Healthcare and recreational sector collaboration strategies to support community-based physical activity participation among young people with childhood-onset physical disability: A scoping review protocol

Karen Brady; Aoife Cooper; Ailish Malone; Nora Shields; Jennifer Ryan

doi:10.12688/hrbopenres.13961.1

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Study Protocol

Healthcare and recreational sector collaboration strategies to support community-based physical activity participation among young people with childhood-onset physical disability: A scoping review protocol

[version 1; peer review: 1 approved with reservations]

Karen Brady ¹, Aoife Cooper², Ailish Malone¹, Nora Shields³, Jennifer Ryan¹

Karen Brady ¹, Aoife Cooper², [...] Ailish Malone¹, Nora Shields³, Jennifer Ryan¹

PUBLISHED 04 Sep 2024

Author details Author details

¹ CP-Life Research Centre, School of Physiotherapy, RCSI University of Medicine and Health Sciences, Dublin, Ireland
² North Kerry Children’s Disability Network Team, Brothers of Charity Ireland, Listowel, Kerry, Ireland
³ La Trobe University Olga Tennison Autism Research Centre, Melbourne, Victoria, Australia

Karen Brady
Roles: Conceptualization, Data Curation, Formal Analysis, Methodology, Project Administration, Validation, Writing – Original Draft Preparation, Writing – Review & Editing

Aoife Cooper
Roles: Data Curation, Formal Analysis, Validation, Writing – Review & Editing

Ailish Malone
Roles: Conceptualization, Data Curation, Formal Analysis, Project Administration, Supervision, Validation, Writing – Original Draft Preparation, Writing – Review & Editing

Nora Shields
Roles: Conceptualization, Data Curation, Formal Analysis, Project Administration, Supervision, Validation, Writing – Original Draft Preparation, Writing – Review & Editing

Jennifer Ryan
Roles: Conceptualization, Data Curation, Formal Analysis, Project Administration, Supervision, Validation, Writing – Original Draft Preparation, Writing – Review & Editing

OPEN PEER REVIEW

REVIEWER STATUS

Abstract

Objective

The objective of this scoping review is to identify evidence of collaboration between healthcare and recreational sectors aimed at supporting community-based physical activity participation among young people with childhood-onset physical disability.

Introduction

Most young people with physical disabilities do insufficient physical activity, significantly impacting their future health. There have been long outstanding calls for collaboration between healthcare and recreational professionals to support physical activity participation for people with disabilities. Given the importance of physical activity and the roles of health and recreational professionals, there is a need to systematically identify evidence on collaborative strategies between sectors, describe the experiences of all individuals involved in delivering and receiving these collaborations and describe any outcomes measured as part of implementing these strategies.

Inclusion criteria

This review will include studies that involve healthcare professionals and recreational professionals working together to support community based physical activity. Specifically aimed young people aged 10 to 24 years with childhood-onset physical disabilities. Studies that report the experiences of individuals in delivering and receiving these collaborations will be included as well as studies that describe an evaluation of collaborative strategies.

Methods

This scoping review will be conducted in accordance with the Joanna Briggs Institute methodology of scoping reviews. A comprehensive search strategy will be developed in consultation with an information specialist. The following databases will be searched: MEDLINE, CINAHL, Embase, Web of Science and Scopus. The review will consider studies of any design that address collaboration between health and recreation sectors including qualitative, quantitative and mixed-methods study designs. Two reviewers will independently screen each retrieved title and abstract and assess full-text articles against the inclusion criteria to determine eligibility. Data will be extracted and synthesized quantitively and qualitatively and mapped to a relevant framework.

Keywords

physical activity; childhood-onset disability; stakeholders; recreation; health

Corresponding author: Karen Brady

Competing interests: No competing interests were disclosed.

Grant information: This research is funded by the Cerebral Palsy Foundation
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Copyright: © 2024 Brady K et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

How to cite: Brady K, Cooper A, Malone A et al. Healthcare and recreational sector collaboration strategies to support community-based physical activity participation among young people with childhood-onset physical disability: A scoping review protocol [version 1; peer review: 1 approved with reservations]. HRB Open Res 2024, 7:57 (https://doi.org/10.12688/hrbopenres.13961.1) First published: 04 Sep 2024, 7:57 (https://doi.org/10.12688/hrbopenres.13961.1) Latest published: 13 Mar 2025, 7:57 (https://doi.org/10.12688/hrbopenres.13961.2)

Introduction

Most young people with physical disability do insufficient physical activity^1–4. This has significant implications for their future health⁵. Despite the benefits and collective desire of healthcare professionals, families, recreational professionals, and young people themselves to enhance participation in physical activity, numerous barriers persist. Recreational professionals, such as personal trainers, gym staff, activity programme coordinators and sport coaches value the support of healthcare professionals to support community physical activity participation for people with disability and report a desire for collaboration^6,7. Healthcare professionals can potentially bridge the gap between young people with disabilities, their families and community recreational professionals⁸. However, they often face challenges in supporting and promoting physical activity due to limited knowledge and experience, accessible pathways, time constraints and conflicting priorities⁹. Young people with disabilities and their families often struggle to find suitable activities, usually relying on word of mouth, while recreational professionals face challenges in reaching out to inform young people with disability about available physical activity programmes⁶. These issues may be addressed through improved communication and collaboration between recreational and healthcare professionals. Since healthcare professionals frequently interact with young people and their families, enhancing their connection with recreational professionals may better support community-based physical activity. Young adults with cerebral palsy have prioritised cross sector collaboration strategies to optimise participation at community gyms with specific reference to the creation of pathways to the gym and involving healthcare professionals in training gym staff¹⁰.

Recommendations for scientists and practitioners in both sectors to establish inter-professional communication channels and collaborate to address barriers have been reported¹¹. However, there is a need for efforts to develop, test and deliver collaborative strategies to improve physical activity participation, moving beyond describing the challenges and providing recommendations¹¹. Given the importance of physical activity and the roles of health and recreational professionals, synthesising existing evidence on collaborative strategies may support future research and practice to enhance community-based physical activity participation for young people with childhood-onset physical disabilities.

Therefore, the aim of this scoping review is to identify evidence of collaboration between healthcare and recreational sectors aimed at supporting community-based physical activity participation among young people with childhood-onset physical disability.

Review objectives

1. Identify strategies that involve healthcare professionals and recreational professionals working together to support community-based physical activity participation among young people with childhood-onset physical disability
2. Describe the experiences of all individuals involved in delivering and receiving these collaborations, including healthcare professionals, recreational professionals, young people with disability and those who support them such as parents or personal assistants.
3. Describe the outcomes measured as part of implementing collaborative strategies
4. Consult with stakeholders to confirm the findings of the review, highlight unreported collaboration examples and experiences that have not been reported in the literature, and direct future collaborative strategies aimed at supporting community-based physical activity participation among young people with childhood-onset physical disability

Inclusion criteria

Participants

We will include studies with people aged 10–24 years, hereafter referred to as young people. This age-range encompasses ages included in definitions of adolescents and young people^12,13. Where studies also include people outside of these age ranges, we will include them if the mean age is between 10 and 24 or if at least 50% of the sample is between 10 and 24. We will include people with any childhood-onset disability that primarily results in physical impairment, where the disability was either congenital or acquired before the age of 15 years. These may include cerebral palsy, spina bifida, spinal cord injury, acquired brain injury, traumatic brain injury, skeletal abnormality, brachial plexus injury, obstetric brachial plexus palsy, limb loss, neuromuscular disorder, multiple sclerosis, or genetic disorders in line with previous diagnostic categories reported^14,15. We will include studies involving individuals with comorbidities such as intellectual disability and sensory impairment, provided they have a primary physical impairment. Where studies include a mixed population group, we will include them if at least 50% of the sample have a childhood-onset physical disability. When examining the experiences of collaborations, we will include studies with young people, healthcare professionals, recreational professionals, and people who support the young people including parents, other family members, disability support workers or personal assistants.

