Male adolescents' reasons for participating in physical activity, barriers to participation, and suggestions for increasing participation.

Allison, Kenneth R. ; Dwyer, John J.M. ; Goldenberg, Ellie 等

Physical activity and fitness are generally recognized as contributing to enhanced physical and mental health as well as prevention of a number of diseases and other problems later in life (Blair et al., 1989; Haskell, Montoye, & Orenstein, 1985; Powell & Blair, 1994; Stephens, 1988; U.S. Department of Health and Human Services, 1996). Furthermore, concern about greater numbers of overweight and obese children, and the question of whether this pattern will continue into later adolescence, also suggest the benefits of physical activity among children and youth (Dishman, Sallis, & Orenstein, 1985; Sallis, Prochaska, & Taylor, 2000; U.S. Department of Health and Human Services, 1996). The normal pattern during adolescence, based largely on cross-sectional studies in North America and other settings, indicates a decrease in activity with increasing age (or grade), compounded by consistently lower levels of activity among females compared to males (Allison & Adlaf, 1997; Tappe, Duda, & Ehrnwald, 1989; Trost et al., 2002). Because of the health and other benefits of physical activity, these lower levels of physical activity among older adolescents are of concern.

One explanation for the decreasing levels of physical activity during the mid-teenage years is the number of barriers that make it difficult to participate. Barriers refer to the obstacles individuals face in undertaking, maintaining, or increasing physical activity. Much of the existing empirical work examining barriers and other factors influencing activity consists of quantitative studies and reviews of the correlates and predictors of physical activity, exercise, and sport (Allison, Dwyer, & Makin, 1999; Frankish, Milligan, & Reid, 1998; Higgins, Gaul, Gibbons, & Van Gyn, 2003; Robbins, Pender, & Kazanis, 2003; Sallis, Prochaska, & Taylor, 2000; Saxena, Borzekowski, & Rickert, 2002; Sherwood & Jeffrey, 2000; Tappe, Duda, & Ehrnwald, 1989; Tergerson & King, 2002). These factors have been categorized and analyzed as individual and environmental characteristics (Sherwood & Jeffery, 2000) or internal and external barriers (Allison, Dwyer, & Makin, 1999).

Sallis and colleagues (2000) have developed five categories of these factors: demographic and biological; psychological, cognitive, and emotional; behavioral attributes and skills; social and cultural; and physical environment. While not all of these factors were considered to be barriers to physical activity, many can be conceptualized as such. For example, age represents more than just time; it signifies stages in the life course. Age can be considered to represent a whole series of (often unmeasured) events which serve as barriers to physical activity: increasing interest in interpersonal relationships and dating, getting a driver's license, worrying about what to do following high school graduation, and (in some cases) spending more time on academic subjects in order to improve the chances of entering college or university. Thus, it is not simply age, but the meaning of age, which may represent barriers to physical activity among adolescents. To extend this argument, it is likely that the meaning of such factors as gender, ethnicity, and race are important when considering barriers to physical activity rather than simply their correlational or predictive relationship to particular outcomes.

Since females are consistently reported to be less involved in physical activity, exercise, and sport than are males, there is justifiably more attention in the literature devoted to this group. Nevertheless, male physical activity participation also decreases with increasing age during adolescence, and the barriers and other factors related to physical activity are likely to be somewhat different for males and females (Allison, Dwyer, & Makin, 1999; Tappe, Duda, & Ehrnwald, 1989; Tergerson & King, 2002). Therefore, it is important to examine the perceptions and experiences of adolescent boys in relation to physical activity, in particular those which make participation difficult.

Much of the literature on male adolescents' experiences of physical activity focuses on reasons for their involvement in sport: issues of sanctioned violence (Gard & Meyenn, 2000; Light & Kirk, 2000), acceptability of physical pain and the possibility of injury (Gard & Meyenn, 2000; Light & Kirk, 2000), dominance (Light & Kirk, 2000; Sisjord, 1997), the value of muscularity, size and strength (Drummond, 2001; Laitinen & Tiihonen, 1990; Sisjord, 1997), and masculinity (Light & Kirk, 2000; Coakley & White, 1992). Parker (1996) categorized "hard boys" as those displaying traditional forms of masculinity through violence and aggression. The construction of masculine identity is seen as based on boyhood participation in organized sport (Messner, 1990). Thus, it appears that masculine identity is both shaped and reinforced by physical activity and sport involvement. Some of the most prominent perceived barriers for males in previous surveys of high school students include wanting to do other things with their time; lack of time in general (Tappe, Duda, & Ehrnwald, 1989; Tergerson & King, 2002) or specifically due to school work, other interests or family activities; lack of interest; not being in the mood (Allison, Dwyer, & Makin, 1999); too tired (Tergerson & King, 2002); and the weather (Tappe, Duda, & Ehrnwald, 1989).

