Barriers and enablers to physical activity in type 1 diabetes: A mixed-methods study of adults and parent-reported child perspectives in the UK

IF 3.3 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Diabetic Medicine Pub Date : 2026-10-07 Epub Date: 2026-06-19 DOI:10.1111/dme.70378

Emma J. Cockcroft, Chris Bright, Hilary Nathan, Dan Farrow, Catherine Russon, Richard M. Pulsford, Robert. C. Andrews

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引用次数: 0

Abstract

Aims

To identify and compare barriers and enablers influencing physical activity in adults and parent-proxy responses for children with type 1 diabetes in the UK.

Methods

A cross sectional survey was distributed via BreakthroughT1D (formerly JDRF) networks between December 2022 and January 2023. The survey included closed and open-ended questions on physical activity behaviours and influencing factors. Responses were collected from adults with type 1 diabetes and parent-proxy responses for children with type 1 diabetes. Quantitative data were analysed using descriptive statistics and two-proportion z-tests. Free-text responses were analysed thematically. Barriers and enablers were synthesised using the COM-B model and socioecological framework to identify behavioural determinants and intervention targets.

Results

311 responses were analysed (182 adults; 129 parent proxies for children). Stigma and negative comments were reported by nearly three-quarters of both groups. Adults more frequently reported clinical and motivational barriers: fear of hypoglycaemia (53%) and lack of motivation (39%). Adults reported significantly less healthcare provider support for physical activity (24%) compared with parent-proxy responses for children (57%). Parent-proxy responses for children more frequently reported external barriers, including lack of education among coaches (31%).

Conclusion

This is one of the first UK-based studies to comprehensively compare barriers and enablers across age groups. Stigma in physical activity and sports settings emerges as a major, under-recognised barrier requiring urgent attention. Multilevel interventions are required, targeting individual knowledge and motivation alongside systemic changes. These should include mandatory diabetes education for coaches and teachers, policy enforcement to address discrimination and enhanced healthcare provider support for physical activity.

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1型糖尿病患者身体活动的障碍和促进因素：英国成人和家长报告的儿童观点的混合方法研究

目的：确定并比较英国成人和儿童1型糖尿病患者父母代理反应中影响身体活动的障碍和促进因素。方法：在2022年12月至2023年1月期间，通过BreakthroughT1D（原JDRF）网络进行横断面调查。该调查包括关于体育活动行为和影响因素的封闭式和开放式问题。收集了成人1型糖尿病患者的反馈和儿童1型糖尿病患者的家长代理反馈。定量资料采用描述性统计和双比例z检验进行分析。对自由文本回复进行主题分析。使用COM-B模型和社会生态框架综合障碍和促进因素，以确定行为决定因素和干预目标。结果：分析了311份回复（182名成人；129名家长代表儿童）。这两个群体中都有近四分之三的人表示有过耻辱和负面评论。成年人更频繁地报告临床和动机障碍：害怕低血糖（53%）和缺乏动力（39%）。成人报告的医疗保健提供者对体育活动的支持（24%）明显低于儿童的家长代理回应（57%）。家长代理对儿童的回应更多地报告了外部障碍，包括教练缺乏教育（31%）。结论：这是英国第一个全面比较跨年龄组障碍和促进因素的研究之一。身体活动和运动环境中的耻辱感成为需要紧急关注的主要、未得到充分认识的障碍。需要多层次的干预措施，针对个人的知识和动机以及系统的变化。这些措施应包括对教练和教师进行强制性的糖尿病教育，执行政策以解决歧视问题，并加强医疗保健提供者对体育活动的支持。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetic Medicine 医学-内分泌学与代谢

CiteScore

7.20

自引率

5.70%

发文量

229

审稿时长

3-6 weeks

期刊介绍： Diabetic Medicine, the official journal of Diabetes UK, is published monthly simultaneously, in print and online editions. The journal publishes a range of key information on all clinical aspects of diabetes mellitus, ranging from human genetic studies through clinical physiology and trials to diabetes epidemiology. We do not publish original animal or cell culture studies unless they are part of a study of clinical diabetes involving humans. Categories of publication include research articles, reviews, editorials, commentaries, and correspondence. All material is peer-reviewed. We aim to disseminate knowledge about diabetes research with the goal of improving the management of people with diabetes. The journal therefore seeks to provide a forum for the exchange of ideas between clinicians and researchers worldwide. Topics covered are of importance to all healthcare professionals working with people with diabetes, whether in primary care or specialist services. Surplus generated from the sale of Diabetic Medicine is used by Diabetes UK to know diabetes better and fight diabetes more effectively on behalf of all people affected by and at risk of diabetes as well as their families and carers.”