e \u003cstrong\u003e284\u003c/strong\u003e, 114221 (2021).\u003c/li\u003e\n\u003cli\u003eRhodes, R. E., Quinlan, A., Naylor, P.-J., Warburton, D. E. \u0026amp; Blanchard, C. M. Predicting personal physical activity of parents during participation in a family intervention targeting their children. \u003cem\u003eJ. Behav. Med.\u003c/em\u003e \u003cstrong\u003e43\u003c/strong\u003e, 209\u0026ndash;224 (2020).\u003c/li\u003e\n\u003cli\u003eChan, A.-W. \u003cem\u003eet al.\u003c/em\u003e SPIRIT 2013 statement: defining standard protocol items for clinical trials. \u003cem\u003eAnn. Intern. Med.\u003c/em\u003e \u003cstrong\u003e158\u003c/strong\u003e, 200\u0026ndash;207 (2013).\u003c/li\u003e\n\u003cli\u003eSchulz, K. F., Altman, D. G. \u0026amp; Moher, D. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. \u003cem\u003eJ. Pharmacol. Pharmacother.\u003c/em\u003e \u003cstrong\u003e1\u003c/strong\u003e, 100\u0026ndash;107 (2010).\u003c/li\u003e\n\u003cli\u003eRhodes, R. E., Wierts, C., Kullman, S., Magel, E. \u0026amp; Strachan, S. M. Experimental manipulations of physical activity identity: A systematic review and meta-analysis. \u003cem\u003eHealth Psychol. Rev.\u003c/em\u003e (In press).\u003c/li\u003e\n\u003cli\u003eWright, C. E., Rhodes, R. E., Ruggiero, E. W. \u0026amp; Sheeran, P. Benchmarking the effectiveness of interventions to promote physical activity: A metasynthesis. \u003cem\u003eHealth Psychol. Off. J. Div. Health Psychol. Am. Psychol. Assoc.\u003c/em\u003e \u003cstrong\u003e40\u003c/strong\u003e, 811\u0026ndash;821 (2021).\u003c/li\u003e\n\u003cli\u003eRhodes, R. E. Translating physical activity intentions into regular behavior is a consequence of reflective, regulatory, and reflexive processes. \u003cem\u003eExerc. Sport Sci. Rev.\u003c/em\u003e \u003cstrong\u003e52\u003c/strong\u003e, 13\u0026ndash;22 (2024).\u003c/li\u003e\n\u003cli\u003eYao, C. A. \u0026amp; Rhodes, R. E. Parental correlates in child and adolescent physical activity: a meta-analysis. \u003cem\u003eInt. J. Behav. Nutr. Phys. Act.\u003c/em\u003e \u003cstrong\u003e12\u003c/strong\u003e, 10 (2015).\u003c/li\u003e\n\u003cli\u003eTremblay, M. S. \u003cem\u003eet al.\u003c/em\u003e Canadian 24-Hour Movement Guidelines for Children and Youth: An Integration of Physical Activity, Sedentary Behaviour, and Sleep. \u003cem\u003eAppl. Physiol. Nutr. Metab.\u003c/em\u003e \u003cstrong\u003e41\u003c/strong\u003e, S311\u0026ndash;S327 (2016).\u003c/li\u003e\n\u003cli\u003eWarburton, D. E., Jamnik, V. K., Bredin, S. S. \u0026amp; Gledhill, N. The physical activity readiness questionnaire for everyone (PAR-Q+) and electronic physical activity readiness medical examination (ePARmed-X+). \u003cem\u003eHealth Fit. J. Can.\u003c/em\u003e \u003cstrong\u003e4\u003c/strong\u003e, 3\u0026ndash;17 (2011).\u003c/li\u003e\n\u003cli\u003eDumas, J. E., Lynch, A. M., Laughlin, J. E., Smith, E. P. \u0026amp; Prinz, R. J. Promoting intervention fidelity: Conceptual issues, methods, and preliminary results from the EARLY ALLIANCE prevention trial. \u003cem\u003eAm. J. Prev. Med.\u003c/em\u003e \u003cstrong\u003e20\u003c/strong\u003e, 38\u0026ndash;47 (2001).\u003c/li\u003e\n\u003cli\u003eHagger, M.S \u003cem\u003eet al.\u003c/em\u003e Implementation intention and planning interventions in Health Psychology: Recommendations from the Synergy Expert Group for research and practice. \u003cem\u003ePsychol. Health\u003c/em\u003e \u003cstrong\u003e31\u003c/strong\u003e, (2016).