Coakley and White's (1992) qualitative study of sport participation among British adolescents uncovered several themes related to barriers for males including: lack of physical competence, financial constraints, the related problem of transportation, and lack of proper equipment. Cultural representation of barriers to physical education and sport participation, limited to studies of Asian male high school students (Fleming, 1993) and male Muslim students (Carroll & Hollinshead, 1993; McGuire & Collins, 1998), emphasize the role of parental disapproval of sport as compared to activities which facilitate career goals.

The study reported here explores male adolescents' underlying reasons for participating in moderate to vigorous physical activity, perceived barriers to participation, and recommendations for what can be done to increase participation.

METHOD

Participants

Twenty-six male adolescents from three public schools in different regions of Toronto participated in focus group sessions. There was ethno-cultural diversity in each session. Participants consisted of 15-and 16-year-olds, mostly enrolled in grades 10 and 11. A group of physically "inactive" adolescents (n = 5) participated in one session, another group of "active" adolescents (n = 5) participated in another session, and two groups (n = 6 and n = 10, respectively) of both inactive and active adolescents also participated in sessions. Participants who engaged in moderate or vigorous physical activity, which made them sweat and breathe hard, for at least 20 minutes during 2 or less of the past 7 days were considered "inactive." Participants who did this type and duration of physical activity during 3 or more of the last 7 days were considered "active."

Measures

A structured focus group guide began with showing and describing Canada's Physical Activity Guide to Healthy Active Living diagram that explains the type, intensity, and duration of physical activity needed to maintain health (Health Canada, 2000). Discussion focused on three topics. First, participants were asked why they engage in moderate and vigorous physical activity, even seldomly. Second, they were asked to discuss what makes it difficult for them to engage in moderate and vigorous physical activity. Third, they were asked to suggest what needs to happen in their community to help them and other adolescents become more physically active. Toronto Public Health's (TPH's) Physical Activity Workgroup and a small number of adolescents informally pilot tested the interview guide by commenting on whether the questions were clear and elicited discussion.

Interested adolescents completed a background information survey during the recruitment phase. It consisted of questions as to whether they are male or female, their age, grade level, ethno-racial origin, frequency of participation in physical activity, and telephone number.

Procedure

The University of Toronto and a Toronto school board gave ethical approval for the research protocol. TPH nurses promoted the study by describing it in various classrooms in the four schools, leaving information packages in classrooms for those interested in participating, and informing students that additional packages were available in the main office. A package consisted of a student-informed consent form, a parent/guardian consent form, a brief student survey to collect background information, and an envelope addressed to the main office. Posters and morning announcements also promoted the study. TPH nurses picked up 55 completed forms from the main offices and delivered them to the research team.

A review of the background information data students provided indicated that conducting separate sessions for either active or inactive adolescents, which was the initial plan, would yield groups that were too small. Also, since there were not enough interested adolescents in one school to form a focus group, two group sessions were held in the school that had the largest number of volunteers. Thirty-seven interested adolescents were selected as potential participants to ensure that each group was diverse in age, grade, and ethno-racial origin. About two weeks before the focus group session, they were contacted by telephone to inform them when the session would be held. A reminder telephone call was made the evening before the session.

