A qualitative synthesis of the perceived factors that affect participation in physical activity among children and adolescents with type 1 diabetes

Abstract

AimsTo explore the qualitative literature on the perceived factors, positive and negative, affecting participation by children and adolescents with type 1 diabetes in physical activity, from the perspective of children and adolescents with type 1 diabetes, their family members, teachers or sports coaches, and healthcare professionals.Methods MEDLINE, SPORTDiscus, PsycINFO, CINAHL and Scopus were systematically searched in July 2019. Eligible studies included any that reported qualitative findings on the perceived factors that affect participation in physical activity from either the perspective of children or adolescents with type 1 diabetes, their family members, teachers or coaches, and healthcare professionals. ResultsThe literature search yielded a total of 7859 studies, of which 14 (13 qualitative studies and one mixed-methods study) met the review inclusion criteria. In total there were 12 unique populations containing 270 individuals, 105 children or adolescents with type 1 diabetes,108 family members, 37 teachers and 20 healthcare professionals. The main factors thought to influence physical activity for this population were the individual characteristics of children and adolescents, the requirement for self-blood glucose regulation, support systems including friends, family, teachers and professionals, education and knowledge, and communication.Conclusions This review synthesizes views on the perceived factors from several different perspectives. The findings suggest that it is important to consider the needs of the wider support network, as well as the child's or adolescent's concerns and preferences, when developing new or existing strategies and programmes to promote physical activity in children and adolescents with type 1 diabetes.Diabet. Med. 37, 934-944 (2020) DIABETICMedicinePhysical activity in young people with type 1 diabetes K. Dash et al.

Youth and parent perspectives on the acceptability of a group physical activity and coping intervention for adolescents with type 1 diabetes

“…In a qualitative synthesis of factors influencing physical activity among youth with T1DM, Dash et al found that self-management requirements, social support, enjoyment of activities, perceived health benefits, and knowledge of physical activity affected engagement. 38 Interventions to improve physical activity in youth with T1DM have shown significant benefits for A1C and other physical health measures (e.g., body mass index, triglycerides) and small improvements in psychological functioning. 32,[39][40][41][42] In the feasibility and safety evaluation of the present 12-week intervention, participants decreased their systolic blood pressure though there was no improvement in A1C or weight.…”

Feasibility and Acceptability of Physical Activity Monitoring as an Educational Tool in Management of Pediatric Type 1 Diabetes

“…Physical activity (PA) can benefit blood glucose (BG) control, lipid profile, and body composition in children with type 1 diabetes [1,2] but figures suggest these children are less active than their peers [3][4][5][6]. This is potentially influenced by the challenge of managing BG level before, during and after PA, amplified by the spontaneous, often unpredictable and sporadic nature of children's activity [7,8].…”

“…Fluctuation in BG level (hypo-and hyperglycaemia) is a side-effect of PA with significant physical symptoms and potential chronic complications [2,9]. Parents of preadolescent children typically take responsibility for diabetes management and find PA a challenge, have concerns about activity-induced hypoglycaemia (fear of hypoglycaemia) [11,12], may avoid intensive PA for their child due to fears [11] and perceive a need for support from healthcare professionals (HCPs) or other experts to help manage these difficulties [7,8].…”

“…Healthcare professionals, as trusted sources of care can educate and support parents to have confidence in their ability to manage changes in BG level around PA [8,13]. However, research findings suggest that paediatric diabetes HCPs perceive a lack of; i) competence, ii) confidence and iii) time to deliver this education in routine clinic appointments [12,13].…”

Diabetic Medicine in lock‐down

“…This month we publish eight papers from around the world that used this methodology. In the first, Dash et al [5] have undertaken a systematic review of qualitative literature on the reasons why children and adolescents with type 1 diabetes participate or not in physical activity. As well as individual characteristics, support from friends, family and teachers were key drivers to increase exercise, while the requirement to manage blood glucose during exercise was a major barrier.…”