\u003c/li\u003e\n\u003cli\u003eRhodes, R. E., Grant, S. \u0026amp; de Bruijn, G.-J. Planning and implementation intention interventions. in \u003cem\u003eThe handbook of behavior change.\u003c/em\u003e 572\u0026ndash;585 (Cambridge University Press, New York, NY, US, 2020). doi:10.1017/9781108677318.039.\u003c/li\u003e\n\u003cli\u003eSchwarzer, R. Modeling Health Behavior Change: How to Predict and Modify the Adoption and Maintenance of Health Behaviors. \u003cem\u003eAppl. Psychol.\u003c/em\u003e \u003cstrong\u003e57\u003c/strong\u003e, 1\u0026ndash;29 (2008).\u003c/li\u003e\n\u003cli\u003eSui, W., Hollman, H., Magel, E. \u0026amp; Rhodes, R. E. Increasing physical activity among adults affected by COVID-19 social distancing restrictions: A feasibility trial of an online intervention. \u003cem\u003eJ. Behav. Med.\u003c/em\u003e ((In press)).\u003c/li\u003e\n\u003cli\u003eLocke, E. A. \u0026amp; Latham, G. P. \u003cem\u003eA Theory of Goal Setting \u0026amp; Task Performance.\u003c/em\u003e (Prentice-Hall, Inc, 1990).\u003c/li\u003e\n\u003cli\u003ePrestwich, A., Lawton, R. \u0026amp; Conner, M. The use of implementation intentions and the decision balance sheet in promoting exercise behaviour. \u003cem\u003ePsychol. Health\u003c/em\u003e \u003cstrong\u003e18\u003c/strong\u003e, 707\u0026ndash;721 (2003).\u003c/li\u003e\n\u003cli\u003eSniehotta, F. F., Scholz, U. \u0026amp; Schwarzer, R. Bridging the intention\u0026ndash;behaviour gap: Planning, self-efficacy, and action control in the adoption and maintenance of physical exercise. \u003cem\u003ePsychol. Health\u003c/em\u003e \u003cstrong\u003e20\u003c/strong\u003e, 143\u0026ndash;160 (2005).\u003c/li\u003e\n\u003cli\u003eSniehotta, F. F., Scholz, U. \u0026amp; Schwarzer, R. Action plans and coping plans for physical exercise: A longitudinal intervention study in cardiac rehabilitation. \u003cem\u003eBr. J. Health Psychol.\u003c/em\u003e \u003cstrong\u003e11\u003c/strong\u003e, 23\u0026ndash;37 (2006).\u003c/li\u003e\n\u003cli\u003eStrecher, V. J. \u003cem\u003eet al.\u003c/em\u003e Goal setting as a strategy for health behavior change. \u003cem\u003eHealth Educ. Q.\u003c/em\u003e \u003cstrong\u003e22\u003c/strong\u003e, 190\u0026ndash;200 (1995).\u003c/li\u003e\n\u003cli\u003eHealth Canada. Canada\u0026rsquo;s food guide: Healthy eating resources. https://food-guide.canada.ca/en/healthy-eating-resources/ (2024).\u003c/li\u003e\n\u003cli\u003eBurke, P. J. Identity change. \u003cem\u003eSoc. Psychol. Q.\u003c/em\u003e \u003cstrong\u003e69\u003c/strong\u003e, 81\u0026ndash;96 (2006).\u003c/li\u003e\n\u003cli\u003eKendzierski, D. \u0026amp; Morganstein, M. S. Test, revision, and cross-validation of the physical activity self-definition model. \u003cem\u003eJ. Sport Exerc. Psychol.\u003c/em\u003e \u003cstrong\u003e31\u003c/strong\u003e, 484\u0026ndash;504 (2009).\u003c/li\u003e\n\u003cli\u003eCox, A. \u0026amp; Rhodes, R. Increasing physical activity in empty nest and retired populations online: a randomized feasibility trial protocol. \u003cem\u003eInt. J. Environ. Res. Public. Health\u003c/em\u003e \u003cstrong\u003e17\u003c/strong\u003e, 3544 (2020).\u003c/li\u003e\n\u003cli\u003eSteffens, N. K., Fransen, K. \u0026amp; Haslam, S. A. Leadership. in \u003cem\u003eThe new psychology of sport and exercise: the social identity approach\u003c/em\u003e 41\u0026ndash;58 (Sage: Thousand Oaks., 2020).