Physically inactive adolescents’ experiences of engaging in physical activity

Abstract

Purpose: This study aimed to describe physically inactive adolescents’ experiences and reflections about engaging in physical activity.

Methods: Nine graduate students from the third year of upper secondary school (six women and three men) participated in this study. Narrative interviews were used for data collection and qualitative content analysis was used to analyse the interviews.

Results: The analysis revealed three themes ‘Acknowledging resistance and barriers to performing physical activity’, ‘Knowing that it is good is not enough’, and ‘Feeling included and accepted is fun and motivating’. These themes show that the adolescent’s experienced barriers, acknowledged pros and cons and identified possibilities to be physically active.

Conclusions: Identifying experiences that impact on inactive adolescents’ attitude and willingness to perform physical activity can be useful to understand the needs of the individual. By relating these experiences to the different stages of the transtheoretical model, this study could provide valuable knowledge for designing future interventions to enhance physical activity in this target group.

Keywords:

• Physical activity
• self-efficacy
• transtheoretical model
• qualitative research

Background

The consequences of physical inactivity are the fourth leading cause of death worldwide [1]. From early childhood onwards, physical activity tends to decline with age, and a large drop occurs in late adolescence [2]. As a result, many individuals are not achieving the recommended levels of 60 min of daily physical activity [3]. Late adolescence is a transition period where the attitudes and behavioural patterns that will be carried on into adulthood are being established in terms of both lifestyle and habits [4], and children and adolescents who are physically inactive in this period are likely to remain inactive as adults [5]. Differences exist between the genders, for example, physical activity among girls often declines during adolescence, as social influence and perceived social norms become factors affecting participation in physical activity [6].

The health benefits of physical activity are well established, and short-term effects are increased aerobic capacity, muscular fitness and body composition, while the long-term effects are a decreased risk of developing diabetes, cardiovascular disease, obesity and osteoporosis. In addition, there seems to be a positive correlation between levels of physical activity and a sense of well-being among adolescents [7]. Studies have also shown an association between adolescents’ physical activity and academic performance and promoting physical activity in school may improve children’s educational outcomes [8]. Despite the good evidence available of the positive effects of physical activity, not all young people are physically active [3]. As evidence mounts worldwide that the promotion of physical activity is essential, there is a need for research concerning physical activity and motivational strategies and how physical activity could be promoted [9]. Health behaviour change involves progress through multiple stages of change according to the transtheoretical model [10] and research shows that there are several motivating factors for physical activity [11]. A key motivator for performing a physical activity is the experience that the activity is enjoyable and fun, regardless of the person’s age or level of physical activity. Furthermore, the availability of unstructured, local and low-cost physical activity opportunities supports young people’s physical activity [11]. However, when the routine of doing physical activity is investigated, barriers preventing young people from performing physical activities are revealed [12]. When comparing physically active adolescents with physically inactive adolescents, some differences emerge. The physically active adolescents are motivated by competitiveness and a sense of achievement, which ‘helps with confidence’, while the inactive ones discuss avoiding boredom, well-being and losing weight as factors for being physically active [13,14]. When discussing why they are physically inactive, factors, such as being unmotivated or lazy are mentioned [15]. Some adolescents have not reflected on the correlation between health and physical activity as they take good health for granted [16].

Late adolescence is a transition period in life as young people enter early adulthood, making it a potential risk group for lifestyle diseases, which is a reason to monitor this group [4]. Further research is needed to explore environmental and sociocultural explanations and, if one is to be successful in encouraging and motivating adolescents to perform physical activity, more knowledge is necessary [17]. There is a disconnect between what is available and what adolescents want to do [11]. Those involved in physical activity delivery (e.g. schools) should include experiences of young people to ensure they are meeting the needs of this age group and providing suitable opportunities for adolescents to be physically active [11]. By investigating inactive adolescents’ experiences of physical activity, it is possible to gain knowledge of the importance of obtaining a better understanding of physical activity-related decisions. Such knowledge can provide parents, teachers and healthcare personnel with the tools necessary to promote activity amongst these adolescents in the course of their work. The aim of this study, therefore, was to describe physically inactive adolescents’ experience and reflections about engagement in physical activity.

