Study protocol - assessing parkrun for walking rehabilitation for people living with, and beyond, cancer: acceptability, adherence, social support and physical function

INTRODUCTION

Due to a variety of barriers, the majority of cancer survivors do not do enough physical activity to meet current recommendations. This study will assess the feasibility of participation in parkrun walk-run events as a novel mode of community rehabilitation exercise.

METHODS

This protocol describes a single-arm intervention study with participants acting as their own controls. The study accepts adults diagnosed with any type of cancer, undergoing treatment or in remission. Participants must be able to walk and have medical clearance to exercise. A sample of 100 participants will be recruited across the Sunshine Coast over two years. Data will be collected over 9-months at 4 time points: Baseline (T1); after 4-weeks of usual daily activities and cancer management prior to parkrun participation(T2); after a 6-month parkrun intervention (T3); at 2-month follow-up (T4). The primary objectives are to assess the acceptability of, and adherence to, parkrun as rehabilitation exercise. Secondary outcomes include wellness, health-related quality of life, anxiety, depression, mood, physical function, parkrun metrics, dietary intake, and diet and exercise behaviour.

CONCLUSION

This study will be the first to examine the long-term effects of parkrun as a cancer rehabilitation modality with regard to physical function, psychosocial outcomes and dietary intake.

TRIAL REGISTRATION

Australian and New Zealand Clinical Trials Registry ACTRN12623000473662 registered 09/05/2023.Approved by UniSC Human Research Ethics Committee (A221828) and the UK parkrun Research Board. Original protocol. Authors SB, RB, HHW, MM, YK.

The importance of family support to engage and retain girls in male dominated action sports. A qualitative study of young people's perspectives

ISSUE ADDRESSED

Social support is positively correlated with physical activity (PA), especially amongst girls, but is underexplored in male-dominated action sports (e.g., mountain biking, skateboarding and surfing). This study explored family level social support needs and experiences of girls and boys in three action sports.

METHOD

Aspiring, current or former Australian adolescent (12-18 years; girls n = 25; boys n = 17) mountain bikers, skateboarders and/or surfers were individually interviewed (telephone/Skype) in 2018/2020. A socio-ecological framework guided the semi-structured interview schedule. Audio-recordings were transcribed verbatim and data analysed thematically using a constant comparative approach.

RESULTS

Family level social support was highly influential in young people's participation in action sports, with its absence a common reason for no or discontinued engagement amongst girls. Parents and siblings were the main social support providers with extended family (e.g., grandparents, aunts/uncles, cousins) also notable. Participation (current/past/co-) was the main social support type followed by emotional (e.g., encouragement), instrumental (e.g., transport, equipment/funding) and informational (e.g., coaching) support. Girls were inspired/encouraged by brothers but boys were not inspired/encouraged by sisters; boys and girls co-participated with both parents but co-participating and being inspired by fathers was most common, especially amongst girls; fathers were more commonly the main transport provider if they co-participated with their child; fathers mostly provided initial coaching; only boys were taught equipment maintenance by parents.

CONCLUSIONS AND SO WHAT

Sport-related organisations/groups have numerous opportunities to improve girls' representation in action sports by fostering family level social support through various means. Intervention strategies should be tailored to account for gendered participation differences.

Patterns and Correlates of Participation in a Weekly Mass Participation Physical Activity Event, parkrun, in Australia, 2011-2020

BACKGROUND

Studying effective interventions already operating at scale is critical to improving physical activity intervention research translation. The free, weekly, timed 5-km run or walk parkrun represents a unique opportunity to examine successful organic dissemination. We conducted an ecological analysis to identify patterns of growth in Australian parkrun participation and their correlates from 2011 to 2020.

METHOD

Outcome variables were (1) weekly counts of walkers/runners and (2) monthly number of new parkrun registrants. We used latent class analysis to characterize growth trajectories followed by logistic regression on class membership. Covariates included parkrun course characteristics (eg, surface type and route), site-level aggregate participant profile (eg, proportion women and mean age), and surrounding area characteristics (eg, population density and physical activity norm).

RESULTS

Three hundred and sixty-three parkruns were included (n = 8,388,695 participation instances). Sixty-nine percent followed a low-growth and 31% a high-growth participation pattern. High growth was associated with greater participation by women, concrete/bitumen surface type, lower area socioeconomic status, and greater volunteer heterogeneity. Odds of being in the slow-growth class were higher if the course contained >1 km of repetition, higher average age of participants, better average parkrun performance, and higher running group membership. Two patterns of new registration were identified: high start followed by steep decline; and low start, slow decline with similar correlates to participation.