Concept

Collaborative strategies implemented to support young people with childhood-onset physical disability to participate in community-based physical activity. This review will include studies that involve healthcare professionals and recreational professionals working together to support community based physical activity. If explicit evidence of collaboration is not available, we will accept the setting as indicative of collaboration, or look for explicit statements of partnerships, funding, or acknowledgments of cross-sector collaboration. The interaction could occur online or in person or over the phone at a single time-point or multiple time-points. Examples include but are not limited to healthcare professional contact with coaches or activity leaders, healthcare professionals instructing participants regarding exercises alongside recreational professionals, healthcare professionals educating or advising fitness professionals on disability, accessible pathways involving healthcare professionals and community organisers¹⁶.

Context

The aim of the collaborative strategy should be to support physical activity participation in the community. Community settings may include but not be limited to gyms, swimming pools, sports clubs, indoor and outdoor recreation centres. However, the interaction between healthcare professionals and recreational professionals does not have to occur in the community. Physical activity programmes or interventions that take place in a clinical setting will be included, if the aim of the study is to support community-based physical activity. Routine rehabilitation programmes, or programmes conducted in a participants home, education or employment setting will be excluded. We will include studies conducted in any country.

We will include studies published in any language. We will exclude studies published before 2000 because of the evolving perspectives on disability since 2000, such as the publication of the World Health Organization's International Classification of Functioning, Disability and Health (ICF) in 2001. This ensures our strategies stay relevant in light of current insights into disability and physical activity.

Types of sources

The review will include studies of any design that explore collaboration between health and recreation sectors, including qualitative, quantitative, and mixed-methods studies. Quantitative studies may involve experimental (e.g., randomized and non-randomized trials) or observational (e.g., cohort, cross-sectional) designs. Excluded from the review are reviews, editorials, case reports, protocols, opinion papers, and conference abstracts

Methods

This review will be conducted in accordance with the Joanna Briggs Institute methodology for scoping reviews and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR)^17,18.

Search strategy

A comprehensive search strategy will be developed in consultation with an information specialist. First, an initial limited search of MEDLINE (PubMed) will be conducted to identify potentially relevant articles. Keywords from the title and abstract of relevant articles will inform the search strategy. Search terms will include keywords and index terms relating to childhood-onset disability, physical activity, healthcare and recreational professionals, and collaboration. The search strategy for MEDLINE (PubMed) is included (Appendix I). The search strategy will be modified as needed for the other databases. The following databases will be searched MEDLINE, CINHAL, EMBASE, Scopus and Web of Science. Reference list checking of included studies will take place

Study selection

Following the search, all identified publications will be collated and uploaded into Covidence with duplicates removed. A sample of randomly selected titles and abstracts will be independently screened by two reviewers, with results compared and discussed by the reviewers and further detail provided to eligibility criteria as needed. Two reviewers will then independently screen the titles and abstracts for inclusion. Full-text articles will be obtained and full-texts will be screened independently by two reviewers. Discrepancies will be resolved through discussion between the reviewers, and if consensus is not reached, a third reviewer will be consulted.

Data extraction

Data will be extracted from the included studies independently by two reviewers using a modified version of the JBI data extraction template (Appendix II). Two reviewers will pilot the data extraction tool on at least two studies and make necessary amendments. Extracted data will include details about the population, concept, contexts, study design, methods, experiences, and outcomes relevant to the review questions. Authors of papers will be contacted for clarification or additional information if needed. In accordance with guidance on scoping review, a quality appraisal will not be conducted¹⁷.

Data analysis and presentation

Results of the literature search and study screening process will be presented in a PRISMA-ScR flow diagram¹⁸. Narrative synthesis will describe collaborative strategies between healthcare and recreational professionals. We will report the identified strategies under the five pre-defined implementation strategies of the conceptual model of implementation research¹⁹. The strategies will then be mapped to a relevant framework. The experiences of those delivering and receiving the collaboration will be analysed descriptively and based on the model's outcomes¹⁹. The outcomes of implementing the collaborative strategies (participant outcomes or quantitative data) will be analysed descriptively. Our findings will be presented in tables or figures with three key headings: details of the collaborative strategy used, experiences with the strategy, and outcomes of its implementation.

Knowledge user engagement

Engaging knowledge users is an important aspect of conducting scoping reviews. The latest JBI guidance recommends consultation at every stage of the scoping review, including topic prioritisation, planning, execution and dissemination, rather than limiting it to a single stage¹⁷. In our proposed scoping review, knowledge users will contribute at each of these stages, highlighted below.

Prioritisation and planning

Before conceptualising this scoping review, the research team established strong relationships with healthcare and recreational professionals who aim to better support community-based physical activity for young people with physical disabilities. Consultations at a World Café event with these professionals, young people with disabilities and their families highlighted the need for local and national collaboration between healthcare and recreational sectors “Children’s Disability Network Teams need to be connected and talking to sports organisations locally and nationally”.

Execution and dissemination

Knowledge users from health and recreational sectors have approved the research question and reviewed the proposed protocol to ensure it aligns with the priority area identified through consultation. Their engagement will address review question four.

This may be achieved through a World Café event, an effective co-production method²⁰, or a similar opportunity where knowledge users can informally discuss the review's findings, highlight unreported collaboration examples and suggest dissemination strategies for the results. Knowledge users will be involved in the dissemination of the results and may include: development of evidence summaries or science communication strategies for social media, or advocate for findings to be shared in relevant community and political organisations to ensure they are reaching decision-makers.

Ethics and consent

No Ethical approval or consent is required.

Data availability

Underlying data

No underlying data are associated with this article.

Extended data

Open Science Framework (OSF): Healthcare and recreational sector collaboration strategies to support community-based physical activity participation among young people with childhood-onset physical disability: A scoping review protocol https://doi.org/10.17605/OSF.IO/BPGZ3

This protocol has been registered prospectively on OSF and the registration includes a PDF document that provides the rationale for the review, the aim of the review, eligibility criteria, the search strategy, and plan for data extraction and data analysis and knowledge user engagement. A sample search strategy (Appendix I) and data extraction template (Appendix II) are included (subject to iterative changes). Extended data are available under the terms of the CC0 1.0 Universal licence

Acknowledgements

We wish to thank the, Information Specialist at RCSI University of Medicine and Health Sciences for his assistance in the development of search strategy.

