Methods
Creators: name: Mekdes Gebremariam
name: Ribeiro, José
name: Brazo-Sayavera, Javier
name: Dygryn, Jan
name: Netz, Yael
name: Cruz, Joana
Publisher: name: OSF Registries
Year: 2023

description: Study design
This study is part of the Work Package 3 of the COST Action CA19101 - Determinants of Physical Activities in Settings (DEPASS). We plan to utilize a four-step modified Delphi method (Niederberger &amp; Spranger, 2020) in our initiative. This terminology consensus study will involve a mix of quantitative and qualitative methods. It will be based on the systematic extraction of terminology (definitions) from the literature, as well as feedback received from academics and professionals in relevant areas. The feedback process will entail a systematic reduction of the multiple definitions presented in the literature for each term, resulting in the identification of the most widely accepted definitions.
The original list of 35 determinants, for which we aim to achieve a consensus statement, primarily stems from previous umbrella systematic literature reviews from the project 'Determinants of Diet and Physical Activity' (DEDIPAC). This list has been supplemented with additional systematic reviews concerning determinants of physical activity to ensure comprehensive coverage of all categories (Individual, Biological, Psychological, Behavioural, Environmental, and Socio-cultural). The original list includes the following determinants: age; sex; socioeconomic status; ethnicity; education attainment level; setting; household income; health status; stress; life events; physical fitness; heart rate; body fat; genetic profile and regulation; perceived competency; self-regulation; mental fatigue; motivation/goal setting; perceived behavioral control; enjoyment; self-efficacy; parental (role) modeling; PABs history and patterns; sedentary behaviour; phone usage; independent active mobility; sleep; participation in organised sports; active transport; backyard access/size; green space access; PA provision and ethos in setting; neighbourhood characteristics; provision proximity (parks/playground); access to sport/recreational facilities; time outdoors; availability of physical activity programs and equipment within schools and community; cultural perspective on PAB; group, family and peer support; companionship; social contact.
Stage 1- Panel committee and participants selection

Panel Committee
During the initial online meeting, DE-PASS members will be approached with an invitation to join the Panel Committee. Interested members should possess the required expertise, encompassing both academic knowledge and/or lived experiences. The Panel Committee aims to have representatives with expertise in sports, health, psychological, and social sciences. Furthermore, it's our goal to ensure that the Panel Committee includes members from equity-deserving groups, considering factors such as geographical location, gender, and ethnicity.

Participants selection
We will invite approximately 300 participants from 40 countries who are involved in the DE-PASS project. We anticipate a diverse representation among participants in terms of gender, ethnicity, geographical location, age groups, and occupation. As the DE-PASS Cost Action focuses on determinants of physical activity, all members within this network have an academic and/or practical background related to physical activity and/or the health domain.
Stage 2 - Literature review on definitions
Two types of data sources will be incorporated into this study: 
1. Definitions sourced from the literature through a systematic process, as well as definitions obtained from grey literature, including Medical Subject Headings (MeSH), dictionaries and organizational websites; 
2. The knowledge and perspectives of DE-PASS members, who are academics and practitioners in the fields of sport, health, psychological, and social sciences.

Search strategy
Initially, a systematic search will be conducted in databases including PubMed, Ovid MEDLINE, and Google Scholar.

The formula used for the search in databases will be applied to each determinant separately, as follows (the specific determinants will substitute the general term ‘determinant’):

((“determinant” was defined as) OR (“determinant” is defined as) OR (“determinant” is described as))

Subsequently, we will examine the potential sources that offer readily available and commonly utilized definitions of determinants. This will predominantly involve searching the MeSH and specialized dictionaries and reports from areas of sport, health, psychological, and social sciences.

Two reviewers (JD and JBS) will screen articles independently and consensus will be reached through discussion. 

All definitions will be gathered in a structured table format with the corresponding references to be used in the next steps (surveys, as described below). In cases where no definition is found, the term will still be included in the surveys.
 
