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ORIGINAL RESEARCH
published: 07 March 2022
doi: 10.3389/fspor.2022.789259
Frontiers in Sports and Active Living | www.frontiersin.org 1March 2022 | Volume 4 | Article 789259
Edited by:
John G. Morris,
Nottingham Trent University,
United Kingdom
Reviewed by:
Jana Vaší ˇ
cková,
Palacký University, Olomouc, Czechia
Sarah Taylor,
Liverpool John Moores University,
United Kingdom
*Correspondence:
Sarah Nally
Nally-s@ulster.ac.uk
Specialty section:
This article was submitted to
Physical Activity in the Prevention and
Management of Disease,
a section of the journal
Frontiers in Sports and Active Living
Received: 04 October 2021
Accepted: 01 February 2022
Published: 07 March 2022
Citation:
Nally S, Ridgers ND, Gallagher AM,
Murphy MH, Salmon J and Carlin A
(2022) “When You Move You Have
Fun”: Perceived Barriers, and
Facilitators of Physical Activity From a
Child’s Perspective.
Front. Sports Act. Living 4:789259.
doi: 10.3389/fspor.2022.789259
“When You Move You Have Fun”:
Perceived Barriers, and Facilitators
of Physical Activity From a Child’s
Perspective
Sarah Nally 1
*, Nicola D. Ridgers 2, Alison M. Gallagher 3, Marie H. Murphy 1, Jo Salmon 2
and Angela Carlin 1
1Centre for Exercise Medicine, Physical Activity and Health, Sports and Exercise Sciences Research Institute, Ulster
University, Newtownabbey, United Kingdom, 2School of Exercise and Nutrition Sciences, Institute for Physical Activity and
Nutrition (IPAN), Deakin University, Geelong, VIC, Australia, 3Nutrition Innovation Centre for Food and Health (NICHE),
Biomedical Sciences Research Institute, University of Ulster, Coleraine, United Kingdom
In Northern Ireland (NI), many children do not meet the recommended levels of physical
activity (PA). To reduce the prevalence of physical inactivity and associated health
conditions, it is important to understand the influences on children’s PA, which in turn
has the potential to inform future intervention design. The purpose of this formative study
was to examine the current views, barriers, facilitators, experiences, and perceptions
of children in relation to PA in the classroom, school, and home environments, and to
assess the acceptability of components for a school-based intervention. Write and draw
tasks and semi-structured focus groups (n=10) were conducted with 50 children aged
7–9 years (22 boys, 28 girls) from six primary schools. Focus groups were recorded,
transcribed, and analyzed thematically. Pen profiles were constructed from the transcripts
in a deductive manner and represent key emergent themes. Results indicated that
children’s perception and knowledge of PA was mainly structured and sport-based,
while some referred to fun, play and health. Fun, social support and outdoor activity
were identified as key facilitators. Barriers included parental restrictions, lack of time
and space in the different environments. The acceptability of intervention components
was examined, children recognized the potential benefits of additional movement in the
classroom, but opinions differed on the sit-to-stand desks. Findings contribute to a more
detailed understanding of children’s perceptions of context specific PA, the barriers they
face, in addition to factors that support them to lead a physically active lifestyle, which
may inform future PA promotion strategies.
Keywords: children, health, qualitative—quantitative analysis, school, physical activity
INTRODUCTION
Developing effective health promotion strategies targeting primary school-aged children is
necessary to reduce the future burden of preventable non-communicable diseases (Janssen and
LeBlanc, 2010). Regular physical activity (PA) provides children with broad-ranging physical and
psychological health benefits (Poitras et al., 2016), including improved cardiometabolic health,
Nally et al. Barriers and Facilitators of Physical Activity
academic performance (Rasberry et al., 2011), cognitive function,
and prosocial behavior (Donnelly et al., 2016; Sampasa-Kanyinga
et al., 2020). According to the World Health Organization
(WHO), a major public health concern is the increasing number
of children who fail to meet the current PA guidelines of
an average of 60 min/day of moderate- to –vigorous-intensity
aerobic PA across the week (Bull et al., 2020; Guthold et al.,
2020). This issue is particularly prevalent among primary-school
children in Northern Ireland (NI), who are least likely to meet the
recommended levels of PA, when compared with other countries
in the United Kingdom (UK) (Griffiths et al., 2013) and in
Europe (Verloigne et al., 2016). The Children’s Participation
and Physical Activity Study found that only 20% of primary
school children in NI meet PA guidelines (Woods et al., 2019).
Research suggests that moderate-to-vigorous physical activity
(MVPA) decline begins in early to mid-childhood (Farooq
et al., 2020). There are also concerns about coexisting sedentary
behavior (SB) in children, specifically screen-based activities like
television viewing, which has unfavorable effects on various
health indicators, independent of PA (Tremblay et al., 2011).
