Barriers to physical activity

Background

There is little research on household and physical environment barriers to physical activity, particularly in minority populations at high risk for obesity and inactivity. Few studies include data on caregiver and daughter dyads. Formative data were used to develop intervention strategies and pathways for the Girls Rule! obesity prevention intervention, in under-studied high-risk pre-adolescents.

Methods

Participants included 12 African-American girls (mean age 7.8 years) and their 11 primary female caregivers (mean age 41.8 years)—eight mother–daughter dyads and three grandmother–granddaughter dyads—for a total of 51 interviews across 23 participants interviewed from April to October 2000.A qualitative approach was used for 51 semistructured in-depth interviews with 11 dyads (female caregiver and girl), consisting of up to three interviews per respondent (mean=2.4 interviews per respondent). Interviews were transcribed, coded, and systematically analyzed between January 2002 and January 2003 to identify recurrent patterns and themes related to physical activity.

Results

Findings indicate clear preference of the girls for sedentary, rather than active, behaviors. Caregivers were unaware of the amount of TV viewed and found positive benefits of TV viewing, including safe supervision of their daughters. Barriers to physical activity include perceived lack of affordable and accessible recreation facilities and low caregiver motivation. Potential intervention strategies identified by respondents include walking for exercise and transportation and several low-cost, favored physical activities, such as hopscotch, jumping rope, and dance.

Conclusions

These findings point toward several physical activity and obesity intervention strategies that can guide obesity prevention efforts.

Introduction

Childhood obesity has increased dramatically in the United States,1, 2, 3, 4 particularly among African-American females1, 3, 5 who have higher inactivity relative to non-Hispanic whites.⁶ It is suggested that activity is more important than diet in obesity etiology in this population.⁷ Approximately 36.7% of African-American girls aged 6 to 11 years are at risk for or overweight, compared to the population average of 27.8%.⁸ Overweight tracks from childhood through adolescence and into adulthood⁹; physical activity declines with age and pubertal development among girls,10, 11 especially African-American girls.¹² Health consequences of childhood overweight include psychosocial and cardiovascular risks.¹³

Overweight parents create obesigenic household environments.14, 15, 16 Diet and lifestyle patterns are initiated during early childhood,¹⁷ and family support and encouragement are strongly and consistently associated with childhood physical activity.18, 19, 20 Intervention research shows positive fitness changes associated with home- and community-based physical activity programs,²¹ with recent focus on family-based interventions.²² However, interventions have not been adequately successful in bringing about health behavior change because of a failure to identify appropriate mediating variables.²³

Qualitative data are extremely valuable for providing insight into health determinants.24, 25, 26, 27 Collection of qualitative data in both caregivers and their children provides a rich description of the context within which diet and activity choices are made.26, 28 Despite these strengths, there is minimal empirical research on patterns of activity among caregiver–daughter dyads. The aim of this qualitative research is to explore perceptions of sedentary behaviors, barriers to and facilitators of physical activity, and directions for intervention factors in this high-risk population.