Delphi procedure
Phase I - Preliminary Consensus Round
The initial survey (Survey 1) will be conducted among a Panel committee of six members of the DE-PASS Cost Action with expertise in sport, health, and social sciences. The objective will be to streamline definitions identified from the literature for survey purposes. Members of the group will attempt to select the most appropriate definitions for each determinant. In making their selections, they will adhere to criteria concerning universal applicability and broad relevance, as well as the clarity and comprehensibility of the definitions. Following this, the members will convene for a consensus-building session. Through rigorous discussions, we will aim to finalize up to the top three definitions for each determinant. If no definition is found for a particular determinant, this will be explicitly stated, and the determinant will proceed to the next phase in this manner.

Phase II - Best Definition Identification
This second phase will use a web-based survey (Survey 2) and will be distributed among all DE-PASS members. The Survey 2 will present three definitions (if possible) for each determinant, and the participants will be asked to anonymously select the one they believe best characterizes the given determinant. In the survey, participants will be given the choice to indicate if any of the provided definitions are unsuitable. Additionally, they will have the option to propose an alternative definition (free text option), which must be supported by existing literature, and also provide comments on the presented definitions.
After the completion of Survey 2, each member of the Panel committee will independently analyze the collected data. The analysis process will follow these steps: 1) If a definition is widely accepted as suitable based on the survey results and comments, it will proceed unchanged to the next phase of the project; 2) If a definition is deemed unsuitable, members have the option to refine its wording. In such cases, they will start with the highest-ranked definition from the survey as their base. If the gap between the top-rated definition and the next highest-rated is less than 10%, members may also consider combining elements from multiple definitions to improve clarity and relevance.
During this individual analysis, members should also pay close attention to any alternative definitions submitted in the free-text responses, as well as any additional comments provided by the participants. Any changes made to the definitions should aim to improve their overall clarity, relevance, and comprehensibility, ensuring they can be universally applied.

Phase III – Ranking evaluation
In a web-based Survey 3, participants will be asked to independently rank a total of 35 definitions (one ‘best’ definition per determinant), using a 5-point Likert scale (where 5 represents “strongly agree” and 1 “strongly disagree”). Consensus will be determined a priori to be achieved if ≥75% of participants “strongly agree” or “somewhat agree” with a particular definition.

Once the Survey 3 is completed, we will categorize the definitions of determinants into two groups based on the results and a predetermined threshold. The first group will meet the 75% threshold and will be presented at the expert panel meeting for evaluation. The second group will not meet this threshold and these definitions will not go forward to the next phase. 

Phase IV – Expert panel meeting
The aim of this meeting is to assemble a conclusive report on the definitions of determinants where consensus has been reached. The meeting will be moderated by the Leader D3.3 (YN). All participants who took part in the previous rounds (Phase II and Phase III) will be invited. If there is an overwhelming interest in joining this panel, candidates will be selected to ensure the final group of 10 experts is sufficiently diverse and balanced. Each proposed definition will be discussed individually by the expert panel, with the goal of achieving a final version through primarily formal adjustments, such as ensuring consistent English usage and maintaining a uniform tone. Furthermore, based on our discussions, we will delineate future directions and pinpoint areas requiring further research.

DATA COLLECTION INSTRUMENTS/TOOLS/PLANS
• The definitions gathered in the literature review will be integrated in a table. The table will include the list of determinants, the collected definitions for each of them, and the source (e.g., author(s), year of publication, title, DOI). 
• A web-based questionnaire (Survey 1) with the collected definitions for each determinant will be designed and distributed among the core group, who will be asked to select the three most appropriate definitions. 
• A web-based questionnaire (Survey 2) will be designed and distributed among DE-PASS members, with up to three definitions provided for each determinant. It is possible that some determinants may have no definitions available, or only one or two definitions. In addition to the three provided definitions, an optional "other" answer will be included, asking participants to propose an additional definition and provide a source. In addition, participants will have the possibility of not providing an answer for a particular determinant, if they don’t feel comfortable to do that (‘I prefer not to answer’). The questionnaire will be anonymous. However, participants will only be asked to provide the following background details: age (range), gender, ethnicity, country of living, work setting, level of education, occupation, and area of expertise.
• A web-based questionnaire (Survey 3) will be created to grade the selected single definition in a 5-point Likert scale. 
• Referring to both Survey 2 and 3, a Panel Committee will analyze the data to reach agreement on any unresolved definitions.
• The results of the process will be reported in full and presented according to Literature review requirements.