Methods

Design

This qualitative study is one of four studies mapping and exploring physical fitness and experiences of physical activity among adolescents. A qualitative design was chosen to answer the aim of the study.

Participants

Within this project, 884 third-grade students in the north of Sweden, aged 18–20 years, answered a questionnaire survey investigating physical activity. Of these students, 99 were interested in participating in further studies and, of them, 16 had classified themselves as physical inactive the last 6 months on the International Physical Activity Questionnaire (IPAQ). Inclusion criteria were performing less than 60 min of daily physical activity 7 d per week at the vigorous or moderate level, according to international recommendation [3]. All of the 16 were contacted, and nine (six women and three men) agreed to participate. The participants specified the number of minutes of physical activity on vigorous to moderate level that they had performed a typical week the last six months on IPAQ. Activity on vigorous to moderate level was in median 60 min/week among the participants. Examples of described activities were construction work, bicycling and walks, which was mostly performed on moderate level. The time and place for the interviews were decided in accordance with the students’ preferences. Of the nine participants, five studied vocational and four studied theoretical programmes. Four of the participants reported knee or back problems.

Data collection

The data collection was performed through individual interviews. The open interview covered two areas: 1. Experiences of physical activity; 2. Barriers and facilitators to physical activity, and started with the request: ‘Please, tell me about your experiences of physical activity and health’, and each adolescent was encouraged to talk freely and follow-up questions were used to deepen the information. The interviews were conducted in a quiet room in the participant’s own home or an office at the university. The interviews lasted approximately 30–45 min and were recorded and transcribed verbatim by the first author.

Data analysis

An inductive qualitative content analysis [18] was used to analyse the interviews. Each interview was read several times to obtain a sense of the content. Next, the whole text was divided into meaning units guided by the aim of the study. After that, the meaning units were condensed, then coded and after that grouped in subthemes. Similar subthemes where summed into broader themes. To ensure trustworthiness and the coherence of the original data, the transcriptions were read and compared with the themes. During the process of theme identification and refinement, all authors read and discussed the meaning units, condensed meaning units, codes, subthemes and themes until consensus was reached. Furthermore, to strengthen the credibility of the study, Table 1, give examples of the data analysis process and quotations are used to illustrate the conclusions drawn.

Table 1. Examples of the data analysis process.

Meaning unit	Code	Subthemes	Theme
‘In sport education at elementary school there was a lot of competition, who is the best at this and that, that is not fun and almost frightening’	Competition about who is best is not fun	Competition and judgement is demotivating	Acknowledging resistance and barriers to performing physical activity
‘…why you exercise is, of course, because you know it’s good for you but you have to constantly motivate yourself to make sure that you do not end up watching TV instead’	Physical activity is good but demands that you motivate yourself	Difficult to motivate yourself despite knowing that it is good	Knowing that it is good is not enough
‘If my closest friends had done more sport, I would have done so too…’	Active friends promote physical activity	Doing physical activity together is motivating	Being included and accepted is fun and motivating

Ethical considerations

The study was performed in accordance with the Helsinki declaration and each participant signed an informed consent before participating in the study. This study was approved by the Regional Ethical Review Board (Dnr 3202-06).

Results

The adolescents talked about barriers, pros, cons and possibilities to be physically active. The analysis revealed three themes and six subthemes, see Table 2.

Table 2. Overview of the results.

Theme	Subtheme
Acknowledging resistance and barriers to performing physical activity	Competition and judgement is demotivating
	Living environment and injuries can be barriers to physical activity
Knowing that it is good is not enough	Recognising the advantage of physical activity
	Difficult to motivate yourself despite knowing that it is good
Being included and accepted is fun and motivating	Feeling competent and accepted makes physical activity fun
	Doing physical activity together is motivating

Acknowledging resistance and barriers to performing physical activity

Competition and judgement is demotivating

The adolescents had identified several barriers to being physically active. A strong discouragement was being judged or evaluated about their physical performance. For example, in activities like testing aerobic capacity or taking part in team sports activities, such as football and indoor hockey. This decreased their motivation for performing physical activity both in school and during leisure time. Generally, have too many competitive elements in the sport or physical activity was considered as demotivating. In addition, ‘being forced’ to participate in competitive activities resulted in most of these adolescents losing their interest in participating in sports physical education, which contributed to their negative experience of this school subject.

