1. Introduction

Sedentary lifestyles and obesity among children are major public health problems globally, despite the immense health benefits physical activity offers [1]. In the UK, one in six deaths is related to physical inactivity and is estimated to cost the NHS about £0.9 billion and the whole of the UK about £7.4 billion annually [2]. Regulatory guidelines recommend children and adolescents between the ages of 5 and 17 years old accumulate at least an average of 60 minutes per day of moderate-to-vigorous, mostly aerobic, physical activity (PA) [3]. However, children and young adults between the ages of 10 and 24 years constitute 24% of the world’s population, of which 80% of children are not adequately active, spending over two hours daily on sedentary related activities [4]. In England, only 44.6% of children and young people between school years 1–11 (ages 5–16) achieved the Chief Medical Officers’ PA guideline of 60 minutes per day from 2020 to 2021 [5]. Similarly, almost a quarter of children aged 4–5 years starting primary school are already overweight [6]. These figures are higher for ethnic minority groups [7].

According to Love et al. [8], some of the huge disparity and inequality that exists in the amount of vigorous activity achieved by children is accrued along socioeconomic and ethnic lines. In contrast, others attribute insufficient PA or a sedentary lifestyle to rapid economic development, such as improved means of transportation [9], as well as proliferation and ease of access to technological gadgets increasing screen time viewings on laptops, televisions, phones, and other electronic devices, resulting in higher levels of physical inactivity and lower energy expenditure [10]. Furthermore, factors suggested as barriers to PA uptake in children from ethnic minority groups are parental behaviours, as most parents of ethnic minority origin have lower educational and income status and so might not know the importance of PA or have the time to take the children to PA-related activities [11,12]. This is further compounded by the fact that some parents overestimate the level of PA achieved by children [13].

Physical inactivity is a risk factor for global diseases such as colon cancer, type II diabetes, breast cancer, and cardiovascular diseases [14]. Adults and children from ethnic minority groups, when compared to the general population, have a higher incidence of physical inactivity-related diseases such as type II diabetes, cardiovascular diseases and colon cancer [15]. Available evidence suggests South Asians are 1.5 times more at risk of stroke and 9.0% vs 3.9% at risk of diabetes compared to white British individuals [16], while Afro-Caribbeans are 2.5 times more at risk of stroke compared to the total population [17]. The issue of physical inactivity amongst ethnic minority groups has been prevalent for years and is thus a public health concern [18] and neglecting to address the challenge it poses would place a higher burden on government resources as it is estimated that the NHS spent £6.1 billion on obesity-related illness in 2014/15 alone [19]. To address this public health concern, there is a need to focus PA interventions on children at an earlier age to develop and encourage life-long PA behaviours [20]. Evidence from a study conducted in Australia [21] revealed that the decline in sports and PA participation begins as early as the age of eight. Similarly, the age of decline in PA is the same for children in the UK [22]. Therefore, interventions should target young children, before the steep decline in PA and sports is observed, so that adequate PA levels are maintained [23].

Information on barriers and motivators to participation in PA in children has mostly come from parents and teachers. However, there is a need to incorporate the voices, experiences, and perceptions of children themselves, especially children from ethnic minority groups, in research and health promotion. It is important to show respectful regard for and recognition of children as active participants who have interest and capacity to discuss and impact decisions that pertain to them [24]. Controversy in the past has disputed the need for children’s voices in studies; however, the search for children’s perspectives through their inputs is a search for reality and authenticity [25]. This is one of the only means by which we can genuinely learn about a person’s (children in this instance) lived experience and fundamental nature, plus it reflects their truth, hence the value of the involvement of children in studies [26]. However, children are largely excluded from studies and interventions that pertain to them [27].

Applying the Ottawa Charter’s five-action health promotion framework has been shown to be effective as it conveys the core values of equity, participation, and empowerment [28]. Crucially, the charter suggests that programmes and interventions should be customised to the needs of participants who will be taking delivery of them, so they should include detailed planning that involves stakeholders in a needs assessment as well as implementation and evaluation [29]. Unfortunately, as we have seen, health promotion design and studies targeted at increasing children’s PA levels are largely devoid of children’s voices [30]. Also, PA research studies of children between the ages of 8 and 14 years in school settings in high-income countries are few and poorly implemented [4], while children and adolescents from ethnic minority groups receive relatively little attention [31]. Studies are further compounded by the fact that most parents overestimate the level of PA of their children [13].