Faculty Opinions recommended

References

1. Ryan JM, Forde C, Hussey JM, et al.: Comparison of patterns of physical activity and sedentary behavior between children with Cerebral Palsy and children with typical development. Phys Ther. 2015; 95(12): 1609–16. PubMed Abstract | Publisher Full Text
2. Carlon SL, Taylor NF, Dodd KJ, et al.: Differences in habitual physical activity levels of young people with Cerebral Palsy and their typically developing peers: a systematic review. Disabil Rehabil. 2013; 35(8): 647–55. PubMed Abstract | Publisher Full Text
3. Verschuren O, Peterson MD, Balemans AC, et al.: Exercise and Physical Activity recommendations for people with Cerebral Palsy. Dev Med Child Neurol. 2016; 58(8): 798–808. PubMed Abstract | Publisher Full Text | Free Full Text
4. Martin Ginis KA, van der Ploeg HP, Foster C, et al.: Participation of People Living With Disabilities in Physical Activity: a global perspective. Lancet. 2021; 398(10298): 443–55. PubMed Abstract | Publisher Full Text
5. Ryan JM, Albairami F, Hamilton T, et al.: Prevalence and incidence of chronic conditions among adults with Cerebral Palsy: a systematic review and meta-analysis. Dev Med Child Neurol. 2023; 65(9): 1174–89. PubMed Abstract | Publisher Full Text
6. Shields N, Synnot A: Perceived barriers and facilitators to participation in physical activity for children with disability: a qualitative study. BMC Pediatr. 2016; 16(1): 9. PubMed Abstract | Publisher Full Text | Free Full Text
7. Cunningham C, O'Donoghue G, Cosgrave S, et al.: Gym staff perspectives on disability inclusion: a qualitative study. Disabil Rehabil. 2023; 45(3): 441–8. PubMed Abstract | Publisher Full Text
8. Brunton LK: Clinicians are the missing link to sustainable community-based physical activity participation for children with disabilities. Phys Occup Ther Pediatr. 2017; 37(4): 359–61. PubMed Abstract | Publisher Full Text
9. Wright A, Roberts R, Bowman G, et al.: Barriers and facilitators to physical activity participation for children with physical disability: comparing and contrasting the views of children, young people, and their clinicians. Disabil Rehabil. 2019; 41(13): 1499–507. PubMed Abstract | Publisher Full Text
10. McKenzie G, Willis C, Yao A, et al.: Identifying and prioritising strategies to optimise community gym participation for young adults with Cerebral Palsy: an e-Delphi study. Disabil Rehabil. 2024; 46(7): 1309–1317. PubMed Abstract | Publisher Full Text
11. Martin Ginis KA, Ma JK, Latimer-Cheung AE, et al.: A systematic review of review articles addressing factors related to physical activity participation among children and adults with physical disabilities. Health Psychol Rev. 2016; 10(4): 478–94. PubMed Abstract | Publisher Full Text
12. World Health Organization: Adolescent health. 2024. Reference Source
13. United Nations: Global issues youth. No date. Reference Source
14. Anaby D, Avery L, Gorter JW, et al.: Improving body functions through participation in community activities among young people with physical disabilities. Dev Med Child Neurol. 2020; 62(5): 640–6. PubMed Abstract | Publisher Full Text
15. Brady K, Cleary R, O'Gorman E, et al.: Identifying the top 10 priorities of adolescents with a physical disability regarding participation in physical activity: a Delphi study. Dev Med Child Neurol. 2024. PubMed Abstract | Publisher Full Text
16. Kennedy RA, McKenzie G, Holmes C, et al.: Social support initiatives that facilitate exercise participation in community gyms for people with disability: a scoping review. Int J Environ Res Public Health. 2022; 20(1): 699. PubMed Abstract | Publisher Full Text | Free Full Text
17. Aromataris E, Lockwood C, Porritt K, et al.: JBI manual for evidence synthesis 2024. 2024. Publisher Full Text
18. Tricco AC, Lillie E, Zarin W, et al.: PRISMA extension for Scoping Reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018; 169(7): 467–73. PubMed Abstract | Publisher Full Text
19. Proctor EK, Landsverk J, Aarons G, et al.: Implementation research in mental health services: an emerging science with conceptual, methodological, and training challenges. Adm Policy Ment Health. 2009; 36(1): 24–34. PubMed Abstract | Publisher Full Text | Free Full Text
20. Monforte J, Netherway J, Smith B: The world café is an unmethod within co-produced research. Qual Res Psychol. 2023; 20(3): 398–419. Publisher Full Text

Comments on this article Comments (0)

Version 2

VERSION 2 PUBLISHED 04 Sep 2024

Author details Author details

Karen Brady
Roles: Conceptualization, Data Curation, Formal Analysis, Methodology, Project Administration, Validation, Writing – Original Draft Preparation, Writing – Review & Editing

Aoife Cooper
Roles: Data Curation, Formal Analysis, Validation, Writing – Review & Editing

Ailish Malone
Roles: Conceptualization, Data Curation, Formal Analysis, Project Administration, Supervision, Validation, Writing – Original Draft Preparation, Writing – Review & Editing

Nora Shields
Roles: Conceptualization, Data Curation, Formal Analysis, Project Administration, Supervision, Validation, Writing – Original Draft Preparation, Writing – Review & Editing

Jennifer Ryan
Roles: Conceptualization, Data Curation, Formal Analysis, Project Administration, Supervision, Validation, Writing – Original Draft Preparation, Writing – Review & Editing

Competing interests

No competing interests were disclosed.

Grant information

This research is funded by the Cerebral Palsy Foundation
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Article Versions (2)

version 2

Revised

Published: 13 Mar 2025, 7:57

https://doi.org/10.12688/hrbopenres.13961.2

version 1

Published: 04 Sep 2024, 7:57

https://doi.org/10.12688/hrbopenres.13961.1

© 2024 Brady K et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Brady K, Cooper A, Malone A et al. Healthcare and recreational sector collaboration strategies to support community-based physical activity participation among young people with childhood-onset physical disability: A scoping review protocol [version 1; peer review: 1 approved with reservations]. HRB Open Res 2024, 7:57 (https://doi.org/10.12688/hrbopenres.13961.1)

NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article.

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Open Peer Review

Version 1

VERSION 1

PUBLISHED 04 Sep 2024

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Reviewer Report 11 Nov 2024

Kwok Ng, Physical Activity for Health Research Centre, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, County Limerick, Ireland

Approved with Reservations

https://doi.org/10.21956/hrbopenres.15317.r42799

The area of healthcare professions' role in promoting PA among adolescents with disabilities is an important one. The authors have chosen a good topic to carry out a scoping review, as it would broaden the knowledge than just effectiveness that would come from a meta analyses. The authors could more clearly the reason and justification for doing a scoping review. It is not clear.
Also, I would like to have seen authors used established definitions of 'people with disabilities' and then go into the concept of physical disability, how healthcare workers promoting PA differs from people from other impairment groups, and outline clearly which disability model is being used. This may be a useful exercise for the authors to consider the keywords, inclusion/exclusion criteria, and world cafe, and reporting from the review.

Here are some comments on the research objectives that the authors may like to consider responding to.

The research objective is to 'identify strategies', it would be good to know what lens is being used to identify a 'strategy' over a 'programme', 'technique', 'actions', 'policies', etc. Authors should outline a clear definition of what makes a strategy, and use frameworks that have helped to define strategies over other aspects.
2nd research objective is a bit vague. I believe a more narrow focus is more feasible in a scoping review. how do you plan to 'describe the experiences'. This was not mentioned clearly in the methods or even in the introduction to suggest there is a need for this. The diverse group of individuals that the experiences would be described from is very broad, and authors could outline how they plan to disseminate this without diluting the information.
3rd research objective seems incomplete. Kindly outline it, and take into note of more detail required from 2nd objective.
4th objective, as I understand it, they are doing this as part of the scoping review, through the world cafe. Overall, that would fit without an objective to carry out a scoping review, and following JBI recommendations. To me, that would not be needed to be outlined as an objective. Rather, if there is more that would be done, , then it can be included.