Schools have been identified as an important setting to
promote PA (Neil-Sztramko et al., 2021) and reduce SB (Hegarty
et al., 2016), with the WHO specifying that the principle of
a whole-of-school approach should be applied (World Health
Organization, 2018; Milton et al., 2021). Children spend a
significant amount of their waking time at school (Nickel et al.,
2021) and many schools have the facilities, equipment, and large
amount of contact time to deliver PA interventions. Timing of
PA program implementation is important (Milat et al., 2015),
teaching staff must not feel over-burdened, and children should
not lose out on class time (Day et al., 2019). Several systematic
reviews examine efficacy trials provide evidence of a slight
increase of time spent in PA for children exposed to school-
based interventions (Kriemler et al., 2011; Dobbins et al., 2013:
Nally et al., 2021). Neil-Sztramko and colleagues found school-
based PA interventions do not result in meaningful changes
in MVPA, however, these findings should be interrupted with
caution as there was a high degree of heterogeneity across all
studies (Neil-Sztramko et al., 2021). The out-of-school period
offers additional opportunities for family-based PA. Parents can
serve as role models through their parenting practices (Maric
et al., 2020), sources of support, and gatekeepers through their
control over children’s opportunities for PA (Lindsay et al.,
2006; Mitchell et al., 2012). Xu et al. (2015) found that there
was a positive association between parental encouragement and
support with children’s PA. Additionally, parents also govern
the home environment and can impact PA behavior through
the provision of opportunities to be physically active (e.g.,
accessibility of play and sports equipment) (Maitland et al., 2013).
Despite large-scale quantitative research being able to
assess the direction and strengths of the trends of children’s
participation in PA, they are unable to explain the reasons
why children maintain or cease PA. Despite years of such
intervention research, increases in PA remain both modest and
short term (Mitchell et al., 2012; Craike et al., 2018). There is
now widespread recognition that health behaviors are difficult
to change (Sheeran et al., 2016). As such, PA interventions
have shifted focus to include the factors that influence these
behaviors beyond individual choice alone. The socioecological
model recognizes that efforts to change health behaviors are
more likely to be successful when multiple levels of influence
including individual, social, environmental and policy levels are
addressed at the same time. To be successful, future intervention
development needs to address these multiple influences on
behavior, including the family and home setting (Sallis, 2001).
The evidence base is not as extensive, as research to date designed
to increase PA in children and inform intervention design has
largely underrepresented children’s perceptions (Noonan et al.,
2016) and has been limited to singular qualitative methods that
omit children’s verbal ability and interaction preference (Morgan
et al., 2002). There is a paucity of data analyzing PA barriers and
facilitators in the school setting, particularly from the perspective
of children aged 7–9 years. Previous literature in this age group
examines children’s perceptions of obesity prevention (Clarke
et al., 2015; Hesketh et al., 2017), not PA.
Transform-Us! was designed in response to the
aforementioned low levels of PA and high levels of SB. It is
a multi-component school- and family-based intervention
which was developed through a series of extensive iterative
work in Australia (Salmon et al., 2011). Transform-Us! aims to
increase children’s PA and decrease SB across the school day
incorporating a mixture of educational, pedagogical, behavioral,
and environmental approaches to integrate movement into
everyday class lessons and recess/lunchtime. Family-based
components comprise of newsletters and homework assignments
containing family-based activities for parents to complete with
their children. The study is based on elements from the social
cognitive theory (Bandura, 1986), theory of planned behavior
(Rachlin, 1989) and behavioral choice theory (Bronfenbrenner,
1986). Although the Transform-Us! intervention has proved
very promising as a multi-component program (Carson et al.,
2013; Yildirim et al., 2014) and is in the final stages of longer-
term evaluation in Australia (under review), we do not have
similar multi-component programs which have been subjected
to rigorous evaluation within NI. Several local contextual
differences between the Australia and NI, in particular the
educational system, social and environmental influences on PA
and policy level differences mean that whole scale replication
would be inappropriate. Formative research is important in
the development and implementation of the intervention, as it
identifies specific behaviors, the determinants of these behaviors
and collects as much information as possible to assist in forming
the intervention aims and objectives (Bleijenberg et al., 2018).
A more detailed understanding of NI children’s perceptions
of context specific PA, the participation barriers they face,
in addition to factors that support them to lead a physically
active lifestyle may inform future PA promotion strategies.
This exploratory study used a formative assessment to inform
the adaptation of a pre-existing PA and SB intervention
Transform-Us! This study aimed to use a combination of
qualitative techniques to explore children’s current views,
experiences and perceptions of classroom, school, and family-
based PA. It was envisaged that the contextual information
gathered from this study will provide valuable insights into
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Nally et al. Barriers and Facilitators of Physical Activity
the connotations children ascribe toward PA and inform the
subsequent intervention design of future PA promotion and SB
reduction strategies targeting primary-school aged children.
MATERIALS AND METHODS
Reporting of this study was guided by the consolidated criteria
for reporting qualitative research (COREQ, Tong et al., 2007)
(Supplementary Table 1). Ethical approval was granted by the
University Ethics Committee (REC/20/0033), and informed
written consent and assent was obtained from parents and
participants prior to participation. Data collection took place
between November 2020 and April 2021, during the second wave
of the COVID-19 pandemic. Schools in NI had been closed
during the period of March to August 2020 due to a period of
‘lockdown’ through public health legislation.