\u003c/li\u003e\n\u003cli\u003eCarron, A. V., Widmeyer, W. N. \u0026amp; Brawley, L. R. The Development of an Instrument to Assess Cohesion in Sport Teams: The Group Environment Questionnaire. \u003cem\u003eJ. Sport Psychol.\u003c/em\u003e \u003cstrong\u003e7\u003c/strong\u003e, 244\u0026ndash;266 (1985).\u003c/li\u003e\n\u003cli\u003eOakes, P. J., Haslam, S. A. \u0026amp; Turner, J. C. \u003cem\u003eStereotyping and Social Reality.\u003c/em\u003e (Blackwell Publishing, 1994).\u003c/li\u003e\n\u003cli\u003eMichie, S. \u003cem\u003eet al.\u003c/em\u003e The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions. \u003cem\u003eAnn. Behav. Med.\u003c/em\u003e \u003cstrong\u003e46\u003c/strong\u003e, 81\u0026ndash;95 (2013).\u003c/li\u003e\n\u003cli\u003eHaslam, S. A., Oakes, P. J. \u0026amp; Turner, J. C. Social identity, self-categorization, and the perceived homogeneity of ingroups and outgroups: The interaction between social motivation and cognition. (1996).\u003c/li\u003e\n\u003cli\u003eEsliger, D. W. \u0026amp; Tremblay, M. S. Physical activity and inactivity profiling: the next generation. \u003cem\u003eAppl. Physiol. Nutr. Metab.\u003c/em\u003e \u003cstrong\u003e32\u003c/strong\u003e, S195\u0026ndash;S207 (2007).\u003c/li\u003e\n\u003cli\u003eCain, K. L., Sallis, J. F., Conway, T. L., Van Dyck, D. \u0026amp; Calhoon, L. Using accelerometers in youth physical activity studies: a review of methods. \u003cem\u003eJ. Phys. Act. Health\u003c/em\u003e \u003cstrong\u003e10\u003c/strong\u003e, 437\u0026ndash;450 (2013).\u003c/li\u003e\n\u003cli\u003eTrost, S. G., McIver, K. L. \u0026amp; Pate, R. R. Conducting Accelerometer-Based Activity Assessments in Field-Based Research. \u003cem\u003eMed. Sci. Sports Exerc.\u003c/em\u003e \u003cstrong\u003e37\u003c/strong\u003e, (2005).\u003c/li\u003e\n\u003cli\u003eTroiano, R. P. \u003cem\u003eet al.\u003c/em\u003e Physical activity in the United States measured by accelerometer. \u003cem\u003eMed. Sci. Sports Exerc.\u003c/em\u003e \u003cstrong\u003e40\u003c/strong\u003e, 181 (2008).\u003c/li\u003e\n\u003cli\u003eEvenson, K. R., Catellier, D. J., Gill, K., Ondrak, K. S. \u0026amp; McMurray, R. G. Calibration of two objective measures of physical activity for children. \u003cem\u003eJ. Sports Sci.\u003c/em\u003e \u003cstrong\u003e26\u003c/strong\u003e, 1557\u0026ndash;1565 (2008).\u003c/li\u003e\n\u003cli\u003eMigueles, J. H. \u003cem\u003eet al.\u003c/em\u003e Accelerometer data collection and processing criteria to assess physical activity and other outcomes: a systematic review and practical considerations. \u003cem\u003eSports Med.\u003c/em\u003e \u003cstrong\u003e47\u003c/strong\u003e, 1821\u0026ndash;1845 (2017).\u003c/li\u003e\n\u003cli\u003eGodin, G., Jobin, J. \u0026amp; Bouillon, J. Assessment of leisure time exercise behavior by self-report: a concurrent validity study. \u003cem\u003eCan. J. Public Health Rev. Can. Sante Publique\u003c/em\u003e \u003cstrong\u003e77\u003c/strong\u003e, 359\u0026ndash;362 (1986).\u003c/li\u003e\n\u003cli\u003eGodin, G. \u0026amp; Shephard, R. J. A simple method to assess exercise behavior in the community. \u003cem\u003eCan. J. Appl. Sport Sci. J. Can. Sci. Appl. Au Sport\u003c/em\u003e \u003cstrong\u003e10\u003c/strong\u003e, 141\u0026ndash;146 (1985).