Despite the benefits of physical activity (PA), the proportion of children not meeting the current recommendations of PA is rapidly increasing in most of the developed countries, especially in the Mediterranean area
[1, 2], where the prevalence of overweight and obesity keeps growing at a very fast rate
It is well known that low levels of PA tend to persist (tracking) from childhood to adolescence and adulthood
[4–6]. In fact, PA levels usually decline through childhood and adolescence, being the peri-pubertal age a critical period of change
. School interventions in this age-group are thought as an applicable and effective way to improve PA levels, but consistent evidence about the optimal strategy to intervene is lacking
Children typically perform PA under several situations, such as structured activities at school or sport facilities, and as unstructured ones like commuting to school or “active play”. Active play can be understood as the unstructured PA that takes place outdoor during children’s leisure time. In addition to physical health benefits, active play can also improve peer relationships and shows some other psychological benefits
. Understanding children’s perceptions about barriers and facilitators for both, structured and unstructured PA, could be helpful to design intervention and policy strategies to promote PA in this age-group.
Little is known about the influence of built environment on children’s physical activity
[10–12]. The characteristics of the urban environment have been associated with various aspects of the population health
. The availability of infrastructures for leisure time, the climate of each area, distances, transport, the urban planning and configuration, and mainly access to workplaces and leisure areas, may have a deeply influence on the practice of habitual PA
[6, 14]. The urban environment in most of our modern cities does not facilitate the use of public spaces, reducing playground safety, and therefore influencing PA patterns of residents in those areas
School is the place where children are spending a great number of hours with opportunities for playing and with trained professionals who can encourage students to do PA
[8, 16, 17]. As a result, the school environment is the most suitable place to intervention programs aimed to promote the PA by increasing the playtime of children
. Inside the school, during recess children can play freely with other children without inhibitions and therefore is an adequate setting for studying spontaneous PA
The influences of social environment in the promotion of PA have received a lot of attention. Nevertheless, only a small number of studies have been focused on examining the influence of social and family relationships in the activities that children do during their leisure time
. Sharing time with classmates and/or relatives increases the active time of children and avoids sedentary behaviors
[22–26]. Recent studies show a relationship between social environment, such as collective self-efficacy and social capital, and health outcomes like obesity
The majority of studies aimed to analyze barriers and facilitators for PA in children have employed quantitative methods including neighborhood walkability scales to commuting or geographic information systems (GIS)
. Not many of these studies have examined the school environment and they have generally been focused on a quantitative measurement of sport facilities
. Likewise, there are not many studies involving qualitative research in order to know schoolchildren preferences on activities to be carried out on their free time, neither concerning children perception about their physical and social environment, and their relationship with PA
. To our knowledge very few of them have used mixed designs that combine qualitative methodology with objective measurement of PA
There is a lack of insight about the reasons of the increasing prevalence of obesity in children from Spain and other Mediterranean countries
[1, 2]. This growing prevalence parallels the increasing frequency of sedentary behavior in children and adults, something difficult to understand if we considered the number of hours of day-light and good temperature enjoyed by these countries most of the year. Therefore, we think is important to know the children’s perceptions of their school, neighborhood and social environment, but also to validate this perception with objectively measured PA.
Rationale and objectives
This study is nested within “MOVI-2” project
, that consists of two parts: 1) a cluster-randomized trial aimed to assess the effectiveness of a leisure time physical activity intervention (LTPA) in schools to reduce overweight/obesity and other cardiovascular risk factors, and 2) a mixed study aimed to know what are the children’s preferences to practice PA and how physical and social environment are influencing those preferences in a subsample of children.
The main objective of our study is to get a deep understanding of barriers, facilitators and preferences for PA of schoolchildren from Cuenca, Spain. To meet this goal we propose the following research questions:
How children perceive the physical environment for the PA the school?
How influence schoolchildren’s family and peers in the PA they do during leisure time?
Which are the schoolchildren’s playground behaviors during recess time at the school?
Is there any similarity between the children’s speeches about how they spent their leisure time and the PA they do?