Qualitative physical activity studies: exploring context

Qualitative studies aim to assist our understanding of human behaviour through the investigation of perceptions, meanings and social and cultural context using focus groups, interviews, participant observation or open ended questions on questionnaires (109). The methods used and type of analysis undertaken may be determined by a particular

theoretical approach (grounded theory, interviews and iterative thematic analysis), type of data collected (content analysis of written document), topic under investigation and the aims of the study.

Studies exploring perceptions of PA in active and inactive adolescents and adults of all ages using interviews and focus groups find that PA is perceived positively, being considered important for improving health and fitness, improving well-being and providing opportunities for socialising and learning new skills (110-120). Few studies explore perceptions of different intensities of PA, but studies of walking in adults found they believed walking to be too slow to achieve any health benefits (121, 122). Health and fitness benefits were associated with participation in regular high intensity PA by adolescents and adults, but high intensity PA is perceived negatively as hard work and requiring effort (110, 113, 119).

Qualitative studies exploring participation in PA have commonly focused on identifying facilitators and barriers to participation. Reviews of such studies have compiled lists of barriers (cost, time, access, transport, social support, safety) and facilitators (fun, social support, facilities) to participation in children and adults (123-125). These studies tend to reflect quantitative studies that identify correlates or determinants of PA by failing to capture the complex interaction between individual, social, cultural and environmental factors on PA behaviours (126). A recent systematic review of 19 qualitative studies exploring PA participation in adolescent girls (11 – 19 years) found that ability comparison and competition, family, peer, teacher influence and appearance concerns were the most

common factors influencing participation (127). Where qualitative studies give greater consideration to the broader social and cultural context of participants’ lives it has been found that changing academic expectations in older adolescents (15 – 18 years) have a significant impact on participation in PA (111, 128-131). Changing academic expectations result in increasing time pressure with a subsequent cessation of PA or a shift from participation in structured team sports to more flexible unstructured individually based activities (128). This reported shift to individual activities was demonstrated in the population based Survey of Sport and Exercise carried out in Ireland in 2003 where interviews with 3,080 adults reconstructed individual sports and exercise histories and found a shift from team sports to individual activities in late adolescence (132).

Interviews with young people aged 13 – 23 years found that decisions about continuing participation in organised sports in older adolescence are influenced by their perceptions of adulthood (133). Males more commonly than females considered sports participation consistent with their perceptions of adulthood. Older adolescents also found

opportunities to participate in organised sport restricted by talent or competency as competition for places on teams becomes greater (131, 133). In focus groups exploring the perceptions and expectations of PA with adolescent girls, participants indicated that they prefer a focus on participation and informal unstructured PA (134, 135). However, a study using focus groups to explore the meaning of PA with active adolescent girls aged 13 - 16 years participants enjoyed the physical challenge participation provided (136). In this study participants self-identified as active on the basis of regularly engaging in one PA during their leisure time and were recruited from areas in England with significant deprivation and poor health status. As well as providing them with a physical challenge focus group participants also found that participation in PA provided them with

opportunities for time out therefore enhancing their emotional well-being (136). This enjoyment of physical challenge was also found during interviews with 21 active

adolescent girls aged 15 years (112). Recruitment processes limited this study, with study participants selected by PE teachers. As a result the researchers considered their study population to include only those who were interested and committed to PE. (136)No measures of PA behaviours were undertaken as part of these two studies.

influences between those women who always participated in sport or PA with those who never participated in sport and PA found that family and friends and a positive

assessment of their own ability were key characteristics of those who always participated in sport or PA (111). During focus groups with 160 young people aged 12 – 18 years in Canada purposefully selected from low and high SES areas social factors, such as support from friends and adults, were found to be important influences on participation

irrespective of SES categorisation (129). In this same study perceived competency was also found to influence participation. In an Australian study with 27 rural living young women aged 16 – 17 years focus group discussions also highlighted the important role support from family and friends played in facilitating participation in PA (128). None of these studies used validated measures of PA (self-report or objective) to determine actual PA and were more commonly undertaken with females than males. A review of

qualitative studies examining sport and PA participation among children and adults also found that support from parents and peers and perceived competency were important considerations for adolescents of all ages (123).

A Canadian study classified participants (age not specified, but recruited from senior secondary school) as maintainers and decliners using retrospective reporting of PA in when study participants were in grade 7 and the Physical Activity Questionnaire for Adolescents to measure current PA (130). Four single-sex focus groups were then conducted with those classified as maintainers and three single-sex focus groups conducted with those classified as decliners. During qualitative analysis themes were compared between groups. Parental support and perceived competence were found to positively influence PA maintenance for male and female maintainers. While this study classified participants on the basis of self-report PA the focus group questions explored motivations for participation in PA and social influences and did not examine this behaviour in the broader context of participants’ lives.

The Australian-based Life Activity Project, a longitudinal qualitative study following three cohorts of children and adolescents (18 primary school, 18 year 7 and 8 students, 18 year 10 students) recruited through schools with a range of social, cultural and geographic characteristics, explored the role of PA and values associated with health and the impact these had on choices, self-perceptions and embodiments of young people (137). This

comprehensive study used themed interviews, journals, mapping exercises, cameras and direct observation over a 3-5 year period. Geography, social class (as determined by attendance at independent school versus government school), socioeconomic status and schools’ values were found to influence the PA choices of adolescent males and females (126, 138). Similarly to the studies outlined above support from family and friends and competency were found to influence participation. For those participants who completed high school during the study, ongoing participation was influenced by their PA identity developed during the school years, changing priorities and social, cultural and economic constraints (138). While this study followed young people over time it was not designed to focus on those who remained active.