The Delphi method, developed by Dalkey and Helmer (1963), was adopted as the study design, as it is appropriate in cases where the subjective opinion of a group of experts is needed to reach consensus on a topic, but these individuals cannot meet to discuss in-person (due to constraints such as distance and time).(30,31) The Delphi technique involves multiple rounds of surveys with controlled feedback, allowing participants to reassess their answers based on their review of other panelists’ responses (30). Further, this method allows for anonymity, which mitigates challenges associated with traditional group consensus methods, where dominant individuals and pressure to conform can be confounding factors (32). The study design and procedures were loosely modeled after Gillis and colleagues’(33) Delphi study, which aimed to achieve consensus on research priorities for children’s and adolescents’ physical activity and sedentary behaviours. The Non-Medical Research Ethics Board at the University of Western Ontario provided ethical approval (REB# 114435) for the conduct of this research.
Participants and Recruitment
Canadian (n = 13) and international (n = 18) early years physical activity and sedentary behaviour experts were identified by the research team and invited via email to participate in two online surveys through Qualtrics. Experts were selected based on: 1. their established research in the field; and, 2. provincial/geographic location (i.e., to ensure appropriate representation within and outside of Canada). Additional experts (n = 17), referred to the research team by the initial group of study participants, were then invited as national (n = 2) and international (n = 15) experts. If no response was received within 2 weeks, a reminder email was circulated. Recruitment took place in October 2019 and a total of 25 physical activity and sedentary behaviour experts agreed to participate prior to the first round of surveys. One additional expert agreed to participate prior to the second round of surveys (53% response rate).
In order to ensure module content was appropriate and contextually relevant to integrate into Canadian ECE curricula, 46 Canadian ECE experts were identified by the research team and invited via email to participate. Experts were selected based on their: 1. occupational position (i.e., ECE university professor, board/executive member of a relevant ECE organization, dean or program head/instructor of a post-secondary ECE program); 2. years of experience in the ECE field (5 years minimum); 3. provincial/territorial location (i.e., to ensure appropriate representation); and, 4. online email address availability. Additional experts (n = 14), referred to the research team by the initial group of ECE experts, were also invited to participate. Recruitment took place in November 2019 and a total of 35 ECE experts agreed to participate (58% response rate). See Figure 1 for the full recruitment process of physical activity/sedentary behaviour and ECE experts.
Physical activity/sedentary behaviour experts completed two online surveys. The first survey gathered their top 12 physical activity and sedentary-behaviour-related content areas they felt should be included in an e-Learning module for ECE students (with a brief justification for each topic). Two study investigators (BAB, PT) reviewed the topics generated in the first round of surveys and pooled them together. Similar topics were merged, and a list of unique content areas was created. Content areas that were only mentioned by one participant were excluded from the final list.
In the second round of surveys, experts were provided the pooled list of content areas (along with a brief description of what would be included in that section of the module). They were asked to rate the importance of each content area on a 5-point Likert scale (0 = unimportant to 5 = very important). In order to ensure all proposed content areas were captured in the pooled list, experts were asked to indicate whether the topics they proposed in the first survey were accurately represented. Occupational positions for physical activity experts were retrieved by the research team via their institutional websites.
The ECE expert panel completed a version of the second online survey, which, in addition to gathering their importance ratings of the content areas generated by the physical activity/sedentary behaviour expert panel, also captured: 1. demographics (occupational position, years of experience); 2. suggestions for topics not already proposed; 3. how important they felt this type of training was for ECE students; and, 4. whether they felt the module content aligned with ECE curriculum objectives and accreditation criteria/vocational learning outcomes, and complemented current ECE curriculum.
Experts were assigned a unique participant code to use when filling out each online survey so that study investigators could determine which panel (i.e., Canadian, international, or ECE) each expert belonged to, and who had participated (in order to determine the need for subsequent survey dissemination).
Descriptive statistics of demographics, content area importance ratings, representation of panel-suggested topics, and perspectives regarding the importance of this type of training were completed in SPSS (version 25). Within each panel of experts (i.e., physical activity/sedentary behaviour and ECE), mean (M) scores on each of the 19 content areas was generated. Pearson product-moment correlation coefficient was then calculated between the means of the two panels, and the 19 content areas were ranked within each panel. Similarity in rankings between the two panels was assessed using Spearman’s rho. Analyses were conducted in R version 3.6.1.(34)