Using Participatory Action Research to Examine Barriers and Facilitators to Physical Activity Among Rural Adolescents with Cerebral Palsy

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Disability and Rehabilitation






Purpose: The purpose of this study was to use a qualitative, community-based participatory action research method – Photovoice – to identify perceived facilitators and barriers to physical activity among adolescents with cerebral palsy (CP) in a rural community.

Materials and methods: Fifteen participants including adolescents with CP (n = 7) and parents (n = 8) were included in this study. The researchers followed the nine-step methodology recommended for Photovoice. During the training session, participants completed versions of the Barriers to Physical Activity Questionnaire for People with Mobility Impairments. This questionnaire was used to generate descriptive information about participant barriers and facilitators. Participants were given 14 days to take photographs after which researchers used in-depth and focus group interviews structured by the SHOWeD method. Content analysis of transcripts was used to identify common themes.

Results and conclusions: Photographs and accompanying text were presented to local stakeholders and an action plan to increase physical activity for adolescents with CP was created. Perceived barriers included lack of inclusiveness, family isolation, and limited accessibility of equipment and resources. Facilitators included support services for families and adaptive sport leagues. Photovoice serves as a powerful tool to initiate change to promote physical activity among rural adolescents with CP.

  • Implications for rehabilitation
  • Adolescents with cerebral palsy living in rural areas face unique barriers to physical activity.

  • Accessibility of equipment and the structural environment can serve as barriers to participation.

  • Lack of accessibility can lead to feelings of isolation.

  • Families need support services outside of rehabilitation settings to support physical activity for their children and overcome potential barriers.