During a period with lunch provided, 90-minute focus groups were conducted in the three schools during the fall of 2001. Conducting four sessions in this study was consistent with the view that three to five sessions to reach theoretical saturation is common (Morgan, 1998). Between 5 and 10 adolescents participated in each session. An experienced moderator, knowledgeable about general principles of conducting focus groups (Krueger, 2000; Stewart & Shamdasani, 1990), facilitated the sessions. An assistant audiotaped the sessions and took notes. Audiotapes were transcribed verbatim following a specific protocol (Poland, 1995). Two transcripts were compared to their audiotapes for quality control. All transcripts were imported into The Ethnograph, a qualitative software package (Qualis Research Associates, 1998). The research team used a constant comparison approach to developing themes which involved coding comments by continually referring to previously coded comments for comparison (Flick, 1998; Morse & Richards, 2002). Two research assistants and the second author independently read the four transcripts and inductively generated a list of themes with descriptive comments. They compared and discussed the themes and agreed on a common list of themes and codes. Both research assistants then coded two transcripts, and coding discrepancies were discussed until agreement was reached. One of the research assistants then coded the remaining transcripts.

RESULTS

Reasons for Participating in Physical Activity

Focus group participants reported both intrinsic and extrinsic reasons why they engage in physical activity. However, their discussion focused mostly on extrinsic reasons.

Intrinsic reasons. Participants said that they participate because it is enjoyable. For example, one participant said that he "just wants to do it for the enjoyment of the activity." Participants were concerned about events, such as competition, that diminish their enjoyment of the activity. For example, a participant commented on the consequences of focusing on winning when participating in sports: "That's when you start playing for ... not the fun of it. You start getting too aggressive; just to win. That causes stress." Some participants mentioned challenge and skill development as a reason for engaging in physical activity. They liked the challenge of mastering skills. For example, a participant said that although he gets injured doing skateboarding, he experiences a sense of satisfaction and accomplishment when trying to learn new skills. Participants felt a sense of mastery when overcoming obstacles and achieving personal goals in physical activity. They felt that physical activity provided an opportunity to test their abilities. They enjoyed competing against themselves.

Extrinsic reasons. Several participants mentioned that they engaged in physical activity to socialize. They were able to spend and enjoy time with friends and to meet new people. This was exemplified by the comment: "I think a lot of times, when people play sports, such as team sports like hockey or football, they're definitely going to build relationships and friends on that team that you can cherish." A participant who did not like sports participated in them to "fit in" with his friends and to spend time with them. Another confided that he was not interested in playing a particular sport, but he joined the team to be around the girl he had a crush on.

Some participants reported that they engage in physical activity to achieve physical and psychological health benefits. They were motivated to stay fit, to develop physical strength and stamina, to burn calories, and to feel good about themselves. Some participants engaged in physical activity to maintain an attractive appearance. They wanted to appear healthy and fit to impress girls. For example, a participant who acknowledged participating in order to "show off' to girls said, "Let's just put it this way--girls appreciate a guy who has better conditioning more than a guy who has a pot belly." Some participants engaged in physical activity, particularly sports, to make an impression on others or to gain a good reputation. They played sports because they liked competing against others. They were motivated to prove themselves to their peers.

Participants mentioned psychological benefits of participation in physical activity, such as increased self-confidence, feeling good about their physique, and greater self-discipline. They engaged in physical activity to relieve stress, and to decrease tension and anger during physical activity. For example, a participant said, "If you're mad and you want to cool off, or if you had a busy day at school and you want to have fun, just go out and play sports. Get your mind off things." They participated in physical activity as a distraction from their daily stressors. Some participants viewed physical activity as a positive form of leisure. For example, one said that being physically active keeps him out of trouble. To illustrate, he described a television commercial that provided an anti-drug message: "It's a good football commercial with Tiki Barber coming around to some park. He sees a bunch of kids and says, 'Football is my anti-drug.' Well, physical activity is my antidrug. It keeps me out of trouble; keeps me active; doing something."

Perceived Barriers to Participating in Physical Activity

Participants in the focus groups cited a number of internal barriers (individual characteristics, lower priority for physical activity, and involvement in technology-related activities), and external barriers (influence of peers and family, lack of time, and inaccessibility and cost of facilities) to physical activity participation.

Internal barriers. Participants discussed the role of individual characteristics such as physical attributes, psychological factors, and competency as impediments to being physically active. Physical attributes identified as barriers to participating in physical activity included being too young or too short for certain activities, needing to be accompanied by an adult, being overweight, having a disability, having already been injured, and not having sufficient skills to perform the activity. Participants mentioned psychological attributes such as laziness, boredom, wanting to avoid stress, and lack of confidence as barriers. Some mentioned that in order to be invited to play in "pick-up games" such as street hockey, others had to perceive you as a good player. Similarly, some said that if their own perceived competence in a specific activity is low, then they will not take part in the activity. Some mentioned fear of failure, which included concern that peers would mock them if they performed poorly.