Recruitment
Participants were recruited from a convenience sample of
primary schools spanning a range of socio-economic areas and
from both rural and urban areas of NI. Ten primary schools
were invited to take part in the study via e-mail/telephone. Eight
primary schools agreed to participate in the study. Following
school principal consent, information packs containing child
and parent information sheets and consent forms were sent to
parents/guardians of pupils in Primary 4 (7–8 years old) and/or
Primary 5 (8–9 years old). The pupils who returned written assent
forms and consent forms from parents/guardians were eligible
to participate. The participants did not receive an incentive or
compensation for taking part in the study. Prior to the visit, all
the pupils were informed about the purpose and procedure of the
study. Participants were told that they could withdraw from the
study anytime.
Data Collection
There were two complimentary qualitative methods used in the
formative study: a write and draw activity and focus groups
exploring children’s perceptions of PA and experiences in greater
depth. Previous studies have shown that a write and draw
activity can provide children with greater control over their
expression and the drawings themselves are visual drawings
that directly represent children’s perspectives and/or experiences
(Knowles et al., 2013; Noonan et al., 2016). The drawing task
is also appropriate for younger children as it can demonstrate
thinking at their own levels of cognitive development (Knowles
et al., 2013). Likewise, focus groups are an effective method to
explore the ideas and perspectives of children (Gibson, 2007).
Using a combination of qualitative research techniques, including
sustained interest, enabled the data-generation process to be
fun and engaging for participants, prevented bias arising from
the overreliance of one method, and served to triangulate and
cross-check data (Punch, 2002). Other than participant age, there
were no specific inclusion criteria employed. Data collection was
facilitated by the first author, in the school’s assembly hall or in an
outdoor classroom where participants and researcher alike could
be overlooked but not overheard. By interviewing children in a
group setting at school, we aimed to create a friendly and safe
space which would encourage children to share their ideas and
thoughts (Adler et al., 2019).
Write and Draw Activity
The write and draw activity was completed prior to the focus
groups and prior to break time (i.e., morning recess) to reduce
the influence recent experiences may have on participants’
thoughts and perceptions. The write and draw activity was double
sided and contained five sections (Supplementary Material 2).
For the purpose of this study, children were asked to express
their perceptions of PA visually, and independently, (i.e., not
completed in conjunction with peers) during class time in
each school. To minimize distraction from the task, no written
instructions were provided (Knowles et al., 2013). The first author
(SN) facilitated the activity and separately engaged with the
children in informal conversations to answer any questions. The
first author refrained from providing any feedback.
Focus Groups
To further triangulate the data and ensure the credibility and
dependability of the findings, participants were invited to express
their perceptions of PA through discussions via focus groups.
A semi-structured topic guide standardized discussions between
subjects and allowed for participants to respond freely whilst
also ensuring key topics were covered in detail to allow a degree
of comparability across the transcripts (Punch and Graham,
2016). The topic guide was derived from reviewing the existing
literature in relation to PA and were designed to be exploratory.
The questions focused on the current views, barriers, facilitators,
experiences, and perceptions of children in relation to PA in
the classroom, school, and home environments, and aimed
to evaluate and assess the acceptability of components used
in Transform-Us! for a school-based intervention (topic guide
available in Supplementary Material 3). The topic guide was
pilot tested with a group of four primary-school children, from
a school that was not included in this study, to ensure that
questions were deemed appropriate for this age group. Probing
questions were used throughout the focus group to facilitate
discussion (Elo et al., 2014).
The first author (female Ph.D. candidate holding an MRes,
trained in running focus groups) facilitated separate semi-
structured focus groups that included 4–6 children (10 focus
groups, n=50). To reduce the potential power imbalance that
may arise when an adult facilitates a children’s focus group, it
was made clear that the moderator was not a teacher, there
were no right or wrong answers, and the children were free
to express their own opinions (Heary and Hennessy, 2002;
Morgan et al., 2002). First names were used to moderate the
hierarchical adult-child relationship. Following an explanation of
the procedure, verbal assent was obtained from all participants.
At the beginning of the focus group, participants were informed
that the definition of “physical activity” was any movement of
the body that uses energy, and this included all forms of sport,
physical education (PE), indoor and outdoor play, adventurous
activities, active travel, and normal activities such as using the
stairs, doing housework and gardening. The questions asked
during the focus groups and the PA definition used were
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Nally et al. Barriers and Facilitators of Physical Activity
purposely kept broad to capture what types of PA and settings
were meaningful from the perspective of the participants. A short
icebreaker was used at the beginning of the focus group to help
children feel comfortable and relaxed. Photographs presenting
a range of active and inactive activities were used to encourage
discussion amongst children, having previously been shown to
be an effective method (Hesketh et al., 2005). Examples of the
activities included children skipping outside, watching television,
and a child brushing the floor. Participants were asked several
questions regarding the activities (Supplementary Material 3).
Moreover, a photograph of a sit-to-stand desk was used to
elicit conversation, ensuring the topic was covered in detail and
allowed a degree of comparability across the transcripts (Ereaut,
2002). Open-ended questions starting with “what”, “why” and
“how” were posed to participants to stimulate conversation.
To maintain the interest and enthusiasm of participants and
accommodate short attention spans (Colucci, 2007), each focus
group discussion lasted between 16 and 30 (mean 20.11) min.
With the participants’ permission, the interviews were audio
recorded using a Homder digital voice recorder.