Therefore, the purpose of this qualitative study was to (i) identify the perceived barriers and motivators to PA of children from ethnic minority groups and white British children in Newcastle upon Tyne, and (ii) explore any similarities or differences in the perceived barriers and motivators to PA among the children, using semi-structured interviewing and inductive thematic analysis.

2. Materials and methods

2.1. Participants

Participants were recruited from December 2022 to March 2023 through a purposive sampling approach from schools with diverse cultural and socioeconomic qualities in Newcastle upon Tyne, UK. A total of 25 schools were approached with a letter containing the study information. Schools that indicated a diverse representation of children from different ethnic minority groups were selected. Two schools consented to participate. Subsequently, the study was advertised to children between the ages of 8 and 11 years old through classroom presentations conducted by the first author and the physical education (PE) teacher. Participants were included if they were fluent in English. A total of 50 children indicated interest and they were given an information sheet and consent form to be signed by their parents/guardians.

Twenty children returned signed consent forms and participated in the study. In this study, participants were grouped into two groups based on self-reported ethnicity: ethnic minority groups and white British children, in line with the UK government recommended terminology. The demographics and self-reported ethnicities of the participants are shown in Table 1.

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Table 1. Description of participants.

https://doi.org/10.1371/journal.pone.0324781.t001

3. Results

3.1. Themes

A total of three barriers and a total of eight motivators were inductively identified for both children from ethnic minority groups and white British children (Table 2).

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Table 2. Themes: Barriers and motivators.

https://doi.org/10.1371/journal.pone.0324781.t002

4. Discussion

Through a series of interviews with children, this study sought to investigate (i) the perceived barriers and motivators to PA participation amongst children from ethnic minority groups and white British children in Newcastle upon Tyne, and (ii) any similarities or differences in the perceived barriers and motivators to PA among the children. The findings suggest barriers and motivators occur at different levels, from the individual themselves to external influences beyond their control. This brings to the fore Urie Bronfenbrenner’s socio-ecological theory.

The socio-ecological theory contributes significantly to the theoretical understandings of PA behaviour in children [42]. It identifies the different levels or factors that could impact PA participation in children, including children from ethnic minority groups, which includes the intrapersonal level (self-autonomy, self-confidence, enjoyment of PA and wellbeing), the interpersonal level (parents, friends, family and teachers), and the institution (schools, introduction of a variety of sports). Understanding the PA behaviour of children from ethnic minority groups and/or developing a PA intervention could therefore be guided by the socio-ecological model [43].

At an intrapersonal level, the outcomes from the current study suggested a lot of the children are knowledgeable about PA and sports and the benefits they present. However, when asked about activities performed during their leisure time, white British children appeared to be more intentional in their PA behaviours, showed skills and exuded confidence in skills they had mastered over time. The white British children had goals, and some sought to improve on their competence irrespective of their perceived ability, having planned activities such as going for walks, playing football and playing on the trampoline. In contrast, some of the children from ethnic minority groups were motivated by playing with siblings while others outlined sedentary activities such as watching movies and playing in their rooms or were simply not allowed to go out to play. These findings are consistent with the discussion of Wigfield et al. [44] that there exist differences in how children and adolescents achieve motivation in pursuit of their PA-related tasks. Some children pursue tasks with great persistence whilst others avoid them. Such observations exist along gender, cultural and ethnic differences.

Researching motivation and how it can be applied to any aspect of PA in children and adolescents is crucial to understanding differences in behavioural, cognitive, and emotional participation; some children exhibit higher levels of engagement while others display boredom, lack of interest, or completely withdraw [45]. Six out of the 20 children in this study (PT01, PT05, PT10, PT12 and PT13, white British; PT06, ethnic minority group) clearly showed initiative and self-motivation in being active and did not need much external prompting. However, child PT04 from an ethnic minority group said, ‘but I don’t do a lot of activities outside of school’ despite the benefits she experiences from being active: ‘It helps me get… rid of like if I have anything on my mind.’

The children were asked to make suggestions about how to improve the PA experience and to list barriers and motivators to PA participation. Nine of them (PT02, PT08, PT10, PT11, PT14, PT15 and PT16, white British; PT06 and PT09, ethnic minority groups) suggested the introduction of a variety of sports as an important factor. This was because it translated into enjoyment of PA and wellbeing for most of them. Available evidence over time suggests there is a positive correlation between children’s level of enjoyment and participating in PE or PA [46]. The higher the level of enjoyment of a particular sport a child experiences, the higher the level of participation in PE and PA [47]. Furthermore, enjoyment of PA and PE may be key to long-term motivation, as children who enjoy PA are likely to adopt a physically active lifestyle [48]. The findings of the current study demonstrate the importance of enjoyment as a motivational factor for PA in children from ethnic minority groups. It is therefore crucial to incorporate it into future interventions, recommendations and guidelines. The possibility of tailoring opportunities to the children’s needs, interests and social environment, allowing for choice, might motivate them and increase participation in PA [49,50].

