Barriers to physical activity among adolescents with asthma and obesity: a qualitative study of multiple stakeholders

Adolescents living with both asthma and obesity face distinctive challenges to physical activity. Evidence that integrates the perspectives of adolescents, families, schools, and healthcare providers remains limited.

This study aimed to explore the barriers to physical activity faced by adolescents with concurrent obesity and asthma, and to understand the perceptions of patients, families, PE teachers, and healthcare providers regarding these challenges.

A qualitative study was conducted with semi-structured interviews of 15 adolescents (12 to 18 years) and focus group discussions with 36 stakeholders (12 parents, 8 physical education teachers, and 16 healthcare providers). Data were analyzed inductively using thematic analysis in NVivo.

Four themes were identified: (1) psychological and social barriers to physical activity (self-efficacy and identity struggles; social acceptance barriers); (2) family and school barriers to physical activity (family support dilemmas; school policy limitations); (3) community and tech adaptation gaps (barriers to community resource access; digital tool personalization gaps); and (4) collaborative support solutions (personalized activity plans; stakeholder collaboration needs).

Barriers operate at intrapersonal, interpersonal, institutional, and community or technology levels. Co-designed and individualized activity plans and coordinated communication among families, schools, and healthcare may enhance participation. Existing digital tools require health-sensitive personalization and safety features to support adolescents with asthma and obesity.