Data Management and Analysis
A form of content analysis was used to analyze the write and
draw activity. Text responses for the write tasks were extracted
verbatim, while drawings were used to identify additional key
themes (e.g., playing sport, social interaction, fun). The following
procedure and terminology were used to analyze the questions.
Drawings had to be legible. Children’s responses to the questions
were categorized as a “mark”. A “mark” within a child’s drawing
referred to an item which could be identifiable as theme. It
was possible for one mark to identify more than one theme.
For example, the identification of how many “times” a theme
was identified (e.g., a child drawing a football game and writing
“playing football”) would be counted as two times. Ten write and
draw sheets were independently reviewed by a second author (N.
R.) and a discussion was had about the findings until a consensus
of the themes were reached. Subsequently, the data were then
analyzed using pen profiles analysis.
The focus group discussions were audio recorded and
transcribed verbatim. The analysis consisted of all together 102
pages of double-spaced transcription. All data were managed in
NVivo12 (Version 12.6.0; QSR International Pty Ltd., Victoria,
Australia) and analyzed independently by SN. To ensure children
were unhindered by researchers’ previous views about PA in
children, in our study we chose a deductive followed by an
inductive approach. Braun and Clarke’s phases of thematic
analysis were used to inform the coding process once S.N
had become familiar with the transcripts (Braun and Clarke,
2019). Transcripts were systematically coded, responses were
transcribed anonymously, and key themes were developed. The
socio-ecological model was used as an initial framework to
initially examine the data. The inductive approach allowed
different themes within the broader socioecological model
constructs to emerge. Quotes that were considered to represent
a similar meaning or pattern were clustered together into
potential themes and subthemes. During this process, themes
were identified and were broadly reflective of the socio-
ecological model (Elder et al., 2007) which has been used
in previous research to demonstrate the influence various
factors have on children’s participation in PA, i.e., intrapersonal,
interpersonal, and organizational factors (Hesketh et al., 2017;
Martínez-Andrés et al., 2020). Quotations from the transcripts
were extracted to further contextualize key findings from the
discussions. The second author acted as a “critical friend” by
independently reviewing a subsample of transcripts and offering
alternative interpretations of the data, encouraging reflection,
and challenging the initial thematic structure. The research group
critically discussed all steps and outcomes in each phase of the
data analysis process until they reached consensus. In case of
disagreements and uncertainties, another member was consulted.
Furthermore, Merriam and Tisdell (2016) strategies to promote
validity and reliability were used to enhance trustworthiness.
The pen profile approach has been utilized in studies
examining youth PA (Mackintosh et al., 2011; Ridgers et al.,
2012; Noonan et al., 2016; Taylor et al., 2018). Pen profiles are a
visual approach for presenting key themes identified during data
analysis through combining verbatim quotes taken directly from
the transcripts and write and draw to provide further context
and insight to the discussions. The authors critically questioned
the analysis and interrogated the data, tracking the process
in reverse from the pen profiles to the write and data sheets
and/or the transcripts, until a consensus had been reached. Thus,
methodological rigor, credibility and transferability was reached
via verbatim transcription of data and triangular consensus
procedure. In some cases, visual illustrations were added to add
further context to the data. Triangulation of the analysis occurred
through presentation of the pen profiles together with associated
verbatim/illustrative material by the research team.
RESULTS
Data are presented in five pen profiles, and focus on children’s
perspectives on PA, PA knowledge, PA barriers and facilitators
and intervention approaches.
Write and Draw
Fifty primary-school aged children (22 boys, 28 girls) completed
the write and draw activity. Blank spaces and answers were due
to children not having sufficient time to complete the activity or
not providing an answer. A total of 49 participants completed
the “what does physical activity mean to you?” section, with all
the responses legible. PA was mostly associated with sport-based
activity e.g., football (n=10), dancing (n=7) and structured
activity e.g., PE (n=8), with participants also defining PA as
“sport” (n=17). Furthermore, participants refer to fun (n=6),
health (n=6) and play-based activities (n=3). Several reported
“movement” as their definition of PA. For example, one child
wrote that: “any movement that keeps your health up” (ID37) and
another child wrote: “it means to me it is sports and help your
body. Any sort of movement” (ID39). Drawings linked to the write
and draw activity are presented in Figure 1.
Forty-nine participants completed the “what I like about
physical activity” section, and 215 marks on specific themes
with two unidentifiable responses were noted within the data
analysis. Forty-seven participants completed the “what I dislike
about physical activity” section, and 108 marks on specific
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Nally et al. Barriers and Facilitators of Physical Activity
FIGURE 1 | (A) Drawing from a boy (ID9) illustrating the football pitch as where he is most likely to engage in physical activity. (B) Drawing from a girl (ID34) illustrating
what she dislikes about physical activity. (C) Drawing from a boy (ID2) illustrating the places where he habitually engages in physical activity. (D) Drawing from a girl
(ID17) illustrating a walk with her dog and friend.
TABLE 1 | Write and draw task completion by section.
