“We are a unique breed”: strategies to enhance physical activity participation for preschool-aged children born extremely preterm, a mixed-methods study

Abstract

Purpose

Preschool-aged children (three to five years old) born preterm participate in less physical activity (PA) than term-born children. Circus activities (a type of recreational PA) are a potential avenue to increase PA rates, but further insight into how to tailor these to address the participation gap is needed. This study investigated barriers and facilitators informing participation in recreational PA for preschool-aged children born extremely preterm and explored strategies to enhance participation in circus activities.

Materials and methods

Sequential mixed-methods study utilizing surveys (n = 217), interviews (n = 43), and a focus group (n = 6) with key stakeholder groups (parents, coaches, and clinicians). Qualitative data (Framework Method) and quantitative data (descriptive statistics) were mixed during preliminary and final analyses.

Results

Five themes were developed from the mixed data: the crucial role of the coach and the need for specific training, the therapeutic role of PA and promoting outcomes beyond the physical, the impact of communication and class planning, consideration of convenience and cost, and finally, the role of clinicians.

Conclusions

Barriers, facilitators, and strategies were identified which may be used to modify or co-design circus-based PA interventions to enhance participation and improve rates of PA for preschool-aged children born extremely preterm.

IMPLICATIONS FOR REHABILITATION

• Families consider recreational physical activities to be part of the therapeutic agenda for their preschool-aged children born extremely preterm.

• Key stakeholders feel that recreational physical activity should target outcomes beyond the physical.

• Coach attributes and capability impact participation of children born preterm and their families, and may be enhanced with specific training.

• Clinicians should be engaged in design of recreational physical activities for children born preterm.

Keywords:

• Preschool-age
• preterm
• physical activity
• participation
• stakeholder involvement

Acknowledgments

We would like to thank the families in the Victorian Infant Collaborative Study (VICS 2016–2017) for their participation in this research, and the VICS research team, in particular Joy Olsen and Marion McDonald. This study will contribute to F.C.'s Ph.D. candidature through The University of Melbourne.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are available from the corresponding author, FC, upon reasonable request.

Additional information

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Physiotherapy Research Foundation #S20-013. The following funding supports the authors: FC: National Health and Medical Research Council of Australia [Centre of Research Excellence #1153176]; Australian Government Research Training Program Scholarship, AS: National Health and Medical Research Council of Australia [Career Development Fellowship #1159533], CM: Australian Government Research Training Program Scholarship, JC: Medical Research Future Fund of Australia [Career Development Fellowship #1141354]; Victorian Government’s Operational Infrastructure Support Program. These funding sources had no role in study design, collection, analysis or interpretation of data, report writing or submission for publication.