Psychosocial factors underlying physical activity

BACKGROUND Given the increasing importance of obesity in China, prevention interventions encouraging physical activity by middle school students are needed. The purpose of this study is to illustrate how a rapid elicitation method can be used to identify salient consequences, referents, and circumstances about physical activity as perceived by middle school students and to provide suggestions for interventions and quantitative research. METHOD A theory-based qualitative study using a self-completion elicitation was conducted with 155 students from two middle schools in Beijing, China. Following the Theory of Planned Behavior, six open-ended questions asked students for their perceptions about performing physical activity at least 60 minutes each day: advantages of participating in physical activity; disadvantages of doing so; people who approve of participation; people who disapprove; things that make it easy; and things that make it hard. Content analysis revealed categories of salient consequences, reference groups, and circumstances. RESULTS While the three most frequently mentioned advantages elicited from the students were physical health consequences (e.g., will strengthen my body (58.7%)), four of the salient advantages were not (e.g., will improve my grades (12.2%)). Parents were the most frequently mentioned social referent (42.6% as approving; 27.7% as disapproving) when students were asked who might approve or disapprove of their participation. Circumstances perceived to hinder daily physical activity included having too many assignments and not having enough time. CONCLUSION While many of the beliefs about physical activity elicited from this study were similar to those found with students from England and the US, several were unique to these students from Beijing. The results of this qualitative research suggest that interventions to encourage physical activity among middle school students should address: perceived consequences of physical activity on academic achievement and other factors beyond physical health; barriers of not having enough time and having too many assignments perceived to hinder frequent physical activity; and parental approval. More rigorous research on psychosocial determinants with close-ended items developed from these open-ended data and with larger sample sizes of students is necessary. Research with parents and school staff will be needed to understand the perceptions of these stakeholder groups key to creating the students' social environment.