CONCLUSIONS

Parkruns with a less competitive social milieu may have more rapid dissemination. As a free and regular event, parkruns in low socioeconomic areas have the potential to improve the activity levels of those with fewer resources.

How can UK public health initiatives support each other to improve the maintenance of physical activity? Evidence from a cross-sectional survey of runners who move from Couch-to-5k to parkrun

Physical activity improves physical and mental well-being and reduces mortality risk. However, only a quarter of adults globally meet recommended physical activity levels for health. Two common initiatives in the UK are Couch-to-5k (an app-assisted 9-week walk/run programme) and parkrun (a free, weekly, timed 5-km walk/run). It is not known how these initiatives are linked, how Couch-to-5k parkrunners compare to parkrunners, and the extent to which this influences their parkrun performance. The aims were to compare the characteristics and motives and to compare physical activity levels, parkrun performance and the impact of parkrun between Couch-to-5k parkrunners and parkrunners. Three thousand two hundred and ninety six Couch-to-5k parkrunners were compared to 55,923 parkrunners to explore age, sex, ethnicity, employment status, neighbourhood deprivation, motives, physical activity levels, parkrun performance and the impact of parkrun. Couch-to-5k parkrunners were slightly older, more likely to be female and work part-time, but similar in ethnicity, and neighbourhood deprivation compared with other parkrunners. Couch-to-5k parkrunners had different motives for participation and reported high levels of physical activity at registration, which remained to the point of survey completion. This group had slower parkrun times but, when registered for a year, completed a similar number of runs (11) per year. Larger proportions of Couch-to-5k parkrunners perceived positive impacts compared with other parkrunners and 65% of Couch-to-5k parkrunners reported improvements to their lifestyle. parkrun appears to be an effective pathway for those on the Couch-to-5k programme, and the promising positive association between the two initiatives may be effective in assisting previously inactive participants to take part in weekly physical activity.

Predictors of successful return to parkrun for first-time adult participants in Scotland

Physical activity is essential for promoting good health and reducing burdens on healthcare systems. parkrun organise free weekly events where participants complete a 5km route. Studies have identified characteristics of participants associated with lower levels of participation. The aim of the study was to identify predictors of the likelihood of returning to parkrun for first-time adult participants. The return rate of adult first-time participants was determined for all 5km parkrun events in Scotland over a 1-year period from February 2019. The dataset consisted of 20,191 adult participants made up of 11,459 females and 8,732 males across 58 venues. A General Linear Mixed Model was used to identify factors associated with return rate. Return rates were negatively correlated with event size and positively correlated with the proportion of first-time adult participants at the event. Age was positively correlated with return rate and males were more likely to return. New participants that finished in a relatively slow time were disproportionately less likely to return. Return rates were positively correlated with the amount of freshwater and woodland on the route. These findings provide potential opportunities to manage events to enhance their efficacy. Specific events could be promoted as first-timer days to encourage new participants to attend together. New events could be prioritised in proximity to events that currently experience high attendances to reduce attendances locally. As the presence of freshwater and woodland are associated with higher return these habitats could play a role in generating the benefits of green exercise. If so the creation of more routes running through or alongside these habitats could be beneficial. The findings are likely to be widely applicable to other mass participation events and those interesting in understanding the mechanism by which green exercise provides its benefits.

New Parkrunners Are Slower and the Attendance Gender Gap Narrowing Making Parkrun More Inclusive

Parkrun is a weekly mass-participation event. Finishes are recorded, with the resulting database potentially containing important public health information. The aim of this study was to identify characteristics of events that overcome barriers to participation, and to identify changing patterns in the demographics of participants. GLMMs were generated of age-graded performance, gender ratio and age of participants at Scottish parkrun events. Predictor variables included age, gender, participant, runs, date, elevation gain, surface and travelling time to the next nearest venue. There was a decline in the mean performance of participants at events, yet individual performances improved. The gender ratio showed higher male participation with a narrowing gender gap. Events in the most remote parts of Scotland had lower performance and a higher proportion of female participants. Events on slower surfaces had more female participants. Parkrun events are becoming more inclusive, with more females and participants exhibiting low performance. In more remote parts of Scotland, more females participated in parkrun than males, suggesting parkrun has overcome traditional barriers to female participation in sport. Prioritising the creation of events at remote locations and on slower surfaces could increase inclusivity further. General practitioners prescribing parkrun might want to prescribe attendance at slower events for female patients.