Both inactive and active participants limited their physical activity because they and their parents placed a higher value on academics than physical activity, including physical education. For example, an active participant stated "I don't want gym. I'll do [physical activity] on my own time. I want to get courses. I want to learn more in school." Some participants underscored that completing homework and performing well in school are higher priorities than engaging in physical activity. Others said that their parents emphasize academics as a priority. This was illustrated by some participants' comments that their parents allow them to engage in physical activity only when their homework is completed.

Participants reported that they prefer to engage in technology-related activities such as watching television, playing computer and video games, using the internet and chat rooms, and talking on the telephone, rather than participating in physical activity. As an example of these competing interests, a participant said, "Instead of being on [the computer[, we could be outside playing sports. But you can talk to people on the internet.... There's good information you can find ... rather than going outside and playing sports." Some noted that these competing interests tend to be time-consuming and, therefore, limit their time for other activities. For example, a participant said: "I go on the internet to just quickly check my email. Then I find out there's other things I have to do--search around looking for information and looking at pictures. Then it ends up being three or four hours, when I was supposed to be on it for half an hour." Some referred to computer games as addictive; that it was difficult to turn off the games. Some commented that it was more appealing to watch television and talk to their friends on the telephone than to go outside and engage in physical activity.

External barriers. Participants reported that their peers and family influenced their decision to be physically active or not. They said that if their friends or siblings did not engage in physical activity, they were less likely to be active; they succumbed to peer pressure when making decisions about physical activity. For instance, a participant explained that, when asked to join a basketball game, his decision to play is based on whether most of his friends are also playing. Also, some did not engage in certain physical activities in order to avoid playing with people who intimidated them. For example, a participant said "I know some people who don't want to go [to the recreation center] because they're scared of what might be there."

Some felt that parents sometimes deterred them from being physically active by not allowing them to go outside to do so or limiting how much time they could do so. Concerned about safety, these parents did not want their sons playing outside after dark; thus, they discouraged physical activity during certain time periods. As an illustration, a participant reported that his father yelled at him when he returned home late after playing basketball. To avoid further friction with his father, he decided not to play that sport anymore in order to arrive home on time.

Participants commented that they lack sufficient time to participate in physical activities. Other commitments such as schoolwork, part-time jobs, relationships, and responsibilities at home competed for their time after school and on weekends. They mentioned that too much homework made it difficult for them to participate in physical activity. Some reported having as much as six hours of homework on many days. In particular, those enrolled in an after-school advanced academic program spent considerable time doing homework.

Some participants had part-time jobs that cut into their free time. For example, a participant who worked 15 hours a week and then did homework did not have sufficient time and was too tired to do physical activity. Some said that they do not have time for physical activity because of the time spent with girlfriends, other friends, and family. Some noted that, instead of engaging in physical activity, they did household chores and helped their parents care for younger siblings.

The following comment exemplified the lack of time for physical activity: "We don't have enough hours in the day. There is only 24; we need maybe 30 hours to get everything that we want to pack into a day, in order to get them all done. We don't have ... that time."

Participants mentioned that they sometimes did not engage in physical activity because it was not easily accessible or too costly. Some felt that indoor facilities for physical activity after school and on weekends were limited. For example, some participants said that an indoor basketball facility was located too far away to access quickly. During a cold winter, some participants stayed home instead of doing physical activity outside or going to an indoor facility. Also, the cost of participating in specific physical activities was a deterrent. They mentioned costs related to registering in sports, using facilities, and attending tournaments. Sometimes, they chose to participate in a particular physical activity, such as playing street hockey versus playing in a hockey league, based on what they could afford.

Suggestions to Increase Participation in Physical Activity

Participants provided several suggestions about what can be done in the community to increase physical activity among adolescents. First, they said that physical activity needs to be presented more as an appealing activity for youth. They felt that successful athletes in the community are role models and, therefore, strategies should be used to have these role models discuss the benefits of being physically active.

