Feasibility and preliminary efficacy of the 'Mothers and Daughters Exercising (M.A.D.E.) 4 Life' pilot randomized controlled trial

Introduction: The aim of the Mothers and Daughters Exercising (M.A.D.E) 4 Life study was to assess the feasibility, acceptability, and preliminary efficacy of an after-school physical activity (PA) program targeting mothers and daughters. Methods: A pilot randomised controlled trial was conducted with 48 primary school-aged girls (mean [sd] age = 8.4 [1.7] years; BMI z-score = 0.7 [1.2]) and their 40 mothers (mean [sd] age = 39.1 [4.8] years; BMI = 27.6 [5.5]). Mothers and daughters were randomised to either (i) M.A.D.E 4 Life program or (ii) a wait-list control. The program involved 8 weekly sessions that included a 30-minute education session followed by a 60-minute PA session. Participants were assessed at baseline, 10 weeks (posttest), 20 weeks (follow up). The primary outcome was girls MVPA (accelerometry). Secondary outcomes included: objectively measured PA, BMI, waist-circumference, body composition, sedentary behaviour and screen time. Maternal outcomes included parenting for PA and social cognitive mediators. Results: Retention was 93% at 20 weeks and the average attendance rate for sessions was 82%. Intention-to-treat analysis using linear mixed models revealed a significant intervention effect for maternal PA role modelling (P = 0.02, d = 0.11). No significant differences were found for PA or other secondary outcomes. Process evaluation data revealed high satisfaction scores for the program. Discussion: The M.A.D.E 4 Life program was feasible with high retention and attendance rates and satisfaction scores for mothers and daughters. While the M.A.D.E 4 Life program positively impact on maternal PA role modelling, there was no effect for PA. Statistically powered experimental studies targeting mothers as agents of change to increase PA among girls are warranted.