Development of a conceptual model to support participation of young people with limb difference in Australian sports and recreation.

The primary objectives of this study were to 1) investigate the participation experiences of young people with limb difference (and their parents) in Australia, and 2) develop a conceptual model to guide support of participation in sports and recreation. 

This qualitative study, designed by a team of multi-disciplinary researchers, clinicians and people with lived experience, used an interpretive description approach and involved nine Australian parent-child dyads. All parents were mothers (n=9), and young people (female n=3, male n=5, gender queer n=1) were aged between 9-16 years (mean 14y1m). Two had bilateral limb differences (upper limb n=1, lower limb n=1); seven had unilateral limb differences (upper limb n=2, lower limb n = 5). Data were collected via 18 semi-structured interviews and analysed inductively, including mapping of barriers and facilitators to the socio-ecological model, and development of a conceptual model.

The conceptual model, titled “Moving through childhood: Participation supports for young people with limb difference” was developed to guide clinicians, coaches, families and policy makers in enhancing sports and recreation participation. This conceptual model is supported by three interpreted themes. Theme 1) "Just treat me like everyone else": equitable participation in sports and recreation describes how expectations of young people’s sports performance should be equal to that of their peers without limb difference, and how subtle, individualised support provided by coaches is key. Theme 2) "Provide them opportunities and let them take the lead": genuine choice within sports and recreation activities describes how participants viewed genuine choice as consisting of availability and accessibility of opportunities, and how agency of the young person influenced activity selection. Theme 3) "I wish they were easier to get":the impact of sports-specific prostheses on participation describes how equitable participation and genuine choice is facilitated by timely access to sports-specific prostheses. 

Within this study young people with limb difference, and their parents, describe a need for equitable participation and choice in sports and recreation. This study also demonstrates that barriers and facilitators for young people with limb difference exist at all levels of the socio-ecological model. Future work may look at developing specific strategies to support participation at the individual, interpersonal, community and social levels. Furthermore, the conceptual model can now be implemented by clinicians, families and policymakers, and evaluation is recommended.