Preferences for Telehealth Physical Activity Participation Among a Cohort of Children and Youth With Disabling Conditions: Cross-Sectional Survey Study.

Background: Children with disabling conditions encounter numerous challenges in participating in physical activity within their community. Telehealth has emerged as an ideal method for promoting physical health and wellness, but there is a need to identify optimal implementation strategies. Objective: This study aimed to describe the telehealth physical activity preferences of active children and youth with disabling conditions to rapidly inform the development of a pilot telehealth program that could be delivered nationally. Methods: A cross-sectional survey was conducted among a convenience sample of pediatric members of a community-based wellness program. Questions probed preferences for delivery method; programming frequency, intensity, duration, and type; desired outcomes; technology access and proficiency; and additional needed supports. Of the initial 56 respondents, 4 (7.1%) over the age of 18 years were excluded, leaving 52 (92.9%) for analysis. Outcomes were summarized descriptively. Results: Of 392 wellness program members, 56 (14.3%) responses were gathered. The mean age of the 52 analyzed respondents was 10 (SD 3; range 5-16) years. The sample predominantly comprised male (32/52, 61.5%) and White (34/52, 65.4%) individuals, with autism spectrum disorder and developmental disorder as the most common disability types (22/52, 42.3% each). Social and psychological barriers were the most frequently reported challenges to physical activity participation (36/52, 69.2% and 27/52, 51.9%, respectively). Most respondents reported an ideal exercise dose of 1 to 2 sessions per week of 30 to 45 minutes at a novice or beginner difficulty level. Winter was the preferred season for participation. The 2 most desired delivery formats were live videoconferencing and prerecorded videos. Desired program outcomes included strength improvement, mental health, developing new hobbies and activities, and social connection. Over 90% of respondents (47/52, 90.4%) reported having adequate technology at home to support virtual participation. Conclusions: Optimal telehealth programs for this cohort should be brief and low intensity and offered seasonally, with both live and prerecorded delivery options. Although this preferred dose does not meet US physical activity guidelines, it may represent an appropriate starting point for many inactive children with disabilities. Future research should examine behavior change strategies that motivate children to enroll in these programs and support gradual increases in physical activity over time.