The next level of influence in the socio-ecological model is the interpersonal level. The interpersonal level concerns the relationships closest to the individual, which exert the most influence on them. These include parents, friends, teachers, siblings and other members of the family [51]. The white British children performed some of their activities with their parents which suggests a deliberate act on the part of the parents, thus suggesting parental awareness and support for PA, unlike some children from ethnic minority groups [52]. This could be as a result of differences in culture, and how parents from ethnic minority groups perceive PA, its purpose and correlated benefits [53]. Parents play a very crucial role in PA uptake in children and adolescents [54]. Furthermore, the feedback from this study highlights the fact that children, as individuals or groups, experienced differences in barriers and motivators unique to them; there is therefore a need to consider these factors in the context in which they occur, based on how they impact decisions to be physically active, if we are to effectively motivate and promote PA behavioural change in children [55]. These factors include but are not limited to social support, PA attitude, negative feelings when active as a result of previous PA experience, and extrinsic barriers such as household responsibilities and limited access to playground or sports equipment at home [56]. Finally, playing with friends, which was one of the important motivating factors, should be taken into account in the design and implementation of PA interventions, as data suggest that greater self-consciousness and peer pressure begin to develop from the age of 6 years [57]. Evidence suggests children would perform better if they had positive feedback from their social circle, however, negative feedback from their social circle will affect their esteem, thus negatively impacting their PA motivation and experience [58]. This is consistent with Harter’s competence motivation theory which suggests perception of competence is correlated to children’s participation in PA [59,60].

Returning to the socio-ecological model, the next level of influence is the institution level (school), within which we have included the role of the teacher. The school environment is crucial in the PA levels of children. This is because children and adolescents spend most of their waking time at school [61], and therefore a large proportion of PA occurs in the school environment. School PA participation also addressed most of the PA barriers experienced by children from ethnic minority groups, such as parental and household responsibilities, lack of sporting equipment and lack of a conducive sporting environment at home.

The role of the PE teacher and the school in establishing a positive PE and PA experience can significantly influence children to choose a healthy, active lifestyle [62]. Furthermore, responsibility for the introduction of gender balance in organised sports – a suggestion made by the children in this study – might also fall on teachers. While some of the children from ethnic minority groups complained of negative feedback from their teammates during PA activities, having a knowledgeable teacher or PE teacher with a grounding in motivational theories can make all the difference as one of the students (PT20, ethnic minority group) reported the positive impact the PE teacher’s motivational statement had on them and how most of them had become more interested in team sports.

Finally, at a community/policy level, the introduction of free local sports opportunities for all children to increase their PA engagement would be valuable as financial resources may also be a barrier [63].

The current study is one of the few studies of PA participation that focuses on children from diverse ethnic backgrounds in the UK. Future research addressing inclusion and low PA uptake in children from ethnic minority groups should consider these findings, for example by acknowledging the importance of enjoyment and choice in addition to introducing exercise as a generic recommendation or intervention, and by acknowledging the potential differences in social factors. In terms of the practical implications of the findings, it is critical to provide a leeway for tailoring generic PA interventions to address specific needs of children from ethnic minority groups to address the variances in barriers and motivators associated with the levels of the socio-ecological model [64]. This includes consideration at the community/policy level, which may be challenging due to the likely need for governmental funding to support the design and delivery of PA initiatives which address factors such as children’s self-motivation for PA participation as well as offering opportunities for varied and enjoyable PA. However, given the public health benefits of children’s participation in PA, including the potential long-term cost savings for the NHS, this is certainly a possibility that policymakers may wish to explore. Initial teacher training programmes and continuing professional development activities may also be extended to further upskill teachers in facilitating positive school-based PA experiences to promote children’s long-term PA participation.

Acknowledgments

We would like to acknowledge and thank all the children, parents and schools who consented to be a part of this study. I would also like to thank my colleague, Dr Kandianos Emmanuel Sakalidis. His guidance and support in the data analysis is much appreciated.