\u003c/li\u003e\n\u003cli\u003eActigraph. ActiGraph Launches New Generation of Bluetooth\u0026reg; Smart Activity Monitors. \u003cem\u003eActigraph\u003c/em\u003e https://www.actigraphcorp.com/press-release/actigraph-launches-new-generation-of-bluetooth-smart-activity-monitors/ (2013).\u003c/li\u003e\n\u003cli\u003eKuzik, N. \u0026amp; Carson, V. Accelerometer Bluetooth proximity validation in parents and early years children. \u003cem\u003eMeas. Phys. Educ. Exerc. Sci.\u003c/em\u003e \u003cstrong\u003e22\u003c/strong\u003e, 287\u0026ndash;293 (2018).\u003c/li\u003e\n\u003cli\u003eDlugonski, D., Wood, A. P., DuBose, K. D., Rider, P. \u0026amp; Schoemann, A. M. Validity and reliability of proximity detection with Bluetooth-enabled accelerometers among adults. \u003cem\u003eMeas. Phys. Educ. Exerc. Sci.\u003c/em\u003e \u003cstrong\u003e23\u003c/strong\u003e, 272\u0026ndash;279 (2019).\u003c/li\u003e\n\u003cli\u003eGledhill, N. \u0026amp; Jamnik, V. K. \u003cem\u003eCanadian Physical Activity, Fitness and Lifestyle Approach.\u003c/em\u003e (Canadian Society for Exercise Physiology, 2003).\u003c/li\u003e\n\u003cli\u003eCanadian Society for Exercise Physiology (CSEP). \u003cem\u003eThe Canadian Physical Activity, Fitness and Lifestyle Approach (CPAFLA)\u003c/em\u003e. (Canadian Society for Exercise Physiology, 2003).\u003c/li\u003e\n\u003cli\u003eRhodes, R. E. The evolving understanding of physical activity behavior: A multi-process action control approach. in \u003cem\u003eAdvances in motivation science\u003c/em\u003e vol. 4 171\u0026ndash;205 (Elsevier, 2017).\u003c/li\u003e\n\u003cli\u003eDavison, K. K., Cutting, T. M. \u0026amp; Birch, L. L. Parents\u0026rsquo; activity-related parenting practices predict girls\u0026rsquo; physical activity. \u003cem\u003eMed. Sci. Sports Exerc.\u003c/em\u003e \u003cstrong\u003e35\u003c/strong\u003e, 1589 (2003).\u003c/li\u003e\n\u003cli\u003eAnderson, D. F., Cychosz, C. M. \u0026amp; Franke, W. D. Association of exercise identity with measures of exercise commitment and physiological indicators of fitness in a law enforcement cohort. \u003cem\u003eJ. Sport Behav.\u003c/em\u003e \u003cstrong\u003e21\u003c/strong\u003e, 233\u0026ndash;241 (1998).\u003c/li\u003e\n\u003cli\u003eAnderson, D. F. \u0026amp; Cychosz, C. M. Development of an exercise identity scale. \u003cem\u003ePercept. Mot. Skills\u003c/em\u003e \u003cstrong\u003e78\u003c/strong\u003e, 747\u0026ndash;751 (1994).\u003c/li\u003e\n\u003cli\u003eAnderson, D. F. \u0026amp; Cychosz, C. M. Exploration of the relationship between exercise behavior and exercise identity. \u003cem\u003eJ. Sport Behav.\u003c/em\u003e \u003cstrong\u003e18\u003c/strong\u003e, 159\u0026ndash;166 (1995).\u003c/li\u003e\n\u003cli\u003eWilson, P. M. \u0026amp; Muon, S. Psychometric properties of the Exercise Identity Scale in a university sample. \u003cem\u003eInt. J. Sport Exerc. Psychol.\u003c/em\u003e \u003cstrong\u003e6\u003c/strong\u003e, 115\u0026ndash;131 (2008).\u003c/li\u003e\n\u003cli\u003eDoosje, B., Ellemers, N. \u0026amp; Spears, R. Perceived intragroup variability as a function of group status and identification. \u003cem\u003eJ. Exp. Soc. Psychol.\u003c/em\u003e \u003cstrong\u003e31\u003c/strong\u003e, 410\u0026ndash;436 (1995).\u003c/li\u003e\n\u003cli\u003eVerplanken, B. \u0026amp; Orbell, S. Reflections on Past Behavior: A Self‐Report Index of Habit Strength. \u003cem\u003eJ. Appl. Soc. Psychol.\u003c/em\u003e \u003cstrong\u003e33\u003c/strong\u003e, 1313\u0026ndash;1330 (2003).