Barriers and facilitators of physical activity in children with bronchiectasis: Perspectives from children and parents

Abstract

BackgroundCurrent bronchiectasis management guidelines recommend regular physical activity but a large proportion of children with bronchiectasis do not meet public health recommendations which call for 60 min or more of moderate-to-vigorous intensity physical activity daily. Knowing the factors that influence physical activity in children with bronchiectasis is necessary for the development of effective interventions to increase physical activity in this patient group. The objective of this study was to identify facilitators and barriers to physical activity in children with bronchiectasis unrelated to cystic fibrosis (CF) from the perspectives of children and their parents.Materials and methodsThis was a qualitative study informed by the theoretical domains framework (TDF). Children aged 7–15 years (8.8 years, 8.4–11.0) (median, interquartile range) and parents (45.8 years, 39.7–48.3) completed separate, semi-structured interviews (n = 21). Recordings were transcribed verbatim, and barriers and facilitators related to each TDF domain deductively coded. Emergent themes were inductively derived via consensus moderation.ResultsFrom the perspectives of children, fun with friends, organized sport and activities, and family co-participation in physical activity emerged as facilitators. Inability to keep up with their peers and time on technology emerged as barriers. From the perspectives of parents, instrumental and logistic support for physical activity and supportive social and physical activity environments emerged as facilitators, while management of symptoms associated with bronchiectasis emerged as a barrier.ConclusionPrograms to increase physical activity in children with bronchiectasis should be fun, accessible, provide opportunities for social interaction and address barriers related to exercise tolerance, perceived competence, and presence of respiratory symptoms.

Experiences of children with bronchiectasis and their parents in a novel play-based therapeutic exercise programme: a qualitative analysis

“…The families’ preference for exercise programmes delivered locally is consistent with the results of a recent qualitative study that identified supportive physical activity environments as a facilitator of physical activity in children with bronchiectasis. 27 In this study, parents liked that the community venues were close to home or school, they felt that it was an accepted place where exercise occurs and appreciated the physical space inside the venues. Multiple systematic reviews highlight that physical environmental factors are consistently associated with physical activity.…”

“It’s what mothers do.” A qualitative exploration of mothers’ experiences of supporting their daughter to be physically active

“…The TDF contains 14 domains examining psychological (e.g., beliefs about capabilities, identity), social (e.g., social influences), and environmental (e.g., environmental context) influences on behaviour and has been utilised in qualitative research exploring children and adolescents’ physical activity. For example, the TDF has informed studies examining the barriers and facilitators to physical activity as perceived by children, parents and physical education teachers [ 46 , 47 ] and it has also been used to inform intervention development studies such as the design of a school-based intervention targeting adolescent girls [ 48 ]. This framework does not propose testable relationships between factors but provides a lens through which to view different influences on behaviour [ 49 ], thus, guiding analysis rather than imposing a predetermined structure [ 50 ].…”