Is the rationale for, and objectives of, the study clearly described?

Partly
Is the study design appropriate for the research question?

Yes
Are sufficient details of the methods provided to allow replication by others?

Yes
Are the datasets clearly presented in a useable and accessible format?

Not applicable

Competing Interests: No competing interests were disclosed.

Reviewer Expertise: I'm an academic researcher in adapted physical activity and evidence synthesis Ireland fellow.

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above.

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Author Response 13 Mar 2025

Karen Brady, CP-Life Research Centre, School of Physiotherapy, RCSI University of Medicine and Health Sciences, Dublin, Ireland

13 Mar 2025

Author Response

We thank the reviewer for the constructive feedback on this protocol. We now address each point in responses below the review comment

The area of healthcare professions' role in ... Continue reading We thank the reviewer for the constructive feedback on this protocol. We now address each point in responses below the review comment

The area of healthcare professions' role in promoting PA among adolescents with disabilities is an important one. The authors have chosen a good topic to carry out a scoping review, as it would broaden the knowledge than just effectiveness that would come from a meta-analyses. The authors could more clearly the reason and justification for doing a scoping review. It is not clear.

Response:
According to Joanna Briggs Institute (JBI) methodology guidelines, scoping reviews help identify the types of available evidence, existing knowledge gaps, clarify key concepts or definitions, assess research trends and inform future systematic reviews.
Our research question aims to identify evidence of collaboration between healthcare and recreational providers supporting community-based physical activity for child-onset physical disability. A scoping review was chosen as the most appropriate method for addressing this question. This will allow the existing evidence to be mapped, key knowledge gaps identified, and the key characteristics of collaboration to be described , following JBI guidelines.

Also, I would like to have seen authors used established definitions of 'people with disabilities' and then go into the concept of physical disability, how healthcare workers promoting PA differs from people from other impairment groups, and outline clearly which disability model is being used. This may be a useful exercise for the authors to consider the keywords, inclusion/exclusion criteria, and world cafe, and reporting from the review.
Response:
The United Nations Convention on the Rights of Persons with Disabilities defines individuals with disabilities as “those who have long-term physical, mental, intellectual, or sensory impairments which, in interaction with various barriers, may hinder their full and effective participation in society on an equal basis with others.” This definition provides a broad understanding of disability, but we recognise the challenge of balancing inclusivity with the need for specificity, given the individuality of disability.
Disability encompasses a wide range of conditions, each presenting unique challenges. For instance, physical disabilities primarily affect a person’s mobility or physical functioning. However, individuals with physical disabilities may have more functional similarities than differences. Law et al. (2004) found that young people with physical disabilities exhibit similar participation levels, regardless of their specific diagnosis. This suggests that an approach based on function, rather than one based solely on diagnosis, may be effective. For this study, we have chosen to focus on young people with child-onset physical disabilities, which may include conditions such as cerebral palsy, spina bifida, or neuromuscular disorders, provided the impairments first appeared before the age of 15. This definition aligns with the approach used by McKenzie et al. (2021) in their reporting on child-onset physical disabilities.
Here are some comments on the research objectives that the authors may like to consider responding to.

The research objective is to 'identify strategies', it would be good to know what lens is being used to identify a 'strategy' over a 'programme', 'technique', 'actions', 'policies', etc. Authors should outline a clear definition of what makes a strategy, and use frameworks that have helped to define strategies over other aspects.
Response:
We recognise the need for greater clarity regarding the definition of strategies and have further expanded on this now. In Proctor’s 2013 conceptual model of implementation research, strategies represent the "how-to" aspect, with Curran (2012) defining implementation strategies as “methods or techniques used to enhance the adoption, implementation, and sustainability of a clinical programme or practice.”

2nd research objective is a bit vague. I believe a more narrow focus is more feasible in a scoping review. how do you plan to 'describe the experiences' . This was not mentioned clearly in the methods or even in the introduction to suggest there is a need for this. The diverse group of individuals that the experiences would be described from is very broad, and authors could outline how they plan to disseminate this without diluting the information.
Response:
We consider our 2nd objective to be appropriate for a scoping review where the purpose is to help identify the types of available evidence, existing knowledge gaps, clarify key concepts or definitions, assess research trends and inform future systematic reviews. Other reviews such as systematic reviews are more appropriate to address precise narrow effectiveness questions.
We plan to describe the experiences through qualitative research. Qualitative research is a type of research that explores and provides deeper insights into real-world problems ( Moser et al 2017). A qualitative approach allows participants themselves to explain how, why, or what they were thinking, feeling, and experiencing at a particular time or during an event of interest. It answers the hows and whys instead of how many or how much (Tenny et al 2022). Therefore, we believe that it is important to report the experiences of the professionals collaborating because understanding their experiences can provide valuable insights into what worked, what didn’t, and what may need to change or adapt to improve the implementation and sustainability of these partnerships. Data describing the experiences of professionals will be extracted from qualitative studies.
Equally important is capturing, the experiences of young people and their families regarding these collaborative efforts. Depending on the available evidence, our synthesis may include descriptions of if / how the collaboration between sectors benefited them; if it made participation easier; and if it addressed barriers to participation. Gathering this feedback can help identify ways to enhance support for young people and their families moving forward. Data describing the experiences of young people and their families will be extracted from qualitative studies.

3rd research objective seems incomplete. Kindly outline it, and take into note of more detail required from 2nd objective.
Response:
Objective 3 has been modified to “Identify and describe any outcomes measures that were used to evaluate the collaboration strategy used by healthcare and recreational providers”
As outlined above, we have now provided further clarity for ‘strategy’ as per Curran 2012 “methods or techniques used to enhance the adoption, implementation, and sustainability of a clinical programme or practice.”

4th objective, as I understand it, they are doing this as part of the scoping review, through the world cafe. Overall, that would fit without an objective to carry out a scoping review, and following JBI recommendations. To me, that would not be needed to be outlined as an objective. Rather, if there is more that would be done, , then it can be included.
Response:
Upon reflection, we agree that this does not need to be an objective. Following JBI recommendations for scoping reviews, stakeholder engagement is important. We will incorporate this consultation throughout the review process, rather than making it a separate objective, and it has been integrated into the knowledge user engagement section of the protocol.
We thank the reviewer for the constructive feedback on this protocol. We now address each point in responses below the review comment

The area of healthcare professions' role in promoting PA among adolescents with disabilities is an important one. The authors have chosen a good topic to carry out a scoping review, as it would broaden the knowledge than just effectiveness that would come from a meta-analyses. The authors could more clearly the reason and justification for doing a scoping review. It is not clear.

Response:
According to Joanna Briggs Institute (JBI) methodology guidelines, scoping reviews help identify the types of available evidence, existing knowledge gaps, clarify key concepts or definitions, assess research trends and inform future systematic reviews.
Our research question aims to identify evidence of collaboration between healthcare and recreational providers supporting community-based physical activity for child-onset physical disability. A scoping review was chosen as the most appropriate method for addressing this question. This will allow the existing evidence to be mapped, key knowledge gaps identified, and the key characteristics of collaboration to be described , following JBI guidelines.