Second, participants suggested that an environment more supportive of physical activity was needed. For example, they suggested that more opportunities to participate in physical activity in school be provided. This included increasing opportunities to participate in intramural and field trip activities. Also, they suggested that physical education in schools should be mandatory.

Active participants said that having facilities close to where they live enabled them to be physically active more often. These included a basketball court, a park, and recreation centers. Inactive participants pointed out that available facilities need improvements. For example, one commented that transportation to accessible facilities where organized sports are offered and better-paved areas for activities such as basketball and street hockey are needed. Some recommended more organized physical activity programs and easier registration for programs. Both active and inactive participants said that better equipment was needed and that reduced program fees would increase their participation.

In order to understand the reasons why adolescent boys participate (or not) in physical activity, and the factors that make participation difficult, the context of their lives needs to be considered. Most adolescent males struggle with issues of identity formation, maturation, and "rites of passage," i.e., getting a driver's license, dating, academics, and planning for the future (Clausen, 1986). These issues form the backdrop for their experiences and help us to understand some of the factors they discussed in the focus groups.

Reasons for Participating

The study participants placed more emphasis on extrinsic rather than intrinsic reasons. Yet, for some participants, the inherent physicality of participation, along with the risk of injury, suggest that some adolescent males are challenged by these issues. This theme, evident in much of the literature on male adolescent sport and physical activity (Drummond, 2001; Gard & Meyenn, 2000; Laitinen & Tiihonen, 1990; Light & Kirk, 2000; Sisjord, 1997) may relate, in part, to the notion that masculinity is developed and confirmed by overcoming the risks and fears associated with pursuits such as skateboarding. These attempts and accomplishments appear to satisfy internal needs, as well as the need to impress others. Thus, the themes of physicality and challenge span both intrinsic and extrinsic reasons for participating.

While some participants acknowledged the importance of enjoyment as a reason for engaging in physical activity, more extrinsic reasons predominated; physical activity was described as having considerable instrumental value, particularly as it contributed to the "presentation of self" (Goffman, 1959) in negotiating relationships with others--spending time with friends, meeting new people, impressing others, and building relationships (including the opposite sex).

In addition to the social capital physical activity appeared to offer in fostering relationships, it provided a direct benefit by contributing to physical appearance through increased fitness, strength, and weight control. This focus on the appearance of their bodies, particularly in relation to developing relationships with females, also represents and confirms a central concern of adolescent males during this stage of the life course (Clausen, 1986).

Finally, the findings related to reasons for participating in physical activity underscore its instrumental value in providing a positive means of enhancing psychological health and dealing with various sources of stress. While previous quantitative studies of the relationship between physical activity and psychological health have produced mixed results (Brown & Siegel, 1988; Norris, Carroll, & Cochrane, 1992; Steptoe & Butler, 1996), the theoretical appeal of a stress-coping framework is compelling. Interestingly, findings from the present study emphasize the role of physical activity as a diversion or distraction from events or problems that give rise to stress. While not dealing with changing the underlying sources of stress, physical activity is generally considered to be a more positive, "healthier," diversionary coping response as compared to other responses, such as watching TV, listening to music, or drinking.

Barriers to Physical Activity

Discussions in the focus groups revealed that some boys consider physical limitations as barriers to physical activity. For some boys, a concern with how their bodies look to others causes them to avoid participation. This perception may be based partly on individual differences in growth, development, and maturation during adolescence, a situation which will at least partly resolve itself over time. Yet, the expression of self-consciousness, lack of confidence, and awareness of the opinion of others relate largely to the appearance and functioning of their bodies. As noted earlier, much of the literature dealing with boys' participation in sport and physical activity emphasizes its role in developing and confirming masculinity (Drummond, 2001; Laitinen & Tiihonen, 1990; Sisjord, 1997). If they perform well, their sense of self-identity is enhanced, while a lack of success results in further fear of failure. This reciprocal and dynamic relationship between individual and environmental factors related to health behavior is conceptually linked to Social Cognitive Theory and the notion of self-efficacy, found to be a consistent predictor of physical activity among adolescents (Allison, Dwyer, & Makin, 1999a).