The 5 K run in popular fiction: Reading about parkrun and couch to 5 K

Recent years have witnessed great interest in mass-participation running events (1), and organisations such as parkrun and fitness programmes like Couch to 5 K, have been instrumental in enabling participation for inexperienced runners. Concomitant with this has been a number of fictional works which centre on the 5 K run. I contend that exploring fictional texts can offer a fresh take on how movements such as parkrun and Couch to 5 K have entered the popular imagination. The four texts explored are Wake's Saturday Morning Park Run (2020), Park's A Run in the Park (2019), Boleyn's Coming Home to Cariad Cove (2022), and James's I Follow You (2020). The analysis is arranged thematically around the categories of health promotion, individual transformation, and community building. I argue that these texts frequently operate as health promotion tools and can help familiarise would-be runners with how parkrun and Couch to 5 K work.

Outcomes of participation in parkrun, and factors influencing why and how often individuals participate: A systematic review of quantitative studies

The primary objective of this systematic review was to synthesise peer-reviewed quantitative research of outcomes associated with participation in parkrun. The secondary objective was to synthesise the quantitative research of factors influencing why, and how often, individuals participate in parkrun. Studies were identified via electronic search of Medline, AMED, CINAHL, Cochrane Library, Informit, PsychInfo, SportDiscus, and Web of Science, to 30 March 2021. Two reviewers independently assessed methodological quality. Eleven studies (18,203 participants) were included. Limited evidence from pre-post measure single-group prospective studies suggests parkrun participation promotes improvements in fitness, body mass index, physical activity levels, mood, and personal wellbeing. Individuals with non-running backgrounds generally had higher levels of participation. The main motivators to participate were to improve fitness and social interaction. Future attendance was most strongly correlated with historical attendance. There is a small evidence base for improvements in broad measures of physical and mental health from participation in parkrun. In addition, the study found improving physical fitness and social wellbeing were the main self-reported factors for participation in parkrun. Further research is needed to strengthen the knowledge base of the effects of parkrun to determine its efficacy as a health intervention strategy for physical and mental health.

Motivation and Behaviour Change in Parkrun Participants in the Western Cape Province, South Africa

Mass participation events are promoted in South Africa as a positive public health initiative. Parkrun has grown to be one of the most popular. The present study identifies the motives of residents in the Western Cape Province to join parkrun and how their involvement influences future physical activity levels. Participants (N = 1787) completed a survey consisting of demographic history, parkrun participation history, motivations for participation, and physical activity-related behaviour changes associated with parkrun participation. The majority of participants were female (n = 952) and over 50 years of age (median = 50; IQR = 38-59). Along with health-related benefits, the provision of a safe and organised event was reported as a key motive to participate. The social connectedness developed by parkrun encouraged continued participation and promoted uptake of more physical activity. Close to half the participants reported increases in physical activity levels after joining parkrun, which demonstrates the benefit obtained from participation in structured mass participation events. With the large diversity in socioeconomic status in South Africa related to physical activity levels, parkrun provides a protected and engaging environment that provides opportunity for increased physical activity and potentially reducing the burden on the healthcare system.

Action research with parkrun UK volunteer organizers to develop inclusive strategies

This article addresses the challenge of promoting physical activity through a focus on equity and engaging physically inactive citizens through the development of inclusive strategies within parkrun UK-a free, volunteer-led, weekly mass community participation running event. We discuss how a UK-based action research design enabled collaboration with volunteer event organizers to understand participant experiences, constraints and develop localized inclusive practices. In contrast with 'expert'-driven health behaviour interventions, our research pursued a 'ground up' approach by asking what can be learnt from the successes and challenges of organizing community events, such as parkrun UK, to promote inclusion? A modified participatory action research approach was used with four parkrun sites across England, Scotland and Northern Ireland, that involved quantitative and qualitative analysis of survey data (n = 655) that informed the process. Our analysis explored parkrunners' and volunteer organizers' perceptions relating to (i) the demographics of parkrun participation and (ii) actions for change in relation to the challenges of engaging marginalized groups (women, ethnic minorities, low income, older people, those with disabilities or illness). We discuss the challenges and opportunities for addressing (in)equity and inclusion through volunteer-based organizations and the implications for translating knowledge into organizational strategies.

Evidence on the reach and impact of the social physical activity phenomenon parkrun: A scoping review

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parkrun research shows health value and a model which suits participants.

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parkrun engages traditionally under-represented populations in physical activity.