Also, I would like to have seen authors used established definitions of 'people with disabilities' and then go into the concept of physical disability, how healthcare workers promoting PA differs from people from other impairment groups, and outline clearly which disability model is being used. This may be a useful exercise for the authors to consider the keywords, inclusion/exclusion criteria, and world cafe, and reporting from the review.
Response:
The United Nations Convention on the Rights of Persons with Disabilities defines individuals with disabilities as “those who have long-term physical, mental, intellectual, or sensory impairments which, in interaction with various barriers, may hinder their full and effective participation in society on an equal basis with others.” This definition provides a broad understanding of disability, but we recognise the challenge of balancing inclusivity with the need for specificity, given the individuality of disability.
Disability encompasses a wide range of conditions, each presenting unique challenges. For instance, physical disabilities primarily affect a person’s mobility or physical functioning. However, individuals with physical disabilities may have more functional similarities than differences. Law et al. (2004) found that young people with physical disabilities exhibit similar participation levels, regardless of their specific diagnosis. This suggests that an approach based on function, rather than one based solely on diagnosis, may be effective. For this study, we have chosen to focus on young people with child-onset physical disabilities, which may include conditions such as cerebral palsy, spina bifida, or neuromuscular disorders, provided the impairments first appeared before the age of 15. This definition aligns with the approach used by McKenzie et al. (2021) in their reporting on child-onset physical disabilities.
Here are some comments on the research objectives that the authors may like to consider responding to.

The research objective is to 'identify strategies', it would be good to know what lens is being used to identify a 'strategy' over a 'programme', 'technique', 'actions', 'policies', etc. Authors should outline a clear definition of what makes a strategy, and use frameworks that have helped to define strategies over other aspects.
Response:
We recognise the need for greater clarity regarding the definition of strategies and have further expanded on this now. In Proctor’s 2013 conceptual model of implementation research, strategies represent the "how-to" aspect, with Curran (2012) defining implementation strategies as “methods or techniques used to enhance the adoption, implementation, and sustainability of a clinical programme or practice.”

2nd research objective is a bit vague. I believe a more narrow focus is more feasible in a scoping review. how do you plan to 'describe the experiences' . This was not mentioned clearly in the methods or even in the introduction to suggest there is a need for this. The diverse group of individuals that the experiences would be described from is very broad, and authors could outline how they plan to disseminate this without diluting the information.
Response:
We consider our 2nd objective to be appropriate for a scoping review where the purpose is to help identify the types of available evidence, existing knowledge gaps, clarify key concepts or definitions, assess research trends and inform future systematic reviews. Other reviews such as systematic reviews are more appropriate to address precise narrow effectiveness questions.
We plan to describe the experiences through qualitative research. Qualitative research is a type of research that explores and provides deeper insights into real-world problems ( Moser et al 2017). A qualitative approach allows participants themselves to explain how, why, or what they were thinking, feeling, and experiencing at a particular time or during an event of interest. It answers the hows and whys instead of how many or how much (Tenny et al 2022). Therefore, we believe that it is important to report the experiences of the professionals collaborating because understanding their experiences can provide valuable insights into what worked, what didn’t, and what may need to change or adapt to improve the implementation and sustainability of these partnerships. Data describing the experiences of professionals will be extracted from qualitative studies.
Equally important is capturing, the experiences of young people and their families regarding these collaborative efforts. Depending on the available evidence, our synthesis may include descriptions of if / how the collaboration between sectors benefited them; if it made participation easier; and if it addressed barriers to participation. Gathering this feedback can help identify ways to enhance support for young people and their families moving forward. Data describing the experiences of young people and their families will be extracted from qualitative studies.

3rd research objective seems incomplete. Kindly outline it, and take into note of more detail required from 2nd objective.
Response:
Objective 3 has been modified to “Identify and describe any outcomes measures that were used to evaluate the collaboration strategy used by healthcare and recreational providers”
As outlined above, we have now provided further clarity for ‘strategy’ as per Curran 2012 “methods or techniques used to enhance the adoption, implementation, and sustainability of a clinical programme or practice.”

4th objective, as I understand it, they are doing this as part of the scoping review, through the world cafe. Overall, that would fit without an objective to carry out a scoping review, and following JBI recommendations. To me, that would not be needed to be outlined as an objective. Rather, if there is more that would be done, , then it can be included.
Response:
Upon reflection, we agree that this does not need to be an objective. Following JBI recommendations for scoping reviews, stakeholder engagement is important. We will incorporate this consultation throughout the review process, rather than making it a separate objective, and it has been integrated into the knowledge user engagement section of the protocol.
Competing Interests: No competing interests were disclosed. Close
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COMMENTS ON THIS REPORT

Author Response 13 Mar 2025

Karen Brady, CP-Life Research Centre, School of Physiotherapy, RCSI University of Medicine and Health Sciences, Dublin, Ireland

13 Mar 2025

Author Response

We thank the reviewer for the constructive feedback on this protocol. We now address each point in responses below the review comment

The area of healthcare professions' role in ... Continue reading We thank the reviewer for the constructive feedback on this protocol. We now address each point in responses below the review comment

The area of healthcare professions' role in promoting PA among adolescents with disabilities is an important one. The authors have chosen a good topic to carry out a scoping review, as it would broaden the knowledge than just effectiveness that would come from a meta-analyses. The authors could more clearly the reason and justification for doing a scoping review. It is not clear.

Response:
According to Joanna Briggs Institute (JBI) methodology guidelines, scoping reviews help identify the types of available evidence, existing knowledge gaps, clarify key concepts or definitions, assess research trends and inform future systematic reviews.
Our research question aims to identify evidence of collaboration between healthcare and recreational providers supporting community-based physical activity for child-onset physical disability. A scoping review was chosen as the most appropriate method for addressing this question. This will allow the existing evidence to be mapped, key knowledge gaps identified, and the key characteristics of collaboration to be described , following JBI guidelines.

Also, I would like to have seen authors used established definitions of 'people with disabilities' and then go into the concept of physical disability, how healthcare workers promoting PA differs from people from other impairment groups, and outline clearly which disability model is being used. This may be a useful exercise for the authors to consider the keywords, inclusion/exclusion criteria, and world cafe, and reporting from the review.
Response:
The United Nations Convention on the Rights of Persons with Disabilities defines individuals with disabilities as “those who have long-term physical, mental, intellectual, or sensory impairments which, in interaction with various barriers, may hinder their full and effective participation in society on an equal basis with others.” This definition provides a broad understanding of disability, but we recognise the challenge of balancing inclusivity with the need for specificity, given the individuality of disability.
Disability encompasses a wide range of conditions, each presenting unique challenges. For instance, physical disabilities primarily affect a person’s mobility or physical functioning. However, individuals with physical disabilities may have more functional similarities than differences. Law et al. (2004) found that young people with physical disabilities exhibit similar participation levels, regardless of their specific diagnosis. This suggests that an approach based on function, rather than one based solely on diagnosis, may be effective. For this study, we have chosen to focus on young people with child-onset physical disabilities, which may include conditions such as cerebral palsy, spina bifida, or neuromuscular disorders, provided the impairments first appeared before the age of 15. This definition aligns with the approach used by McKenzie et al. (2021) in their reporting on child-onset physical disabilities.
Here are some comments on the research objectives that the authors may like to consider responding to.

The research objective is to 'identify strategies', it would be good to know what lens is being used to identify a 'strategy' over a 'programme', 'technique', 'actions', 'policies', etc. Authors should outline a clear definition of what makes a strategy, and use frameworks that have helped to define strategies over other aspects.
Response:
We recognise the need for greater clarity regarding the definition of strategies and have further expanded on this now. In Proctor’s 2013 conceptual model of implementation research, strategies represent the "how-to" aspect, with Curran (2012) defining implementation strategies as “methods or techniques used to enhance the adoption, implementation, and sustainability of a clinical programme or practice.”

