Barriers and facilitators to physical activity and further digital exercise intervention among inactive British adolescents in secondary schools: a qualitative study with physical education teachers

Abstract

BackgroundPrevious studies indicated that physical education programs in schools were unsuccessful to ameliorate physical activity (PA) behaviors among adolescents. This study investigated PE teachers’ perceptions of barriers and facilitators to PA and further digital exercise interventions among inactive British adolescents in secondary schools based on the Capability, Opportunity, Motivation, and Behavior (COM-B) model, the Behavior Change Wheel (BCW), and Theoretical Domains Framework (TDF).MethodA qualitative study was conducted among 156 PE teachers in England. deductive thematic analysis approach was applied to analyze data.ResultsA comprehensive perception of PE teachers revealed 21 barriers to PA among inactive adolescents in secondary schools. The study findings show that barriers exist across all categories of the COM-B model in physical opportunity (7), reflective motivation (5), social opportunity (4), psychological capability (4) and physical capability (1). The majority of these barriers were reported in previous studies as being barriers to PA from the perspective of children and adolescents. This shows that the findings are consistent with the views of children and adolescents that participated in these studies. Particular salient barriers for inactive adolescents were reported and greater insight into their experiences was highlighted. The study reported the main sources of behavior, intervention functions, policy functions, and behavior change tools that can be used for future behavior change interventions to support inactive adolescents.ConclusionThe study recommends using its findings to design interventions for inactive adolescents to achieve recommended levels of physical activity (PA). The study’s comprehensive approach and evidence-based solutions provide extensive reference points for future intervention design, informing policy and contributing to enhancing support for inactive adolescents. Further development of digital exercise interventions, including conversational artificial intelligence (AI), is suggested to engage adolescents at scale and provide personalized support to overcome multiple barriers to PA.

Investigating the Potential of a Conversational Agent (Phyllis) to Support Adolescent Health and Overcome Barriers to Physical Activity: Co-Design Study

“…These findings highlight the significance of developing multicomponent interventions that can effectively address multiple barriers, as advocated in the existing literature [ 12 ]. Notably, a lack of confidence and motivation emerged as significant barriers to this cohort, which is consistent with previous studies [ 15 , 16 , 51 ]. Moreover, adolescents reported experiencing 4 times as many negative feelings as positive feelings when describing the emotional impact of PA, highlighting potential reasons for limited engagement in PA. An unintended outcome of the study was the revelation of a paradox, as some adolescents reported that PA may exacerbate psychological effects such as anxiety, while perceiving it as a means of improving these conditions.…”

“…The primary objective was to support adolescents in overcoming barriers to PA [ 15 - 17 ], to realize the associated benefits [ 1 , 2 , 4 , 50 ], and to provide an alternative digital solution to combat global inactivity [ 6 ]. Furthermore, it aims to promote the development of healthy behaviors during adolescence [ 7 , 8 , 51 ], thereby fostering continued participation in adulthood. The hypothesis guiding the study was that a CA could assist adolescents and that they would perceive Phyllis as a valuable tool for boosting their confidence and motivation to engage in PA.…”

“…The research builds upon prior studies of PA interventions [ 24 , 25 , 27 , 28 , 52 , 53 ] and adolescent barriers to PA [ 15 , 16 , 51 ] and is informed by a behavior change model and theoretical framework [ 29 ]. This approach is unique as it draws upon relevant research, engages in co-design with adolescents and applies relevant theories [ 30 , 35 , 38 , 54 ] to design a CA targeted at adolescents.…”

Facilitators and barriers to physical activity among English adolescents in secondary schools: a mixed method study

“…This study also focuses primarily on individual-level factors, with limited exploration of environmental or contextual influences on PA or from the perspective of other key stakeholders like PE teachers which are reported in other studies ( 15 , 54 , 55 ). Factors such as school policies, access to recreational facilities, or social support systems are not extensively examined, despite their potential impact on adolescent PA levels.…”

“It’s what mothers do.” A qualitative exploration of mothers’ experiences of supporting their daughter to be physically active

“…The TDF contains 14 domains examining psychological (e.g., beliefs about capabilities, identity), social (e.g., social influences), and environmental (e.g., environmental context) influences on behaviour and has been utilised in qualitative research exploring children and adolescents’ physical activity. For example, the TDF has informed studies examining the barriers and facilitators to physical activity as perceived by children, parents and physical education teachers [ 46 , 47 ] and it has also been used to inform intervention development studies such as the design of a school-based intervention targeting adolescent girls [ 48 ]. This framework does not propose testable relationships between factors but provides a lens through which to view different influences on behaviour [ 49 ], thus, guiding analysis rather than imposing a predetermined structure [ 50 ].…”