This study aimed to map available literature on the factors that influence the behaviors of primary carers, teachers and school administrators toward promotion of active lifestyle among CWD.
A scoping review was conducted following the PRISMA-Scoping Review guidelines. Potentially relevant studies published in the English language from 01 February 2012 to 30 June 2023 were identified through the PubMed database. Studies must have explored the capabilities, opportunities, and motivations of primary carers, teachers and school administrators regarding active lifestyle promotion in CWD aged 5 to 17 years. No restrictions as to study design were set and ancestral searching was done to identify other relevant studies. Two researchers independently performed title, abstract, full-text screening, and data charting. Data were organized and analyzed using the Capability, Opportunity, and Motivation model of Behavior (COM-B).
Forty-five studies were included in the review. Most studies employed qualitative research designs and explored perceptions of primary carers from high-income countries. Few studies involved teachers and none involved school administrators. All studies explored aspects of physical activity promotion while only five explored sedentary behavior. The most commonly studied domains and factors based on the COM-B model were Opportunity, specifically physical opportunities (n=42; 93%) and social opportunities (n=38; 84%), and Capability, specifically psychological capability (n=28; 62%). Inclusivity and physical accessibility of resources, costs, and environmental features may facilitate or hinder physical activity promotion. Having adequate knowledge, skills, and capacity (physical, mental, emotional) were facilitative to promoting physical activity among CWD. Beliefs, recognition of role, emotions, and desire to help CWD were noted to influence motivation towards physical activity promotion.
Behaviors of primary carers and educators toward promotion of active lifestyle among CWD are influenced by various capabilities, opportunities, and motivations. It is crucial to consider these factors in providing a holistic approach to promoting physical activity and minimizing sedentary behavior. It is evident from the scoping review that there exist gaps in the literature. Limited studies explored behaviors around reducing sedentary behavior as well as factors that impact active lifestyle promotion at the school level and in low-resource settings.
Results of this study may be used to inform strategies at the policy, program, professional, and primary carer levels that aim to promote active lifestyle among CWD. Healthcare providers, such as physical therapists, may provide education to build knowledge, skills and capacity, and address negative beliefs of primary carers and teachers. Tailoring programs to CWD needs in terms of environmental features and interests also encourages promotion of active lifestyle. Policies that maximize opportunities and ensure accessibility and inclusivity need to be developed and implemented.
health promotion
inclusive health