It is not surprising that some focus group participants mentioned that they, or their parents, gave academic subjects priority over structured school-based physical activity. This may be particularly true for students aspiring to post-secondary education. In a recent study examining teachers' perceived barriers to implementing a physical and health education curriculum in schools, parents' academic priorities were prominent even in elementary schools (Dwyer et al., 2003). The underlying roots of this position may be based on more structural decisions by government which emphasize accountability, such as the requirement for standardized academic testing instituted in Ontario by the Ministry of Education.

The realm of personal barriers to physical activity participation also relates to their use of such time-consuming pursuits as television watching and computer and internet use. Participants portrayed a situation in which the time spent on these pursuits greatly diminished the time available for physical activity. Interestingly, Canadian government guidelines for physical activity for children and youth call for a decrease in the time spent viewing TV, playing computer games, and surfing the internet (Health Canada, 2002). Corresponding policy discussions of these activities tend to take on a moral tone, emphasizing issues of escapism and time wasted, yet the literature examining the relationship between these pursuits and physical activity participation is inconclusive (Robinson & Killen, 1995).

External barriers mentioned included the influence of peers and family. Some participants emphasized the importance of friends on their involvement. Moreover, parents were sometimes seen as a negative influence on their participation, particularly in relation to issues of safety. Thus, autonomous, self-directed behavior was not emphasized by the participants. The literature dealing with health-related behavior among youth supports the importance of peers in both the onset and continuation of specific behaviors (Zakarian et al., 1994).

Role overload appears to characterize much of the experience of the boys participating in the focus groups. Homework, part-time work, relationships, and home responsibilities represent large time commitments, making the likelihood of participating in physical activity slim or impossible. As if in preparation for adult life, the experience of role overload among these adolescent boys causes them to feel frustrated and rushed.

The final external barrier mentioned related to issues of inaccessibility. Such structural determinants as the cost of, and access to, facilities and programs were said to make physical activity difficult for some. In combination with other recent studies (Fein, Plotnikoff, Wild, & Spence, 2004; Sallis et al., 2001), these findings provide further impetus for the need to closely examine the influence of the physical and social environments on physical activity.

One limitation of this study is that two focus groups contained both active and inactive boys. The original design called for these groups to be separate, but recruitment of sufficient numbers of inactive boys was problematic. Thus, it was not possible to analyze the results separately by activity level. Another limitation relates to the relatively small number of individuals (26) in the four focus groups and their status as volunteers in the study, limiting the generalizability of the findings beyond this specific setting.

This study represents one component of a more comprehensive study of barriers to physical activity for Canadian youth. Thus, the findings have been used to inform other study components, including a national survey of youths age 13-18, and in-depth interviews conducted with inactive adolescents. In addition, the findings are important in their own right, providing further insight into reasons for participation, barriers to participation, and recommended changes to enhance physical activity among boys.

Financial support for this study was provided through a grant (#828-19991040) from the Social Sciences and Humanities Research Council of Canada. During the period of this study Dr. Kenneth Allison was supported by a Career Scientist award provided by the Ontario Ministry of Health and Long Term Care. The authors thank Audrey Campbell, Sandy FitzGibbon, Valerie Gauer, Carmen James-Henry, Irene Kassies, Sandra MacMillan, Sari Simkins, and Voula Varsamidou from the city of Toronto Public Health for their contribution in organizing the focus group sessions, and Paul Spanier for contributing to the literature review.

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John J. M. Dwyer, Ph.D., Department of Family Relations and Applied Nutrition, College of Social and Applied Human Sciences, University of Guelph, Guelph, Ontario, and Public Health Research, Education and Development Program, Program Policy and Planning Division, Public Health and Community Services Department, Hamilton, Ontario.

Ellie Goldenberg, MPH, Department of Public Health Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario.

Allan Fein, MSc, Department of Exercise Sciences, Faculty of Physical Education and Health, University of Toronto, Toronto, Ontario.

Karen K. Yoshida, Ph.D., Graduate Departments of Physical Therapy and Rehabilitation Sciences, University of Toronto, Toronto, Ontario.

Marie Boutilier, Ph.D., Centre for Research in Women's Health, University of Toronto, Toronto, Ontario.

Requests for reprints should be addressed to Dr. Kenneth Allison, Associate Professor, Department of Public Health Sciences, Faculty of Medicine, University of Toronto, McMurrich Building, Room 109B, 12 Queen's Park Crescent, Toronto, ON M5S 1A8. E-mail: k.allison@utoronto.ca