2nd research objective is a bit vague. I believe a more narrow focus is more feasible in a scoping review. how do you plan to 'describe the experiences' . This was not mentioned clearly in the methods or even in the introduction to suggest there is a need for this. The diverse group of individuals that the experiences would be described from is very broad, and authors could outline how they plan to disseminate this without diluting the information.
Response:
We consider our 2nd objective to be appropriate for a scoping review where the purpose is to help identify the types of available evidence, existing knowledge gaps, clarify key concepts or definitions, assess research trends and inform future systematic reviews. Other reviews such as systematic reviews are more appropriate to address precise narrow effectiveness questions.
We plan to describe the experiences through qualitative research. Qualitative research is a type of research that explores and provides deeper insights into real-world problems ( Moser et al 2017). A qualitative approach allows participants themselves to explain how, why, or what they were thinking, feeling, and experiencing at a particular time or during an event of interest. It answers the hows and whys instead of how many or how much (Tenny et al 2022). Therefore, we believe that it is important to report the experiences of the professionals collaborating because understanding their experiences can provide valuable insights into what worked, what didn’t, and what may need to change or adapt to improve the implementation and sustainability of these partnerships. Data describing the experiences of professionals will be extracted from qualitative studies.
Equally important is capturing, the experiences of young people and their families regarding these collaborative efforts. Depending on the available evidence, our synthesis may include descriptions of if / how the collaboration between sectors benefited them; if it made participation easier; and if it addressed barriers to participation. Gathering this feedback can help identify ways to enhance support for young people and their families moving forward. Data describing the experiences of young people and their families will be extracted from qualitative studies.

3rd research objective seems incomplete. Kindly outline it, and take into note of more detail required from 2nd objective.
Response:
Objective 3 has been modified to “Identify and describe any outcomes measures that were used to evaluate the collaboration strategy used by healthcare and recreational providers”
As outlined above, we have now provided further clarity for ‘strategy’ as per Curran 2012 “methods or techniques used to enhance the adoption, implementation, and sustainability of a clinical programme or practice.”

4th objective, as I understand it, they are doing this as part of the scoping review, through the world cafe. Overall, that would fit without an objective to carry out a scoping review, and following JBI recommendations. To me, that would not be needed to be outlined as an objective. Rather, if there is more that would be done, , then it can be included.
Response:
Upon reflection, we agree that this does not need to be an objective. Following JBI recommendations for scoping reviews, stakeholder engagement is important. We will incorporate this consultation throughout the review process, rather than making it a separate objective, and it has been integrated into the knowledge user engagement section of the protocol.
We thank the reviewer for the constructive feedback on this protocol. We now address each point in responses below the review comment

The area of healthcare professions' role in promoting PA among adolescents with disabilities is an important one. The authors have chosen a good topic to carry out a scoping review, as it would broaden the knowledge than just effectiveness that would come from a meta-analyses. The authors could more clearly the reason and justification for doing a scoping review. It is not clear.

Response:
According to Joanna Briggs Institute (JBI) methodology guidelines, scoping reviews help identify the types of available evidence, existing knowledge gaps, clarify key concepts or definitions, assess research trends and inform future systematic reviews.
Our research question aims to identify evidence of collaboration between healthcare and recreational providers supporting community-based physical activity for child-onset physical disability. A scoping review was chosen as the most appropriate method for addressing this question. This will allow the existing evidence to be mapped, key knowledge gaps identified, and the key characteristics of collaboration to be described , following JBI guidelines.

Also, I would like to have seen authors used established definitions of 'people with disabilities' and then go into the concept of physical disability, how healthcare workers promoting PA differs from people from other impairment groups, and outline clearly which disability model is being used. This may be a useful exercise for the authors to consider the keywords, inclusion/exclusion criteria, and world cafe, and reporting from the review.
Response:
The United Nations Convention on the Rights of Persons with Disabilities defines individuals with disabilities as “those who have long-term physical, mental, intellectual, or sensory impairments which, in interaction with various barriers, may hinder their full and effective participation in society on an equal basis with others.” This definition provides a broad understanding of disability, but we recognise the challenge of balancing inclusivity with the need for specificity, given the individuality of disability.
Disability encompasses a wide range of conditions, each presenting unique challenges. For instance, physical disabilities primarily affect a person’s mobility or physical functioning. However, individuals with physical disabilities may have more functional similarities than differences. Law et al. (2004) found that young people with physical disabilities exhibit similar participation levels, regardless of their specific diagnosis. This suggests that an approach based on function, rather than one based solely on diagnosis, may be effective. For this study, we have chosen to focus on young people with child-onset physical disabilities, which may include conditions such as cerebral palsy, spina bifida, or neuromuscular disorders, provided the impairments first appeared before the age of 15. This definition aligns with the approach used by McKenzie et al. (2021) in their reporting on child-onset physical disabilities.
Here are some comments on the research objectives that the authors may like to consider responding to.

The research objective is to 'identify strategies', it would be good to know what lens is being used to identify a 'strategy' over a 'programme', 'technique', 'actions', 'policies', etc. Authors should outline a clear definition of what makes a strategy, and use frameworks that have helped to define strategies over other aspects.
Response:
We recognise the need for greater clarity regarding the definition of strategies and have further expanded on this now. In Proctor’s 2013 conceptual model of implementation research, strategies represent the "how-to" aspect, with Curran (2012) defining implementation strategies as “methods or techniques used to enhance the adoption, implementation, and sustainability of a clinical programme or practice.”

2nd research objective is a bit vague. I believe a more narrow focus is more feasible in a scoping review. how do you plan to 'describe the experiences' . This was not mentioned clearly in the methods or even in the introduction to suggest there is a need for this. The diverse group of individuals that the experiences would be described from is very broad, and authors could outline how they plan to disseminate this without diluting the information.
Response:
We consider our 2nd objective to be appropriate for a scoping review where the purpose is to help identify the types of available evidence, existing knowledge gaps, clarify key concepts or definitions, assess research trends and inform future systematic reviews. Other reviews such as systematic reviews are more appropriate to address precise narrow effectiveness questions.
We plan to describe the experiences through qualitative research. Qualitative research is a type of research that explores and provides deeper insights into real-world problems ( Moser et al 2017). A qualitative approach allows participants themselves to explain how, why, or what they were thinking, feeling, and experiencing at a particular time or during an event of interest. It answers the hows and whys instead of how many or how much (Tenny et al 2022). Therefore, we believe that it is important to report the experiences of the professionals collaborating because understanding their experiences can provide valuable insights into what worked, what didn’t, and what may need to change or adapt to improve the implementation and sustainability of these partnerships. Data describing the experiences of professionals will be extracted from qualitative studies.
Equally important is capturing, the experiences of young people and their families regarding these collaborative efforts. Depending on the available evidence, our synthesis may include descriptions of if / how the collaboration between sectors benefited them; if it made participation easier; and if it addressed barriers to participation. Gathering this feedback can help identify ways to enhance support for young people and their families moving forward. Data describing the experiences of young people and their families will be extracted from qualitative studies.

