Barriers and facilitators to young children's physical activity and sedentary behaviour: a systematic review and synthesis of qualitative literature.
Obesity reviews : an official journal of the International Association for the Study of Obesity 2016 ; 18: 987-1017.
Hesketh KR, Lakshman R, and van Sluijs EMF
DOI : 10.1111/obr.12562
PubMed ID : 28589678
PMCID : PMC5575514
URL : https://onlinelibrary.wiley.com/doi/10.1111/obr.12562
Positive activity behaviours (i.e. higher physical activity [PA]/lower sedentary behaviour [SB]) are beneficial from infancy, yet evidence suggests that young children (0- to 6-year-olds) are relatively inactive. To better understand the perceived influences on these behaviours and to aid intervention development, this paper systematically synthesizes the extensive qualitative literature regarding perceived barriers and facilitators to PA and SB in young children (0-6 years old). A search of eight electronic databases (July 2016) identified 43 papers for inclusion. Data extraction and evidence synthesis were conducted using thematic content analysis, underpinned by the socio-ecological model (i.e. individual, interpersonal, community, organizational and policy levels). Parents, childcare providers and children perceived seven broad themes to be important for PA and SB, including the child; the home; out-of-home childcare; parent-childcare provider interactions; environmental factors; safety; and weather. Each theme mapped onto between one and five levels of the socio-ecological model; barriers and facilitators at the interpersonal level (e.g. parents, care providers and family) were most frequently cited, reflecting the important (perceived) role adults/peers play in shaping young children's behaviours. We provide an overarching framework to explain PA and SB in early childhood. We also highlight where gaps in the current literature exist (e.g. from male carers; in developing countries; and barriers and facilitators in the environmental and policy domains) and where future quantitative work may focus to provide novel insights about children's activity behaviours (e.g. safety and weather).