â????They donâ????t see it as priority if the kidâ????s not sportyâ??: Parentsâ???? perceptions of clinic communication around physical activity to children with type 1 diabetes and their families

Background: The aim of the study was to understand parent’s perceptions of the way in which information about physical activity (PA) is communicated to families by healthcare professionals, and gather their views on the use of digital resources for physical activity promotion to inform the design of future supportive interventions. Methods: Data were collected through semi-structured interviews with 11 parents (8 mothers, 3 fathers) who had a child with Type 1 diabetes (T1D). Interviews were recorded, transcribed verbatim and data were analysed using thematic analysis. Results: Perceptions of PA, communication about PA, and the use of digital resources about PA were grouped into 8 overarching themes with 18 sub-themes: (1) Benefits and challenges of PA with T1D; (2) Parental need for more guidance around PA; (3) influence of individual differences on PA communication - relating to i) child’s ‘sportiness’ and ii) healthcare professional’s own PA level; (4) challenges of information-seeking; (5) importance of message pitching, framing and timing; (6) scarcity of digital resources around PA; (7) digital resources as facilitators to PA; (8) challenges for access to, and engagement with digital resources. Conclusion: Parents perceive PA to be important for children with T1D, but raise challenges to managing PA alongside the condition. They report variation in the way in which PA is communicated according to prior activity level of the child, and healthcare professionals’ own interest in exercise. Parents would prefer to receive more information from clinical teams, provided earlier after diagnosis to reduce the burden of information seeking. They express positive views towards the potential of digital resources in diabetes care, although perceive there to be a lack of ‘trusted’ age-appropriate digital resources for PA promotion in children with T1D.