3rd research objective seems incomplete. Kindly outline it, and take into note of more detail required from 2nd objective.
Response:
Objective 3 has been modified to “Identify and describe any outcomes measures that were used to evaluate the collaboration strategy used by healthcare and recreational providers”
As outlined above, we have now provided further clarity for ‘strategy’ as per Curran 2012 “methods or techniques used to enhance the adoption, implementation, and sustainability of a clinical programme or practice.”

4th objective, as I understand it, they are doing this as part of the scoping review, through the world cafe. Overall, that would fit without an objective to carry out a scoping review, and following JBI recommendations. To me, that would not be needed to be outlined as an objective. Rather, if there is more that would be done, , then it can be included.
Response:
Upon reflection, we agree that this does not need to be an objective. Following JBI recommendations for scoping reviews, stakeholder engagement is important. We will incorporate this consultation throughout the review process, rather than making it a separate objective, and it has been integrated into the knowledge user engagement section of the protocol.
Competing Interests: No competing interests were disclosed. Close
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Version 2

VERSION 2 PUBLISHED 04 Sep 2024

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Version 2 (revision) 13 Mar 25	read	read	read
Version 1 04 Sep 24	read

Kwok Ng, University of Limerick, Limerick, Ireland
Ming-Chih Sung, California State University, Los Angeles, USA
Louise Declerck, UCLouvain, Louvain-la-Neuve, Belgium; University of Illinois Chicago College of Applied Health Sciences (Ringgold ID: 315410), Chicago, USA

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Reviewer Report

4 Views

17 Jun 2025 | for Version 2

Louise Declerck, UCLouvain, Louvain-la-Neuve, Walloon Region, Belgium; Kinesiology and Nutrition, University of Illinois Chicago College of Applied Health Sciences (Ringgold ID: 315410), Chicago, Illinois, USA

4 Views Cite this report Responses(0)

Approved With Reservations

In light of the high levels of physical inactivity observed within the population of young people with childhood-onset physical disability, it is vital to identify implementation strategies that have successfully addressed this issue. Increasing collaborations between healthcare and recreational sectors is therefore an excellent avenue that requires further exploration. The research detailed within the protocol submitted by the authors aims aligns well with this. The evidence that will be synthesized in this scoping review will be highly relevant to the field. Some aspects of the protocol remain slightly unclear, and these have been summarized below:

Abstract: The end of the abstract section states "Data will be extracted and synthesized quantitatively and qualitatively...". The use of the word "quantitatively" suggests that a meta-analysis and pooling of quantitative results will be performed. Unless I am mistaken, the complete methods does not mention this. Therefore, the abstract needs to be corrected to more accurately summarize how the data will be presented.

Inclusion criteria: Consider justifying the thresholds you have used (10-24 years, disability acquired before 15 years old).Additionally, consider adding median as well as mean when stating "... we will include them if the mean age is between 10 and 24..."

Concept: The sentence "If explicit evidence of collaboration is not available, we will accept the setting as indicative of collaboration..." is unclear and needs to be changed. In the examples included within this section, consider adding the situation whereby healthcare professionals directly refer a patient to a community-based exercise program, as this situation is, to my knowledge, one of the most common.

Context: "Physical activity programmes or interventions that take place in a clinical setting will be included, if the aim of the study is to support community-based physical activity." Though I understand this choice, I believe it may create some conflicts, as physical activity programmes provided in clinical settings are often (though not always) conducted by physical therapists and/or occupational therapists (so healthcare professionals), as opposed to coaches or activity leaders, as described previously in your method...Please describe what you will decide in such situations (-> include vs exclude).Please add the ICF's manual as reference when mentioning the ICF.

Data extraction: How will discrepancies at the stage of quality assessment and data extraction be resolved?

Data analysis and presentation: It would be very insightful to add more information regarding the five pre-defined implementation strategies of the conceptual model, for example in a table. This will allow a much better understanding of the data analysis plan.

Knowledge user engagement: If I understand this section correctly, you plan to collect additional data as well... Would that not require ethical approval from a board? And the adoption of a methodologically sound qualitative approach, for ex through focus groups or semi-structured interviews? Instead, I would perhaps say that: If the knowledge users highlight remaining research gaps in the literature, these will be subsequently investigated through future qualitative research.

Execution and dissemination: Consider stating how many knowledge users from both the health and recreational sectors have validated your research question/aims/protocol.

I believe that modifying/adding this information would improve the overall quality of the protocol.

Is the rationale for, and objectives of, the study clearly described?

Partly
Is the study design appropriate for the research question?

Yes
Are sufficient details of the methods provided to allow replication by others?

Partly
Are the datasets clearly presented in a useable and accessible format?

Not applicable

Competing Interests

No competing interests were disclosed.

Reviewer Expertise

Post-doctorate research within the field of exercise training in neurorehabilitation.

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2 Views

12 Jun 2025 | for Version 2

Ming-Chih Sung, California State University, Los Angeles, California, USA

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Approved With Reservations

This protocol outlines a planned scoping review aiming to map existing evidence of collaboration between healthcare and recreational sectors in supporting community-based physical activity participation among young people with childhood-onset physical disabilities. The review seeks to identify collaborative strategies, stakeholder experiences, and outcome measures related to these partnerships.

This is a scientifically sound and well-structured scoping review protocol addressing an important and timely topic in disability and physical activity research. The authors have made commendable revisions following peer feedback and have aligned the protocol with best-practice methodologies. However, addressing the minor but meaningful clarifications listed below will strengthen the protocol’s transparency and rigor.

1. The term “healthcare professionals” is used repeatedly but remains undefined. The authors should clarify what constitutes a healthcare professional in this context—e.g., does this include only physicians and physiotherapists, or also occupational therapists, psychologists, nurses, etc.? This has implications for inclusion criteria and generalizability.

2. The age range of 10–24 years is justified by aligning with common definitions of adolescence and youth. However, the exclusion of children aged 7–9 years, particularly those in primary school who may also benefit from collaborative physical activity support, seems arbitrary. The authors should either provide a rationale for this cutoff or reconsider including younger children or at least discuss this limitation explicitly.

3. The authors state they will include studies in any language. While inclusive, they should briefly describe how they will ensure accurate translation and data extraction from non-English publications (e.g., will professional translation services or bilingual reviewers be used?).

Is the rationale for, and objectives of, the study clearly described?

Yes
Is the study design appropriate for the research question?

Yes
Are sufficient details of the methods provided to allow replication by others?

Partly
Are the datasets clearly presented in a useable and accessible format?

Not applicable

Competing Interests

No competing interests were disclosed.

Reviewer Expertise

I am a faculty member in the School of Kinesiology, with research focused on promoting physical activity and motor behavior among individuals with disabilities. My work also includes evidence synthesis, such as systematic reviews, scoping reviews, and meta-analyses.

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4 Views

20 Mar 2025 | for Version 2

Kwok Ng, Physical Activity for Health Research Centre, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, County Limerick, Ireland

4 Views Cite this report Responses(0)

Approved

The authors have thoroughly responded to the earlier queries. I believe they have updated the protocol adequately to help them with their intended search and acceptance.

Competing Interests

No competing interests were disclosed.

Reviewer Expertise

I'm an academic researcher in adapted physical activity and evidence synthesis Ireland fellow.

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard.

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Reviewer Report

19 Views

11 Nov 2024 | for Version 1

Kwok Ng, Physical Activity for Health Research Centre, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, County Limerick, Ireland

19 Views Cite this report Responses(1)

Approved With Reservations

Is the rationale for, and objectives of, the study clearly described?

Partly
Is the study design appropriate for the research question?