Section Writing in the box Drawing in the box
Provided Legible Provided Legible
PA likes 84% 92% 31% 100%
PA dislikes 87% 100% 54% 89%
Place most likely to take
part in PA
94% 100% 40% 96%
Types of PA participated
outside of school
96% 100% 29% 100%
PA, Physical activity.
themes were noted within the data analysis and there were
no unidentifiable responses. Table 1 illustrates completion by
write or draw section. Figure 2 demonstrates the combined
pen profiles of children’s likes and dislikes regarding PA. A
range of physical activities participated in by the children were
described, with the most common being organized sports (n
=20) (i.e., football, hockey) cycling, swimming, tennis, and
walking. Though the activities undertaken varied across the
cohort, a consistent reason for PA participation was for fun (n
=9) and for peer interaction (n=19). Many pupils suggested
that there was nothing that they disliked (n=15) about PA.
Physical exertion (n=11) and going on walks (n=10) were also
commonly reported as dislikes.
Figure 3 illustrates the composite pen profile which denotes
the key themes from the following two questions from the write
and draw activity: “if you could change your classroom, what
would you change?” and “where are you most likely to take part in
physical activity?”. Blank returns were due to insufficient time to
complete the task. Fifty participants completed the “if you could
change your classroom, what would you change?” section. All
the written responses were identifiable and there were 125 marks
on specific themes within the data analysis. Physical changes to
the classroom were the most requested classroom changes by the
children. The “Where are you most likely to take part in physical
activity?” section was completed by all the participants (n=50).
A total of 138 marks on specific themes within the data analysis
were found and data revealed that outdoor (n=30) and sports
facilities (n=19) were the commonly reported themes. Forty-
eight participants completed the “Over the past week what sort
of physical activities did you do outside of school?” section. A
total of 172 marks on specific themes within the data analysis
were noted, structured sport-based activities (n=28), outdoor
play (n=26) and social interaction (n=19) were identified as
the highest frequency themes.
Facilitators of Physical Activity
Overall, children reported a diverse range of PA facilitators
within the school and family environments (Figure 4). One of
the primary motivations reported by children was the sense of
fun experienced through the social aspect of PA. Children in
all focus groups highlighted the importance of social support
from their friends, but family members were also noted. Being
able to go outside, and enjoyment of PA were also commonly
reported facilitators.
Some children expressed a strong desire to exercise, with PA
allowing them an outlet from daily routines and the ability to
share enjoyment with friends. The competitive and vigorous
nature of organized physical activities appeared particularly
appealing and enjoyable for many children as they perceived
them to be more engaging and beneficial to physical health.
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Nally et al. Barriers and Facilitators of Physical Activity
FIGURE 2 | Children’s likes and dislikes toward physical activity.
Peers also played an important role in influencing participants
to be active, with some having a positive experience with their
classmates (Figure 4). At school, children noted unstructured
and structured PA opportunities as facilitators. Boys tended
to mention organized sports, especially football, whereas girls
commonly referred to creative play, drawing and art. PE seen
as an opportunity practice PA and was described as a structured
PA opportunity. At school, children were enthusiastic about the
competitive element and challenges occasionally posed amongst
peers in PE class or during breaktime. Children specified that
family and school play a role in promoting and raising PA
awareness. Parental co-participation in the children’s activities
were also deemed to facilitate activity (Figure 4).
Barriers of Physical Activity
A range of barriers were reported by the children in relation to
PA participation both at home and within school environment
(Figure 5). In the home environment, parents restricting PA and
being able to freely access and watch TV were key barriers.
Using other electronic devices was less commonly reported by
these children. Parental restrictions were due to parental time
restraints, safety concerns, time, and costs. Children were not
allowed go to the park or play near their houses without adult
supervision. In contrast, few children spoke about siblings and
peers limiting engagement in PA. Children expressed the negative
impact weather has on the ability to do PA outdoors.
Regarding the physical environment, children noted that a
lack of space, both at school and home, as well as limited/no
access to equipment/facilities were barriers. The size of indoor
and outdoor space available for play, movement in the classroom
and for PE was identified as a challenge in every focus group. The
unavailability and the inaccessibility of spaces were also identified
as key barriers to children’s PA. Due to the lack of space noted
inside the sports hall, children favored the outdoor environment
for PE at school.
Furthermore, many children stated that they wanted to
participate in PA, however, due to lack of discretionary time
they were not able to do so. Children also indicated that they
do not get time to be active, sometimes owing to external
commitments such as homework. Each focus group raised issues
of physical ability and explained that these insecurities often
prevented them from taking part in PA. Concerns regarding
physical ability included tiredness, being unfit, and having an
illness or injury. Many children explained that they did not like
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Nally et al. Barriers and Facilitators of Physical Activity
FIGURE 3 | Write and draw activity.
to participate in PA after school as they were tired. Teachers who
limit movement in the classroom were also identified as barriers
to maintaining PA.
Children stated that the COVID-19 pandemic was a key
barrier to PA participation. Similar to many countries, NI
imposed restrictions requiring physical distancing (two meters),
and limited community and social gatherings and interactions,
sport, and playground and park use. All organized after-school
activities were canceled. Thus, most children had to comply with
physical distancing, activity constraints and behavior restrictions
(Fegert et al., 2020).
Intervention Approaches
Children discussed a number of intervention components,
including active homework, sit-to-stand desks, and active breaks
(Figure 6). In each focus group, children stated that they enjoyed
the opportunity to be active during the school day. The flexibility
and adaptability of active homework appealed to children. The
idea of incorporating movement and active breaks into the
classroom were perceived as fun. Children were enthusiastic
about the additional movement in the classroom component and
suggested that it may help them with their academic performance
and health.
