A Qualitative Examination of Barriers and Facilitators to Physical Activity for Rural Adolescents
Authors: Chen Biyi , Kattelmann Kendra , Daniels Ann Michelle , Zies Susan , Lindshield Erika , Kidd Tandalayo 
Published: June 2021

ObjectivePhysical activity (PA) is important in childhood obesity prevention. Bronfenbrenner's Bioecological Theory of Development posits that an individual's behavior is influenced by one's interactions with their environment. Interventions promoting PA in context of the environment for rural adolescents are needed. The objective of this qualitative study is to identify barriers and facilitators to PA among 6–8th grade adolescents in rural area.Study Setting and ParticipantsFour focus groups of 6th–8th grade adolescents and four focus groups of adults were conducted in a low‐income, rural community, South Dakota. A focus group moderator's guide for adolescent and adult was created by project team.Measures and AnalysisFocus group discussion were recorded, transcribed, and analyzed using NVivo software (QSR International Pty Ltd. Version 10, 2012) to identify themes influencing PA and categorized into bioecological system of influence (microsystem = face‐to‐face interactions, mesosystem = connection between environments, exosystem = larger social systems, and macrosystem = policy/values of society). Multiple coding were conducted by three researchers to achieve the consensus on the summary of themes.ResultsAdolescents and adults identified barriers in that were reflective of the microsystem (lack of motivation and confidence, and competition from non‐physical activities) and exosystem (distance to the activities and lack of options that they like), but none in mesosystem. Facilitators in the microsystem were acceptance by peers, make the activity fun and prioritize as a family; mesosystem were more education for the activity by school or others; exosystem were better facilities; and macrosystem were more gender equal opportunities.Conclusions and ImplicationsRural adolescents desire greater skills and self‐confidence to complete the PA, acceptance by peers, and a greater variety of both competition and non‐competition activities. When developing programs to increase PA, it is important to include the adolescent perspective and direct programming at the appropriate environmental system of influence.Support or Funding InformationFunding provided by the USDA/NIFA Grant #2012‐68001‐19619.
Identified Adolescents' PA Barriers Using Bioecological Model

Bioecological system of influence
Youth focus group
Adult focus group

Microsystem

Time
+
+

Lack of motivation/dedication (e.g. lack of sense of belonging and influence from coach)
+
+

Bullying
+
+

Lack of ability/confidence
+
+

Competition with other leisure activities (work, hobbies, homework, video games, TV)
+
+

Lack of interest
+

Lack of students
+

Injuries or fear of injuries
+

Influences of friends
+

Parental requirements
+

Lack of knowledge

+

Personal Preference

+

Competition

+

Lack of family support

+

Exosystem

Distance/location
+
+

Lack of facilities
+

Lack of options

+

Climate

+

Lack of bike path

+

PA = physical activity; + denotes factors reported by focus group.

Identified Adolescents' PA Facilitators Using Bioecological Model

Bioecological system of influence
Youth focus group
Adult focus group

Microsystem

Mandatory PE class
+
+

Acceptance (non‐bullying in sports)
+

Have fun
+

Prioritize as a family (i.e. parental reinforcement and need to prioritize)

+

Parenting modeling

+

Mesosystem

Education (individual or group)
+
+

Partnership (i.e. Parent‐Teacher and Parent‐Parent)

+

Exosystem

Community fitness center (e.g. swimming pool)
+
+

Non‐competitive activities
+
+

More Extracurricular activities
+
+

Community league sports
+

Build bike path

+

Challenges/programs

+

Macrosystem

Gender equality
+

PA = physical activity; + denotes factors reported by focus group.