\u003c/li\u003e\n\u003cli\u003eGardner, B., Abraham, C., Lally, P. \u0026amp; de Bruijn, G.-J. Towards parsimony in habit measurement: Testing the convergent and predictive validity of an automaticity subscale of the Self-Report Habit Index. \u003cem\u003eInt. J. Behav. Nutr. Phys. Act.\u003c/em\u003e \u003cstrong\u003e9\u003c/strong\u003e, 102 (2012).\u003c/li\u003e\n\u003cli\u003eRhodes, R. E. \u0026amp; Lithopoulos, A. The Physical Activity Regulation Scale: Development and validity testing. \u003cem\u003eHealth Psychol.\u003c/em\u003e \u003cstrong\u003e42\u003c/strong\u003e, 378 (2023).\u003c/li\u003e\n\u003cli\u003eLithopoulos, A., Zhang, C.-Q., Williams, D. M. \u0026amp; Rhodes, R. E. Development and validation of a two-component perceived control measure. \u003cem\u003eAnn. Behav. Med.\u003c/em\u003e \u003cstrong\u003e57\u003c/strong\u003e, 175\u0026ndash;184 (2023).\u003c/li\u003e\n\u003cli\u003eAjzen, I. The theory of planned behavior. \u003cem\u003eTheor. Cogn. Self-Regul.\u003c/em\u003e \u003cstrong\u003e50\u003c/strong\u003e, 179\u0026ndash;211 (1991).\u003c/li\u003e\n\u003cli\u003eRhodes, R. E. \u0026amp; Courneya, K. S. Investigating multiple components of attitude, subjective norm, and perceived control: An examination of the theory of planned behaviour in the exercise domain. \u003cem\u003eBr. J. Soc. Psychol.\u003c/em\u003e \u003cstrong\u003e42\u003c/strong\u003e, 129\u0026ndash;146 (2003).\u003c/li\u003e\n\u003cli\u003eCourneya, K. S. Predicting repeated behavior from intention: The issue of scale correspondence. \u003cem\u003eJ. Appl. Soc. Psychol.\u003c/em\u003e \u003cstrong\u003e24\u003c/strong\u003e, 580\u0026ndash;594 (1994).\u003c/li\u003e\n\u003cli\u003eRhodes, R. E., Blanchard, C. M. \u0026amp; Matheson, D. H. A multicomponent model of the theory of planned behaviour. \u003cem\u003eBr. J. Health Psychol.\u003c/em\u003e \u003cstrong\u003e11\u003c/strong\u003e, 119\u0026ndash;137 (2006).\u003c/li\u003e\n\u003cli\u003eRhodes, R. E. \u0026amp; Rebar, A. L. Conceptualizing and Defining the Intention Construct for Future Physical Activity Research. \u003cem\u003eExerc. Sport Sci. Rev.\u003c/em\u003e \u003cstrong\u003e45\u003c/strong\u003e, 209\u0026ndash;216 (2017).\u003c/li\u003e\n\u003cli\u003eAllison, P. \u003cem\u003eMissing Data\u003c/em\u003e. (Thousand Oaks, California, 2002). doi:10.4135/9781412985079.\u003c/li\u003e\n\u003cli\u003eCreswell, J. W. \u003cem\u003eQualitative Inquiry and Research Design: Choosing among Five Traditions.\u003c/em\u003e xv, 403 (Sage Publications, Inc, Thousand Oaks, CA, US, 1998).\u003c/li\u003e\n\u003cli\u003eSchwandt, T. A. Three epistemological stances for qualitative inquiry: Interpretivism, hermeneutics, and social constructionism. in \u003cem\u003eHandbook of qualitative research\u003c/em\u003e 189\u0026ndash;213 (SAGE Publishing, 2000).\u003c/li\u003e\n\u003cli\u003eMaykut, P. \u0026amp; Morehouse, R. \u003cem\u003eBeginning Qualitative Research: A Philosophical and Practical Guide\u003c/em\u003e. (Routledge, 2002).\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Table 1","content":"\u003cp\u003eTable 1 is available in the Supplementary Files section.