Test on aerobic capacity in high school gave me nightmares… I don’t think they gave me anything; they definitely did not encourage me to be more physically active. (Participant A).

Living environments and injuries can be barriers to physical activity

Another barrier that had effects on the adolescents’ level of physical activity was the distance between home and the arena or place where their physical activity took place. Living far from bicycle and walking paths could be a barrier to daily exercise. Some adolescents felt that the physical activities offered in their area were limited, which negatively influenced their level of physical activity. Nevertheless, they also mentioned that closeness to facilities for activities was no guarantee the physical activity would be performed. They had also recognised that the weather influenced the amount performed; it was less likely that they would go out if it were raining or in winter conditions.

In the summer, you might do something with people you know, like volleyball or football, but this does not happen during the winter. (Participant N).

Discomfort and injuries were other barriers to performing physical activity. One adolescent had been forced to give up physical activity against her will due to injury and had remained physically inactive afterward. Another adolescent with health problems felt afraid to perform physical activities because of the uncertainty about whether it could be dangerous and might increase the symptoms.

I was obliged to stop with football because of knee problems. (Participant H).

Knowing that it is good is not enough

Recognising the advantage of physical activity

The physically inactive adolescents expressed knowledge about the health benefits of physical activity and the importance of physical activity for a healthy life. After performing physical exercise, they described being satisfied with themselves, and they often sensed an increased level of energy and well-being. Some of our participants had earlier been in good physical shape, which than had served as a positive stimulus for them as they were able to perform better. Some adolescents had experience of exercise relieving discomfort in their body, which had served as a good factor for motivation to physical activity, at least for a short while.

… it feels really good when one comes home after doing exercise; it is like the kick comes afterward. (Participant L).

Difficult to motivate yourself despite knowing that it is good

The adolescents displayed several interests in their leisure time, such as playing instruments, singing in choirs, watching movies or TV and playing video games. When prioritising between interests, physical activity was not a top priority relative to other activities. Spending time with girlfriends/boyfriends and going out in the evenings were activities that the adolescent became ever more involved in during adolescence. At certain periods, school-work could also occupy a considerable amount of leisure time. Some adolescents had been forced to choose between different activities, due to time and demands and, therefore, stopped being physically active.

I played in an orchestra too, which meant that I could not attend all of the training sessions, so I gave up the sport. (Participant S).

Even though the adolescents had much knowledge, they said that they had an interest in learning more about health and physical exercise. They believed that physical education in school was important and they had an interest in being taught more about personal exercise and health, thereby gaining a better understanding of the effect of physical activity. They believed that increased knowledge might motivate them to become more physically active.

Being included and accepted is fun and motivating

Feeling competent and accepted makes physical activity fun

Feeling confident and having the courage to be oneself was important to participate in physical activity and when the adolescent sensed a feeling of being good enough at the activity, then it was perceived as fun. Also, being accepted and included in a social group as they were, regardless of their level of skill or physical fitness, was fun and encouraged them to engage in exercise. The adolescents stressed that physical activity had to be fun to be involved in and, when it was boring, they were unwilling to participate.

… if you are good at it [the sport], you do enjoy it (Participant K).

Doing physical activity together is motivating

The adolescents described how some of the physical education teachers, coaches and parents had inspired them to participate in physical activity through encouragement, which had given them self-confidence and a more positive attitude towards physical activity. They appreciated teachers who acknowledged their effort when they showed commitment and tried their best, even if they did not always succeed or performed at a great level. They also described how they could engage in team sports for pleasure if the activity was performed in a non-serious manner and the purpose of the game was not winning. They also described that when sport brings friends and community together, it was a motivating factor to physical activity.

I’m not a great fan of team sports… but they can be enjoyable when just played for fun. (Participant A).

The adolescents described how their parents had been models, especially when they were younger, for establishing habits in daily life, both in terms of physical activity and for other health-related issues. They had accompanied their parents in activities, and with time, some of these activities had become the adolescents own interests, for example, downhill skiing. The adolescents had acknowledged how having active or inactive friends impacted on their amount of physical activity. Some adolescents said that they would never go training on their own but that exercising with friends was stimulating. In physical education, having a choice of activity was perceived as positive and fun, as well as testing physical activities where everyone is a novice, such as climbing, which had given some adolescents interest in trying more alternative physical activities.