Children had a mixed response to the sit-to-stand desks.
Children were apprehensive regarding the mechanical and
logistical side of the sit-to-stand desks. Furthermore, children
voiced their concerns regarding the flexibility and adaptability
of the desks in the classroom. Additional barriers to the
implementation of sit-to-stand desks included time within
an intense curriculum, space, and tiredness after prolonged
standing. Children noted that they wanted to change the seating
and table arrangements to make different patterns to create
more space.
DISCUSSION
The aim of this research was to examine the influences on
children’s PA current views, experiences, and perceptions of
PA in the classroom, school, and home environment and to
examine the perceived benefits and barriers of participation.
Although previous qualitative research has examined barriers
and facilitators to primary-school children being physically
active (Brunton et al., 2003; Hesketh et al., 2017), most studies
were based in the USA, making their generalizability to the
UK setting uncertain. This exploratory study has identified
factors that facilitate and inhibit children’s participation in
PA from the child’s perspective and has provided important
considerations for adapting Transform-Us! to the NI context.
Findings from the current study suggest parental restrictions,
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Nally et al. Barriers and Facilitators of Physical Activity
FIGURE 4 | Facilitators to children’s physical activity +ve =positive.
being able to access and watch TV and lack of discretionary time
are barriers to PA participation at home for children aged 7–9
years. Children identified access to, and high levels of, screen
time negatively impacted on PA. Other important school-based
barriers included a lack of space, in addition to limited or no
access to equipment and facilities. The ability to have fun, play,
go outside and enjoy PA were important facilitators of PA.
These identified issues should be areas of focus for program
developers as well as school staff to ensure that strategies are
available to mitigate these factors when they serve as barriers,
to support program implementation. Based on the data from
the present study, many children recognized the physical health
benefits of PA. However, data revealed a lack of knowledge
and identified lack of PA recognition, which is comparable to
previous formative research (Mackintosh et al., 2011) where
some children demonstrated a limited understanding of what
constitutes PA. When describing the likes and dislikes, children
were more inclined to focus on their favorite activity. Participants
“likes” were predominantly structured and sport-based activities
were more common than play activities and feelings. Consistent
with other studies (Timperio et al., 2013; Watson et al., 2015)
children generally conflated PA with sport, which was confirmed
within the write and draw data, with children expressing a greater
recollection of structured physical activities, games (i.e., football)
(refer to Figures 1A,B). In contrast, during the focus groups
children ascribed PA with fun and tended to participate in PA
if they perceived themselves to be physically capable; that is, they
had the necessary skills and it felt it was worthwhile. Educators
could teach children the meaning of PA and emphasize that it
does not have to equate to sport. Providing opportunities to try
different activities at school, beyond PE and organized sport, may
help to redefine children’s perceptions of PA to include a range of
activities that they may enjoy.
Interestingly, many of the themes identified were reported to
act as both facilitators and barriers across the different schools
(e.g., role of parents, school environment, peer influence and
interrelationships). Similar to findings from other qualitative
studies, parents were perceived as both significant barriers and
enablers to children’s PA participation, indicating that parents
have a great influence over their children’s involvement in PA
with the ability to both facilitate and impede participation
(Brockman et al., 2009; Stenhammar et al., 2012; Noonan et al.,
2016). In this study, some children specifically identified their
father as a role model for PA participation (Figure 4). The
findings are in line with previous research by Lijuan et al.
(2017), who found that 23.3% of the variance in MVPA for boys
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Nally et al. Barriers and Facilitators of Physical Activity
FIGURE 5 | Barriers to children’s physical activity -ve =negative.
(aged 7–11) was explained by the MVPA engagement of fathers.
Sigmundová et al. (2018), found that mother’s and father’s levels
of PA are associated with children’s weekly PA. Furthermore,
research suggests that active parents, who could act as role models
for children, facilitate children’s activity (Rodrigues et al., 2018).
Consequently, targeting parents to increase their own PA levels,
particularly through the participation in organized PA, may be an
effective way to increase the activity levels of their children while
providing health benefits for the whole family.
Within the home and family environment, our findings found
that being able to go outside appeared fundamentally important
to children’s PA within drawings (refer to Figures 1A–D), so
much so that many children reported traveling with parents
to parks farther afield that are larger in size and have “better”
provision. PA participation through family walks were discussed
by participants alongside dog ownership. Dog ownership is
associated with a number of health benefits and research
indicates that children from dog-owning families accumulate
more PA (Westgarth et al., 2019). Data also revealed siblings were
perceived as a barrier and as a facilitator. Participants indicated
that siblings may increase activity through co-participation and
social support but can also persuade each other to co-participate
in sedentary pursuits, including television viewing or electronic
device use. Participants identified siblings’ preferences for
sedentary activities as a deterrent to being active, stating that
the sibling was not at the same developmental level as they were
in sport, in most cases mentioning that the younger sibling was
not at the same level. However, participants also emphasized the
positive influence siblings have on sports participation and play.
