Understanding the Barriers and Enablers to Sporting Activity in Relation to Bone Health: A Qualitative Narrative Study among Adolescents andYoung Adults in New Zealand

Abstract

Background: Sports participation may be considered a method of reducing the risk of fragility fracture in later life by maximizing Peak Bone Mass (PBM) in the growing years. However, sports participation typically declines during late adolescence and adulthood. This qualitative study aims to identify barriers and facilitators to engaging with regular weight bearing sporting activity in adolescents and young adults in New Zealand. Methods: 44 adolescents and young adults aged 17 to 33 participated in nine focus groups. The study was conducted using a semi-structured approach with open-ended questions and prompts. Transcripts were thematically coded using an inductive content analysis approach. Results: The three main barriers to sports participation that emerged were a) structural (disorientation in a new living environment, facilities, access to healthcare), b) social (financial and time constraints) and c) personal (social pressures and lack of an understanding of why sporting activity matters for bone health) while enablers of sports participation included a) supportive environments, b) access to health checks including support to avoid injury and c) education to better understand benefits of recreational sporting activity. Conclusions: Current awareness of osteoporosis and lifestyle factors that impact PBM is limited. Educational interventions are now warranted and urgently required.