The more choice there is, the greater the possibility that you will come to the decision that you want to join in, and I can consider trying some activities again, like dancing (Participant M).

Discussion

The analysis of this qualitative study resulted in three themes where physically inactive adolescents describe their experience and reflections about physical activity. Earlier research has identified that college student’s exercise behaviour significantly correlate with the constructs of the transtheoretical model [19] and, therefore, we have found it valuable to use this theory to increase the understanding of factors interfering with a more active lifestyle. The transtheoretical model posits that health behaviour change involves several stages of change and represents a temporal dimension where healthy behaviour change is occurring over time [10]. The students in this study expressed a multifaceted picture of experiences that could be categorised into different stages of the transtheoretical model. However, by relating these experiences to the model, this study could provide valuable knowledge to what impact inactive adolescents’ attitudes and willingness to perform physical activity which could be used in future interventions to enhance physical activity in this target group.

Individuals in the pre-contemplation stage, as defined by Prochaska et al. [10], are not intending to take action in the near future, and this might be consistent with our ‘Acknowledging resistance and barriers to performing physical activity’ theme, where several barriers to physical activity were present. Feelings of pressure, being evaluated by teachers in physical education and not receiving the back-up and support that the adolescent had anticipated were barriers to physical activity. The adolescents expressed that they became uninspired by the teachers due to lack of support, which is similar to Rees et al. [14] reporting negative perceptions of school education from some studies. As the goal for school physical education in Sweden is to teach about a healthy lifestyle and for students to enjoy and perform physical activity, these goals are not met for all adolescents. Altogether, regarding physical activity and a healthy lifestyle, it seems as the school has failed to meet, motivate and guide most of the physically inactive adolescents participating in this study. The weather in northern Sweden, which is often cold, snowy and dark, was sometimes mentioned as an obstacle for performing activities by the adolescents, and this is consistent with previous research [20]. In addition, a review that assessed the effects of weather conditions on physical activity, which concluded that the weather has an impact on physical activity [21]. Low accessibility to sporting arenas and recreational facilities where experienced as barriers to physical activity. Davison and Lawson [22] found that physical activity was increased when adolescents had access to environments that promote physical activity, such as sports halls and recreational areas. Furthermore, it is known that distance between home and school matters since adolescents are more physically active if they can walk or cycle to school, which is known as active transport [23].

Individuals in the contemplation stage are more aware of the pros of changing but are also aware of the cons [10], and this might mirror the experience in our ‘Knowing that it is good is not enough’ theme. A growing awareness that the advantages of changing outweigh the disadvantages might promote a behavioural change; however, this decisional balance between the costs and benefits of changing can also produce profound ambivalence that might keep people stuck in this stage [10]. The physically inactive adolescents had knowledge and understanding about the importance of physical activity for a healthy life, consistent with findings by Power et al. [24]. However, the participants in our study expressed that they often prioritised other activities like schoolwork, meeting boyfriends and singing in a choir above physical activity, findings which are similar to those of Lindqvist et al. [25]. Whitehead and Biddle [26] reported similar findings in their study, where, during their teenage years, inactive girls did not prioritise physical activity but preferred to prioritise their social life, which they claimed to be more important. However, the adolescents knew that physical activity was good for them and they performed physical activity with this in mind. However, this was often insufficient as they felt a barrier to performing physical activity, maybe arising from laziness or because other activities were more interesting. Furthermore, the adolescents expressed an interest in learning more about health and the health benefits of exercise. This might be consistent with the transtheoretical model where more knowledge and a deeper understanding might promote moving on to a higher level [10]. This could be attained in sports physical education classes by integrating health-related instruction and physical activity. Our participants experienced that health education theory and practice was not integrated or individualised, which is preferable when aiming to achieve more long-term effects.