Other studies looking at sibling influence on sports participation
have reported similar findings (Hohepa et al., 2007; Silva et al.,
2016). Kracht and Sisson (2018) reviewed siblings influence
on children’s objectively measured PA and found that children
with siblings have a healthier PA pattern with more PA and
potentially less SB. Thus, the involvement of parents, pet and/or
family members appear to be fundamental to children’s PA levels
and it is therefore important that the key components of the
intervention are structured around both parents and schools.
Whilst parents clearly have a significant role in shaping young
children’s health behaviors, our findings revealed that children
see peer interaction as reasons to be physically active and the
role of friendship groups was key in helping to promote and
influence the participation of PA at home and within the school
environment. Play, fun and social support were reported as
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Nally et al. Barriers and Facilitators of Physical Activity
FIGURE 6 | Intervention approaches to tackle children’s physical inactivity +ve =positive -ve =negative.
key facilitators for PA participation in children aged 7–9 years.
Present results are in line with previous findings that participants
reported that enjoyment of PA and spending time with friends
were the key influences on maintaining participation in PA
(Knowles et al., 2013; Hesketh et al., 2017). Some of the enablers
support previous qualitative research, including a UK qualitative
study with 10–11-year-olds, which found that children engaged
in PA for multiple reasons including socializing, preventing
boredom and a sense of freedom (Brockman et al., 2011).
Findings also support previous research which indicates that
friends’ social support is known to be valuable for after school
activities, although parental support may be less important
(Jago et al., 2009). In line with our findings, recess literature
shows that playtime is a critical time to play with peers and
is one of the last free-play opportunities that they have with
peers (Ridgers et al., 2012; Parrish et al., 2020). Thus, providing
PA opportunities that enable children to socialize with their
friends was identified from focus group discussions as a key
component within future intervention. Given that play (Ridgers
et al., 2012), appreciation of outdoor activity (Knowles et al.,
2013) and opportunities to socialize with peers (Salmon et al.,
2003) are strongly associated with PA participation in children,
these factors should be highlighted when planning strategies
for future PA interventions. Furthermore, interventions
that focus on providing social opportunities for activity
may be effective activity promotion methods to control
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Nally et al. Barriers and Facilitators of Physical Activity
the intrinsic enjoyment of PA that was expressed by these
primary-school children.
Previous systematic reviews of PA interventions in schools
found favorable effects of classroom movement breaks on
increasing PA (Norris et al., 2015; Martin and Murtagh, 2017;
Watson et al., 2017). In this qualitative study, the majority of
children found the idea of active breaks and/or incorporating
movement in the classroom to be desirable. Participants
perceived the additional movement as being “very good for your
body” and suggested that the addition of activity in the classroom
may have possible health benefits. However, some children noted
that having to engage in active breaks or perform activities within
the confined space of their classroom served as a limitation. This
finding is in line with previous process evaluations exploring
children’s perceptions of active breaks, where some participants
did not like taking part in active breaks due to lack of space
(Howie et al., 2014; Watson et al., 2019). Overall, this finding
suggests that researchers should consider the classroom space
when adapting the Transform-Us! Standing workstations have
the potential to be integrated in the primary-school classroom
environment (Blake et al., 2012; Hinckson et al., 2013). In this
study, contradictory opinions in relation to the sit-to-stand
desks were apparent, with participants voicing concern over the
possibility of class disruption, the practicalities and stability of the
desks. Several participants mentioned potential benefits of using
the sit-to-stand desks, such as improved academic performance
and increased alertness. A pilot study conducted in primary
schools in Australia and England, found that irrespective of
implementation, integrating sit-to-stand desks into classrooms
may be an effective method of reducing classroom sitting
(Clemes et al., 2016). However, the acceptability and feasibility
of implementing sit-to-stand desks within NI primary schools is
unknown, such information is essential for determining full-scale
randomized controlled trials where intervention effectiveness can
be evaluated.
Data from this study reveals that several limits were placed
on where and how children could play and highlights those
children had little access to organized sport. In line with our
results, a research study found that COVID-19 restrictions were
both a barrier and a facilitator for PA in Irish adolescents (Ng
et al., 2020). COVID-19 and lockdown presented opportunities
with more time as a facilitator to take part in activities not
done previously, like PA. Children had been working on finding
new and innovative ways to remain physically active. During
the period of the study, children were forced to adapt to a
new “normal” due to COVID-19 restrictions, which may have
caused a substantial decrease in excursions outside of the home.
Recent studies highlight the decline in PA participation, with
only 2.6% of children meeting the Canadian 24-Hour Movement
Behaviors Guidelines, compared to rates between 12 and 17%
before lockdown (Moore et al., 2020) and a three-fold reduction
in PA was observed in Chinese adolescents (Xiang et al., 2020).
A study conducted in Western Australia found no change in
overall PA among children during the COVID-19 pandemic,
and an increase in children’s unstructured PA and outdoor play
was observed (Nathan et al., 2021). However, as a result of the
context-specific nature of the pandemic contextual factors should
be taken into consideration and the imposed restrictions within
and between countries, thus this finding may not be generalizable
to other countries.
