Physical activity on prescription for children with obesity: a focus group study exploring experiences in paediatric healthcare

Abstract

BackgroundInsufficient physical activity is a growing public health concern and is closely linked to obesity in both adults and children. Swedish physical activity on prescription (PAP) is effective in increasing physical activity levels in adults, but knowledge about how PAP is used in paediatric healthcare is lacking. Therefore, this study aimed to explore experiences of working with PAP for children with obesity amongst paediatric staff and managers.MethodsSeven focus group discussions with 26 participants from paediatric outpatient clinics in western Sweden were conducted. Data were analysed both inductively and deductively, framed by the Normalization Process Theory's four core constructs: coherence, cognitive participation, collective action, and reflexive monitoring.ResultsThe PAP work for children with obesity was experienced to be about helping children to become physically active, and less about losing weight. Identified barriers for using PAP were the non-uniform nature of the work and a perceived lack of guidelines. Collaboration with physiotherapists and physical activity organisers outside the organisation was identified as an important facilitator. An important contextual factor for implementing PAP is the collaboration between paediatric clinics and physical activity organisers. In the transition between these stakeholders, maintaining a family-centred approach when working with PAP was experienced as challenging.ConclusionsPAP is a well-known intervention that is inconsistently used for children with obesity. The intervention should include a family-centred approach for this patient group. It also needs to align better with existing collaborations with other healthcare units as well as with new forms of collaboration with physical activity organisers in the community.

Facilitators and barriers in interprofessional collaboration around physical activity on prescription—a focus group study in a Swedish school setting

“…This means an expanded collaboration around the PAP model, providing children with a supportive environment in the form of a network of adults—both medical and educational professionals in school and the family. Also in pediatric healthcare, it is shown that collaboration between different professionals and physical activity organizers is essential to respond to children's needs and promoting effective use of PAP ( 10 ). Establishing lifelong learning and promoting changes in physical activity patterns is a multifaceted effort.…”