Background
Children and adolescents are currently recommended to undertake at least 60 min per day of moderate to vigorous physical activity (PA) [
1]. The physical and psychological benefits of PA in children and adolescents are plentiful [
1,
2], however many young people are failing to meet current guidelines. On a global level, approximately one fifth of 13–15 year olds are meeting the current guidelines [
3]. Similar trends were observed in Northern Ireland with only a quarter of children aged 9–11 years meeting the recommended 60 min per day of MVPA [
4].
There is a need for policy makers to regularly review influences on PA in children and young people and to understand what helps and hinders them in relation to PA participation [
5]. The transition from primary to post-primary education represents a key period of change [
6] and typically represents the onset of declining PA behaviours [
7,
8]. Exploring the issues related to current influences on PA, and comparing these differences between young people with varying existing levels of PA participation is therefore pertinent in this age group to further develop understanding of changing PA behaviours.
A review of qualitative studies highlighted the importance of social support from family and significant others in maintaining participation during key changes in the lifecycle, for example, school transitions [
9]. The majority of included studies in young females cited barriers including negative experiences during physical education, dislike of uniforms or the sports offered, and the conflicting notion that being sporty did not make girls appear feminine and/or desirable to boys [
9]. Boys were found to hinder girls’ participation through name-calling and negative opinions of girls who were active, describing them as ‘disgusting’ and ‘nasty’ [
10]. More recent work confirms these findings as well as highlighting further barriers to participation in girls, for example, lack of time, loss of interest, practical issues, influence of peers and body centred issues [
11,
12]. Friends have been frequently cited as influencing PA during adolescence [
11‐
13], with young people belonging to a number of friendship groups that can influence both the initiation and maintenance of PA [
14].
Given the evidence that activity indicators such as sport participation in adolescence may contribute to future involvement in PA [
15], it is also necessary to examine how best to promote PA in this population, which is important to inform future PA interventions in younger people, particularly amongst the least active. While much qualitative work to date has examined the factors influencing participation and involvement in PA, less is understood about how to actively involve children and adolescents in planning PA interventions, what they prefer in such interventions and how to best promote future PA in this age group. Identifying barriers and facilitators to PA is key to understand the complex relationship between young people and PA [
10] but it is also important to identify components to be utilised in future interventions aiming to increase PA in this group. Furthermore, owing to the greater use of focus groups which to date have been largely homogeneous with respect to gender, most commonly featuring females, there is a dearth of evidence on influences on PA derived from qualitative work that is mixed-gender. Given that at this stage of the lifecycle the school environment represents a key opportunity for modulating PA, and that many children attend co-educational schools, exploring the factors associated with participation in a mixed cohort may provide fresh ideas. Understanding the interactions between males and females and how this can influence PA participation will provide useful insight to inform the development of future interventions which may be targeted at mixed or single gender groups, albeit in a mixed-gender environment, for example, recess-based interventions taking place in the school playground. Although a number of influences on PA may be gender specific at this stage of the lifecycle, children at this age are unlikely to feel as averse about sharing their views and opinions in front of other peers [
16] compared with those at a later stage of adolescence.
The aims of this study were to investigate key influences on current levels of PA and to explore possible ways of increasing participation, for example, identifying components which can be utilised in future interventions in children and adolescents by actively seeking ideas from this target population [
17,
18].
Discussion
This study aimed to explore the main influences on current PA participation and how best to engage adolescents in PA immediately following the transition from primary to secondary school (11 – 13 year olds). The focus groups identified several issues which will be important to consider in the design of future interventions to be targeted at this age group.
Friendship and the influences of peers were consistent themes both for influences on current activity and adolescents’ suggestions on how to promote participation. This theme emerged irrespective of current PA levels and underlines the importance of peers at this stage of the lifecycle [
25]. The influence of friends and the importance of having someone to participate with have been shown to be key factors in young females’ participation in PA [
11,
20,
26,
27]. The present study also suggests that this is equally important amongst males. Gender differences were observed, with girls, especially those who were less active, more likely to cite the negative influence of peers on their levels of PA and how this made them feel conscious about participating in PA in front of others. These findings are supported by previous qualitative work, where young females reported feeling their sporting ability was judged by other girls [
12] and highlights the potential influence of peer victimisation on adolescent PA [
25].
Participants cited the important role parents play in their involvement in PA. Parental support and direct help from parents have previously been correlated with PA in adolescents [
28,
29]. Given the continued influence parents play as children move into adolescence [
29], it is important to incorporate some level of family support into future interventions. Furthermore, the role of parents may be better suited to supporting young people in activities that they can participate in with friends given that highly-active participants were conscious that participating in activity with parents may be viewed as ‘babyish’ by their peers. Parents have been previously shown to negatively influence PA in this population, by actively discouraging participation [
12], not wanting their children to get injured from sport [
10] or placing decreased emphasis on sports participation over other commitments, for example, studying [
11]. These negative influences were not apparent within the present study.