The weather was reported as a barrier to PA. In line with
our findings, several studies have found relationships between
various weather conditions and children’s PA. Rainfall has
been associated with decreased activity (Harrison et al., 2011;
Goodman et al., 2012). Internationally, research indicates that
children in Northern Europe and Melbourne, Australia were
active given the weather conditions they experienced (Harrison
et al., 2017). Contrary to previous research that winter weather
(e.g., snow) is a barrier to outdoor playtime (Burdette et al.,
2004), this research found that it was rain that hindered
children. Nevertheless, it is important to note that contextual
differences between North America and in the UK are apparent,
and snowfall is quite infrequent and short-lived. Thus, there
is a need to provide seasonal and meteorological data, when
developing interventions to increase children’s outdoor PA.
Seasonal variation in young children’s PA is apparent (Carson
and Spence, 2010; McKee et al., 2012). Overcoming weather
issues can be a challenge. Thus, learning to adapt to weather
conditions that may provide fun opportunities for PA (i.e.,
wet weather) or providing parents with feasible contingency
opportunities in locations where weather extremes are common,
may be beneficial and may lead to consistently higher levels of
PA in primary-school age children (Hesketh et al., 2017). The
data also suggests that lack of time for activities is a factor that
appeared to constrain family and school-based activity. Lack of
time has previously been reported by youth as a significant barrier
to PA (Brockman et al., 2009).
STRENGTHS AND LIMITATIONS
This study utilized a write and draw methodology alongside
focus groups, which has not been widely used in primary-
school children in NI. Nevertheless, the participants in this
study responded well to the combination of interactive tasks,
providing important evidence for future studies to adopt a similar
methodological approach. The strength of this study is the design
as it includes the ability to investigate the phenomenon in natural
settings and the use of a variety of research methods to obtain
rich descriptions and deep insights. The drawings informed
about the main environments the participants participated in
PA, helped to express their opinions and experiences, and added
different levels of depth to the children’s responses. Triangulation
of qualitative methods allowed the identification of possibly
overlooked stressors, nuances in theory, and put an emphasis
on the importance of context. Thus, the dual-method approach
provided the participants with alternative ways to express their
perceptions and experiences.
There are some limitations to this study that should be
considered when interpreting the results. Due to COVID-19
protocols and curriculum restrictions, the length of the data
collection was restricted, and a 45-min data collection session was
stipulated by participating schools. Thus, each group completed
both the write and draw task and a focus group within a 45-min
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Nally et al. Barriers and Facilitators of Physical Activity
timeframe, and this was standardized across all participating
schools. Despite this time limitation, the results of this study offer
novel findings into the experiences and understandings of PA in
primary-school children, and 15–20 min write and draw activity
length has been used in previous research. Furthermore, we
were successful in recruiting children from several geographical
locations across NI during the COVID-19 pandemic. This helps
in gaining a better understanding of PA determinants in children
and increases the generalizability of the study findings. It must
be noted that the majority of participants were of white ethnicity
and no participants had physical disabilities. Thus, future work
should include a more diverse sample of participants to reflect
the diversity of NI cultures. Future research should consider
if another setting is more appropriate to capture children’s
experiences of non-school related PA, however researchers
should consider the recruitment difficulties in a community
setting (Brown et al., 2015).
CONCLUSIONS
This qualitative study is the first in NI to explore the identification
of barriers and facilitators of children’s PA during the COVID-19
pandemic. Peers and family were main influences on children’s
PA and could both facilitate and impede on PA participation.
Collectively these findings highlight that elements of fun, social
support, time, space and are likely to be central to the adaptation
and maintenance of PA among primary-school children and
that activity promotion strategies that are based around co-
participation with peers and family members could be an effective
means of engaging in PA. Furthermore, the study findings
offer suggestions to educators regarding the school and family
environment. The study emphasizes social opportunities for
activity may be effective activity promotion methods to provide
the intrinsic enjoyment of PA that was expressed by these
primary-school children.
DATA AVAILABILITY STATEMENT
The original contributions presented in the study are included
in the article/Supplementary Material, further inquiries can be
directed to the corresponding author/s.
ETHICS STATEMENT
Ethical approval was granted by the Ulster University Ethics
Committee (REC/20/0033). Written informed consent to
participate in this study was provided by the participants’ legal
guardian/next of kin.
AUTHOR CONTRIBUTIONS
SN, AC, MM, and AG: conceptualization. SN: conducted the
interviews. SN and NR: initial analysis and interpretation
of the data. SN, NR, AC, MM, and AG: discussions.
All authors drafted the manuscript and were part of the
revision process and agreed to the final version of the paper
before submission.
FUNDING
SN was supported by Northern Ireland Chest, Heart and
Stroke (NICHS), Belfast, UK. NR was supported by a National
Heart Foundation of Australia Future Leader Fellowship
(ID101895). JS was supported by a National Health and Medical
Research Council Leadership Level 2 Fellowship (APP1176885).
NICHS were not involved in the design of the study or
collection, analysis, and interpretation of data or in writing
the manuscript. No other sources of funding were used to
assist in the conduct of this review or the preparation of
the manuscript.
ACKNOWLEDGMENTS
We would like to thank the NICHS for their funding for this
research. The authors thank the participating schools, teachers,
and children for their involvement in the study.
SUPPLEMENTARY MATERIAL
The Supplementary Material for this article can be found
online at: https://www.frontiersin.org/articles/10.3389/fspor.
2022.789259/full#supplementary-material
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