The result showed that when the adolescents had done physical activity, being included and accepted were important factors to continuing being active. In the transtheoretical model, the action is the stage in which individuals are an actively modifying behaviour [10] and our ‘Feeling/Being included and accepted is fun and motivating’ theme could be connected to an important aspect of this stage. The adolescents experienced that, to promote their participation in physical activity, it was important that the activities were fun and made them feel well, which is consistent with previous research [24]. According to Plotnikoff et al. [27], physical activity interventions should address advantageous outcomes (e.g. fun and enjoyment associated with regular participation in physical activity for youth). In addition, asking and listening to youths when they talk about what is fun for them is important for their wellbeing [28]. With this issue in mind, making physical activity more enjoyable might start by listening to the opinions of adolescents.

The result also displayed the importance of feeling confident and being good enough for having fun when participating in physical activity. Self-efficacy is a fundamental belief in the individual’s ability to achieve a goal [29] and Ketteridge and Boshoff [13] showed that self-efficacy was considered important for well-being by adolescents, regardless of the situation or the activity being performed. Previous studies have confirmed that self-efficacy mediates the causal pathway between interventions and adolescent physical activity levels [30]. Thus, treating young people as individuals and ensuring that physical activities are performed with self-confidence and are fun should be kept in mind by everybody working with adolescents and physical activity, especially if the young people are physically inactive. This is also consistent with the transtheoretical model where a person’s self-efficacy might be crucial for whether change can be made and maintained [10].

The adolescents experienced that support given by parents and friends was often essential for participation and worked as a motivator to become physically active, and this is consistent with previous research where peer norms and modelling are known to be associated with adolescent’s health-related behaviours [31]. Besides modelling, the parents are important facilitators of physical activity [32]. Philips et al. [33] concluded that parents should apply more positive constructs, such as helping their child to achieve certain goals and exert less coercive control. The adolescents’ parents had influenced the adolescent, both by offering a model for a healthy lifestyle where both physical activity and eating habits were mentioned, as well as actually performing the activity together with the adolescent. Since the adolescents in our research were not considered physically active at the time of the study, the parents’ healthy lifestyle will hopefully have an impact on the adolescents in the future. However, when children become older and gain more autonomy regarding different health behaviours, the parental influence might become less important, and the peer influence might gain importance [34]. Our findings show that friends could offer a daily opportunity for the adolescent to participate in physical activity by inviting the adolescent to join in an activity. This activity can also be important from a social perspective as it provides an opportunity to meet and spend time with friends [26].

Furthermore, research related to the transtheoretical model shows that interventions to change behaviour are more effective if they are matched to each individual’s stage of change [10]. The results from our study might be useful when designing interventions to promote physical activity for physically inactive adolescents.

Method discussion

A qualitative design with qualitative interviews, analysed by latent content analysis and interpretation of underlying meaning was chosen. Determining an appropriate inclusion criterion for being physically inactive was rather difficult, yet our method follows the recommendations of the World Health Organization [3] at the time when the study was performed. The group was representative from generic and target-group perspectives and was composed of adolescents from different programmes and with mixed experiences of physical activity. Nevertheless, an equal distribution of men and women would have been optimal. Despite the fact that adolescents are known to be difficult to communicate with, most of our interviews were characterised by a feeling of ease, with the adolescents speaking quite freely about the topic. Our participants shared their thoughts and feelings, which then allowed a deep analysis of the data. To enhance the trustworthiness of the study, every step in the data analysis was clearly outlined and described and all researchers were closely involved in the entire process [18]. The researchers involved had mixed experiences, together with an open discussion that enhanced the credibility of the results. Representative quotations from the transcribed text were chosen to describe, explain and enrich the content of the categories, which increases the credibility of the results [18].

Conclusion

When promoting physical activity among inactive adolescents, it is crucial to understand the needs of the individual. The result of this study shows that the adolescents experienced barriers, acknowledged pros and cons of physical activity, and reflected about factors that could promote physical activity. Feeling pressure, being evaluated and not receiving support was demotivating for performing physical activity. On the other hand, feeling accepted and included was a motivating factor to continue doing physical activity. Identifying these factors and relating them to different stages of the transtheoretical model could be useful when designing interventions aiming at increasing physical activity among inactive adolescents.

Acknowledgements

We thank the participants for taking part in this study.

Disclosure statement

No potential conflict of interest was reported by the authors.