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parkrun participation has a dose–response relationship with improved fitness.

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Future research should examine discontinuing participants and non-participants.

The aim of this study was to conduct a scoping review of parkrun literature for evidence of its reach, health impact and appeal whilst identifying gaps for future research. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). Six databases were searched according to search terms set a priori. Empirical studies of any design were included if they provided data on participation in, or benefits of, parkrun and were in English. Two authors conducted the searches independently and screened results by title and abstract, followed by full text reviews. A total of 235 records were screened and 15 studies were eligible; 12 were conducted in the UK and three in Australia. Seven were qualitative interview studies, six were quantitative, and two used mixed methods. parkrun reaches groups traditionally underrepresented in other organised sports or physical activity such as women, the insufficiently active and those aged over 35 years. Participants showed sustained improvements in fitness, physical activity levels, and body mass index with a dose–response effect with participation frequency. Qualitative data shows parkrun’s location in pleasant environments with opportunities for informal social interaction engages priority groups such as individuals with mental health issues, women and children. The small evidence base suggests parkrun has good reach, and can positively impact participants’ health and wellbeing. The data, however, are currently UK-centric and gaps in research on non-participants, long term health impacts and operationally relevant factors should be addressed.

A Scoping Review of the Relationship between Running and Mental Health

Poor mental health contributes significantly to global morbidity. The evidence regarding physical benefits of running are well-established. However, the mental health impacts of running remain unclear. An overview of the relationship between running and mental health has not been published in the last 30 years. The purpose of this study was to review the literature on the relationship between running and mental health. Our scoping review used combinations of running terms (e.g., Run* and Jog*) and mental health terms (general and condition specific). Databases used were Ovid(Medline), Ovid(Embase), ProQuest and SportDiscus. Quantitative study types reporting on the relationships between running and mental health were included. Database searches identified 16,401 studies; 273 full-texts were analysed with 116 studies included. Overall, studies suggest that running bouts of variable lengths and intensities, and running interventions can improve mood and mental health and that the type of running can lead to differential effects. However, lack of controls and diversity in participant demographics are limitations that need to be addressed. Cross-sectional evidence shows not only a range of associations with mental health but also some associations with adverse mental health (such as exercise addiction). This review identified extensive literature on the relationship between running and mental health.

Increasing physical activity in the community setting

Physical activity (PA) is beneficial for both mental and physical health, yet many individuals do not meet PA recommendations. There are a multitude of approaches to increase levels of PA and the role of the community is one area of growing interest. This review discusses the community environment as well as programs within the community and their influence on PA levels. Despite some research limitations, there are clear factors associated with community-based PA. Strategies that improve the built environment along with community-based programs have shown success, although differences between the characteristics of communities can mean strategies to promote PA are not universally effective. Additional research is needed on effective strategies that can be tailored to the characteristics of the community to increase PA. Further, public health interventions and policies should consider the role of the community when aiming to increase PA levels.

Does ethnic density influence community participation in mass participation physical activity events? The case of parkrun in England

Background: parkrun has been successful in encouraging people in England to participate in their weekly 5km running and walking events. However, there is substantial heterogeneity in parkrun participation across different communities in England: after controlling for travel distances, deprived communities have significantly lower participation rates.

Methods: This paper expands on previous findings by investigating disparities in parkrun participation by ethnic density. We combined geo-spatial data available through the Office for National Statistics with participation data provided by parkrun, and fitted multivariable Poisson regression models to study the effect of ethnic density on participation rates at the Lower layer Super Output Level.

Results: We find that areas with higher ethnic density have lower participation rates. This effect is independent of deprivation.

Conclusions: An opportunity exists for parkrun to engage with these communities and reduce potential barriers to participation.

Does ethnic density influence community participation in mass participation physical activity events? The case of parkrun in England

Background: parkrun has been successful in encouraging people in England to participate in their weekly 5km running and walking events. However, there is substantial heterogeneity in parkrun participation across different communities in England: after controlling for travel distances, deprived communities have significantly lower participation rates. Methods: This paper expands on previous findings by investigating disparities in parkrun participation by ethnic density. We combined geo-spatial data available through the Office for National Statistics with participation data provided by parkrun, and fitted multivariable Poisson regression models to study the effect of ethnic density on participation rates at the Lower layer Super Output Level. Results: We find that areas with higher ethnic density have lower participation rates. This effect is independent of deprivation. Conclusions: An opportunity exists for parkrun to engage with these communities and reduce potential barriers to participation.