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Exercise, self-regulation, planning, multi-process action control, attitudes, parental support","lastPublishedDoi":"10.21203/rs.3.rs-4415668/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4415668/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eRegular engagement in moderate-to-vigorous physical activity (MVPA) during childhood yields a myriad of health benefits, and contributes to sustained MVPA behaviors into adulthood. Given the influence of parents on shaping their child\u0026rsquo;s MVPA behaviour, the family system represents a viable target for intervention. The purpose of this study is to compare the effects of two intervention conditions designed to increase child MVPA: 1) \u003cem\u003eA standard education\u0026thinsp;+\u0026thinsp;planning intervention\u003c/em\u003e providing information about benefits, action planning, and coping planning; and 2) An \u003cem\u003eaugmented physical activity education\u0026thinsp;+\u0026thinsp;planning intervention\u003c/em\u003e that includes the components of the standard intervention, as well as a focus on family identity promotion and developing as an active member of the family.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA two-arm parallel single-blinded randomized trial will compare the two conditions over 6 months. Eligible families have at least one child aged 6\u0026ndash;12 years who is not meeting the physical activity recommendations within the Canadian 24-Hour Movement Guidelines (i.e.,\u0026lt;60 minutes/day of MVPA). Intervention materials targeting family identity promotion will be delivered online via zoom following baseline assessment, with booster sessions at 6-weeks and 3-months. Child MVPA will be measured by wGT3X-BT Actigraph accelerometry at baseline, 6-weeks, 3-months, and 6-months as the primary outcome. At these same time points, parent cognition (e.g., attitudes, perceived control, behavioral regulation, habit, identity) and support behaviours, and parent-child co-activity will be assessed via questionnaire as secondary outcomes. Child-health fitness measures will be also administered through fitness testing at baseline and 6-months as secondary outcomes. Finally, upon completion of the trial\u0026rsquo;s 6-month measures, a follow-up end-of-trial interview will be conducted with parents to examine parents\u0026rsquo; experiences with the intervention.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eSo far, 30 families have been enrolled from the Southern Vancouver Island and Vancouver Lower Mainland area. Recruitment will be continuing through 2026 with a target of 148 families.\u003c/p\u003e\u003ch2\u003eDiscussion\u003c/h2\u003e \u003cp\u003eThis study will contribute to the understanding of effective strategies to increase child physical activity by comparing two intervention approaches. Both provide parents with education on physical activity benefits, action planning, and coping planning supports. However, one intervention also incorporates components focused on promoting an active family identity and involving all family members in physical activity together. The findings from this study have the potential to inform the design and implementation of public health initiatives aimed at improving physical activity participation in children and guide the development of more effective interventions that leverage the crucial role of parents and the family system in shaping children's physical activity behaviors.\u003c/p\u003e\u003ch2\u003eTrial Registration\u003c/h2\u003e \u003cp\u003eThis trial was registered on clinicaltrials.gov in March 2nd, 2023. 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