Yes
Are sufficient details of the methods provided to allow replication by others?

Yes
Are the datasets clearly presented in a useable and accessible format?

Not applicable

Competing Interests

No competing interests were disclosed.

Reviewer Expertise

I'm an academic researcher in adapted physical activity and evidence synthesis Ireland fellow.

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Responses (1)

Author Response

13 Mar 2025

Karen Brady, CP-Life Research Centre, School of Physiotherapy, RCSI University of Medicine and Health Sciences, Dublin, Ireland

We thank the reviewer for the constructive feedback on this protocol. We now address each point in responses below the review comment

The area of healthcare professions' role in promoting PA among adolescents with disabilities is an important one. The authors have chosen a good topic to carry out a scoping review, as it would broaden the knowledge than just effectiveness that would come from a meta-analyses. The authors could more clearly the reason and justification for doing a scoping review. It is not clear.

Response:
According to Joanna Briggs Institute (JBI) methodology guidelines, scoping reviews help identify the types of available evidence, existing knowledge gaps, clarify key concepts or definitions, assess research trends and inform future systematic reviews.
Our research question aims to identify evidence of collaboration between healthcare and recreational providers supporting community-based physical activity for child-onset physical disability. A scoping review was chosen as the most appropriate method for addressing this question. This will allow the existing evidence to be mapped, key knowledge gaps identified, and the key characteristics of collaboration to be described , following JBI guidelines.

Also, I would like to have seen authors used established definitions of 'people with disabilities' and then go into the concept of physical disability, how healthcare workers promoting PA differs from people from other impairment groups, and outline clearly which disability model is being used. This may be a useful exercise for the authors to consider the keywords, inclusion/exclusion criteria, and world cafe, and reporting from the review.
Response:
The United Nations Convention on the Rights of Persons with Disabilities defines individuals with disabilities as “those who have long-term physical, mental, intellectual, or sensory impairments which, in interaction with various barriers, may hinder their full and effective participation in society on an equal basis with others.” This definition provides a broad understanding of disability, but we recognise the challenge of balancing inclusivity with the need for specificity, given the individuality of disability.
Disability encompasses a wide range of conditions, each presenting unique challenges. For instance, physical disabilities primarily affect a person’s mobility or physical functioning. However, individuals with physical disabilities may have more functional similarities than differences. Law et al. (2004) found that young people with physical disabilities exhibit similar participation levels, regardless of their specific diagnosis. This suggests that an approach based on function, rather than one based solely on diagnosis, may be effective. For this study, we have chosen to focus on young people with child-onset physical disabilities, which may include conditions such as cerebral palsy, spina bifida, or neuromuscular disorders, provided the impairments first appeared before the age of 15. This definition aligns with the approach used by McKenzie et al. (2021) in their reporting on child-onset physical disabilities.
Here are some comments on the research objectives that the authors may like to consider responding to.

The research objective is to 'identify strategies', it would be good to know what lens is being used to identify a 'strategy' over a 'programme', 'technique', 'actions', 'policies', etc. Authors should outline a clear definition of what makes a strategy, and use frameworks that have helped to define strategies over other aspects.
Response:
We recognise the need for greater clarity regarding the definition of strategies and have further expanded on this now. In Proctor’s 2013 conceptual model of implementation research, strategies represent the "how-to" aspect, with Curran (2012) defining implementation strategies as “methods or techniques used to enhance the adoption, implementation, and sustainability of a clinical programme or practice.”

2nd research objective is a bit vague. I believe a more narrow focus is more feasible in a scoping review. how do you plan to 'describe the experiences' . This was not mentioned clearly in the methods or even in the introduction to suggest there is a need for this. The diverse group of individuals that the experiences would be described from is very broad, and authors could outline how they plan to disseminate this without diluting the information.
Response:
We consider our 2nd objective to be appropriate for a scoping review where the purpose is to help identify the types of available evidence, existing knowledge gaps, clarify key concepts or definitions, assess research trends and inform future systematic reviews. Other reviews such as systematic reviews are more appropriate to address precise narrow effectiveness questions.
We plan to describe the experiences through qualitative research. Qualitative research is a type of research that explores and provides deeper insights into real-world problems ( Moser et al 2017). A qualitative approach allows participants themselves to explain how, why, or what they were thinking, feeling, and experiencing at a particular time or during an event of interest. It answers the hows and whys instead of how many or how much (Tenny et al 2022). Therefore, we believe that it is important to report the experiences of the professionals collaborating because understanding their experiences can provide valuable insights into what worked, what didn’t, and what may need to change or adapt to improve the implementation and sustainability of these partnerships. Data describing the experiences of professionals will be extracted from qualitative studies.
Equally important is capturing, the experiences of young people and their families regarding these collaborative efforts. Depending on the available evidence, our synthesis may include descriptions of if / how the collaboration between sectors benefited them; if it made participation easier; and if it addressed barriers to participation. Gathering this feedback can help identify ways to enhance support for young people and their families moving forward. Data describing the experiences of young people and their families will be extracted from qualitative studies.

3rd research objective seems incomplete. Kindly outline it, and take into note of more detail required from 2nd objective.
Response:
Objective 3 has been modified to “Identify and describe any outcomes measures that were used to evaluate the collaboration strategy used by healthcare and recreational providers”
As outlined above, we have now provided further clarity for ‘strategy’ as per Curran 2012 “methods or techniques used to enhance the adoption, implementation, and sustainability of a clinical programme or practice.”

4th objective, as I understand it, they are doing this as part of the scoping review, through the world cafe. Overall, that would fit without an objective to carry out a scoping review, and following JBI recommendations. To me, that would not be needed to be outlined as an objective. Rather, if there is more that would be done, , then it can be included.
Response:
Upon reflection, we agree that this does not need to be an objective. Following JBI recommendations for scoping reviews, stakeholder engagement is important. We will incorporate this consultation throughout the review process, rather than making it a separate objective, and it has been integrated into the knowledge user engagement section of the protocol.

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Competing Interests

No competing interests were disclosed.

Alongside their report, reviewers assign a status to the article:

Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested

Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit.

Not approved - fundamental flaws in the paper seriously undermine the findings and conclusions

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Healthcare and recreational sector collaboration strategies to support community-based physical activity participation among young people with childhood-onset physical disability: A scoping review protocol

Abstract

Objective

Introduction

Inclusion criteria

Methods

Keywords

Introduction

Review objectives

Inclusion criteria

Participants

Concept

Context

Types of sources

Methods

Search strategy

Study selection

Data extraction

Data analysis and presentation

Knowledge user engagement

Prioritisation and planning

Execution and dissemination

Ethics and consent

Data availability

Underlying data

Extended data

Acknowledgements

References

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Open Peer Review

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Healthcare and recreational sector collaboration strategies to support community-based physical activity participation among young people with childhood-onset physical disability: A scoping review protocol

Abstract

Objective

Introduction

Inclusion criteria

Methods

Keywords

Introduction

Review objectives

Inclusion criteria

Participants

Concept

Context

Types of sources

Methods

Search strategy

Study selection

Data extraction

Data analysis and presentation

Knowledge user engagement

Prioritisation and planning

Execution and dissemination

Ethics and consent

Data availability

Underlying data

Extended data

Acknowledgements

References

Comments on this article Comments (0)

Open Peer Review

Comments on this article Comments (0)

Open Peer Review

Reviewer Status

Reviewer Reports

Comments on this article

Competing Interests Policy

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Are you a HRB-funded researcher?

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