Both male and female participants had a strong awareness of the health benefits of PA however this awareness did not necessarily translate into PA related behaviours amongst those who reported the lowest PA levels based on their PAQ-C responses. Most of the literature to date suggests that most facilitators of children’s PA participation are focused on the ‘here and now’ [
17]; with little focus given to the impact of PA participation on adult health as a motivating factor [
17]. Promoting awareness of the health benefits of PA may be an effective means of engaging young people in PA [
18], however previous work has not evidenced such an awareness in participants aged 12 to 14 years [
18]. This data suggests that awareness of the benefits of an active lifestyle may be increased in this particular population compared with others of a similar age however it is unclear where this increased awareness has come from, for example, schools, media or family. While young people may already be aware of the benefits, it may be important that future interventions reinforce these as they may act a potential motivator [
30].
Moreover, evidence has highlighted that reinforcing specific health benefits of PA, for example, the positive effect it may have on body image, can increase motivation for being physically active, particularly amongst adolescent females [
30]. Over half of participants in the present study reported trying to lose weight in the past through exercising, which was reflected further in focus group discussions, and is consistent with previous studies in female only cohorts [
20]. While direct links were not drawn between exercise and body image [
20], it is likely that references to weight gain and obesity were more closely linked to body image as opposed to the consequences of overweight/obesity on health.
Within the present study, highly-active participants felt the transition to secondary education provided further opportunity to be active given the increased activities on offer, including lunchtime and after-school training and games. Contrastingly, the transition from primary to post-primary education and the associated decrease in time available for participating in PA was a key barrier for low-active participants. Lack of time has previously been identified as a barrier to exercising amongst adolescent females [
31], with males more likely to state ‘wanting to do other things with my time’ as a barrier [
31]. Within the present study, both genders indicated the desire to spend more time doing other things over PA.
Homework and other factors that may limit free-time for activity after school highlights the importance of maximising PA participation within the school day to overcome these barriers, particularly for low-active participants. Timetabled physical education classes may be one of the few opportunities adolescent girls have to be active [
10] and this may also be apparent for low-active boys within the present study. Physical education has the potential to contribute towards time spent in MVPA [
31,
32] however further consideration should be given to the preferences of young people in terms of the types of activities they want to participate in. The present study identified gender differences, with male participants preferring competitive, intense forms of PA, usually comprising structured sport, compared with females who preferred new activities such as dance. A preference for activities that were unstructured in nature amongst low-active females is consistent with previous findings that activity should be informal in nature [
20].
A whole school, multicomponent approach to the promotion of physical activity is key [
5] and was highlighted as one of seven key investments that work for PA [
33]. Within this framework, one main priority was for the provision of a suitable environment and adequate resources to facilitate both structured and unstructured PA throughout the school day [
33]. In addition to the provision of equipment, schools have the ability to reach all youths, irrespective of their socioeconomic status or background [
34]. Participants in this study felt schools provided an ideal environment for helping them become more active, outside of physical education. The extracurricular activities currently offered within schools tended to reflect the content of timetabled physical education, which has been evidenced in previous studies [
35]. Increasing further opportunities to be active could maximise the potential of the school day in helping young people meet the guidelines, especially those who are least active. Future initiatives could include the provision of recess-based activities and after-school programmes providing opportunities for all and not just a select group of skilled pupils [
36].
Active playtime during the school day, i.e. during break and lunchtime, has the potential to contribute up to 40 % of daily recommended PA amongst children [
37]. Despite this, there is currently a paucity of evidence on the effectiveness of recess-based interventions, particularly amongst adolescents [
38] and is therefore an area that warrants further research. Given that females within the present study were more likely to highlight the social benefits that increased PA during the school day would have, in relation to having existing support from friends and peers, future initiatives should further facilitate these peer relationships. Identifying ways to increase social support for PA, particularly from peers, should be a priority for schools when trying to promote PA during school recess [
39], for example, through peer mentoring schemes [
20,
40,
41].
Walking was discussed an option to promote PA; to gauge interest in particular from low-active participants due to the limited evidence to date on interventions in this age group [
42]. Walking presents a suitable activity that may overcome some of the frequently cited barriers to PA participation in this age group [
9]. Many participants didn’t view walking as a form of activity; it was more something that was part of everyday life. This is reflective of previous work focused on walking behaviours, where it was viewed as opportunistic form of activity as opposed to intentional [
43]. Sponsored walks and beach walks were highlighted by participants as informal ways to promote PA amongst adolescents. Findings from the present study highlighted that walking may present a useful means of engaging the least active in activity and provide them with a platform to build and subsequently become involved in other activities.
The school environment would also provide young people with the opportunity to participate in both single-gender and mixed-gender extra-curricular activities. Contrary to previous findings [
44], the present work highlighted that girls, in particular highly-active girls, may enjoy taking part in mixed-gender activities. The mixed-gender nature of the focus groups may have contributed to this finding with female participants wanting to present themselves as ‘sporty’ to impress male members of the group. Clear gender perceptions existed from boys about what sports girls can and can’t do and appeared to be an ingrained attitude within male participants, which is consistent with previous findings from focus groups with boys [
10]. Although females may enjoy participating in PA with their male counterparts, the different activities suggested by females that may increase their participation in PA, in particular the low-active females, highlights that a ‘one size fits all approach’ may not work for engaging this age group in further PA. Future initiatives may wish to provide opportunities for both mixed-gender and single-gender participation in PA.
The use of technology may also be important in future interventions with participants highlighting technology could make activities seem more appealing by increasing the novelty factor. ICT based technology in combination with other approaches can have a positive effect in promoting activity [
45]. Given that 80 % of 15 year olds within the UK presently own a smartphone [
46], developing mobile applications to work alongside PA interventions in terms of facilitating self-monitoring, goal setting and competitions amongst friends may be effective.
Rewards and incentives were also highlighted as a means of engaging young people in PA, and have been previously shown to increase levels of PA in youth [
47,
48]. There is debate within the literature on how the use of rewards works to elicit behaviour change in individuals [
49] however recent evidence has highlighted the effectiveness of financial incentives over usual care in adult populations [
50]. Reward schemes have previously been shown to be highly acceptable for the promotion of healthy eating behaviours amongst adolescents [
51]. This research has highlighted the importance of how rewards are implemented; it is important that all efforts are rewarded and not a competitive environment where only the sportiest achieve prizes. Furthermore, gender differences were highlighted with males preferring rewards that were linked to PA, for example, sporting equipment and trips to sporting events.
This focus group study exploring factors related to PA is the first to be conducted within a Northern Ireland population. Given the high proportion of youth inactivity in the UK, and that children living in Northern Ireland are those least likely to meet the current PA guidelines [
52], this study provides great insight into how to best influence PA involvement in this population. When designing interventions, the involvement of target populations in the initial development of ideas is important [
5]. As well as exploring current influences, this study explored how to increase participation and offset reported declines in PA in this population which may provide a focus for future PA interventions in this age group. A number of qualitative studies in this area have relied on school staff to select pupils, which may introduce bias, particularly in relation to how teachers view pupils’ activity levels. Within the present study, participants were selected for focus groups based on a validated measure of PA [
53]. In addition, anthropometric data was collected to provide descriptive information on the population studied. 25 % of focus group participants were overweight/obese, which is representative of the Northern Ireland population [
54]. The present study is one of the first studies to explore attitudes towards technology as a means of promoting or maintaining PA in this age group.
In contrast to previous work, participants were not assigned to focus groups based on gender. By having mixed-gender discussions, this study enabled the researchers to explore some key gender differences between boys and girls, and to facilitate interaction between participants with group members sharing similar or conflicting ideas on the key themes that emerged from group discussions. Although schoolchildren may be averse to sharing opinions on certain topics with participants from the opposite sex [
55], it was felt that the target age group in the present study were not yet at the stage of adolescence where they would feel conscious about honestly and openly sharing their views and opinions in front of their peers [
16]. Mixed-gender groups may have suppressed some gender-specific discussions about PA which have been identified by previous qualitative studies [
10,
11] however it was useful to explore these areas in a mixed-gender environment as future PA interventions may be targeted at such environments, for example, the school playground. The use of focus groups which are homogeneous in respect to gender may be useful in future research targeted at a similar population to confirm if the key themes identified in this study are consistent to those generated from single gender discussions.
The limitations of self-reported PA are well documented [
56], however using a validated subjective measure of PA to link with individuals’ responses provided weight to the themes, and is stronger than previous studies where children or teachers simply described participants as active without the use of validated tools or measures. The findings of the present study are specific to those who took part and may not be generalizable to other geographical areas however including participants from a range of PA levels increases the generalizability of the results.
Authors’ contributions
AC, MHM and AMG conceived and designed the study. AC carried out the focus groups, analysed the data and drafted the manuscript. MHM and AMG participated in analysing the data. All authors read and approved the final manuscript.