Identifying Barriers and Facilitators to Physical Activity Participation Among Adolescents With CKD: A Qualitative...

Physical activity enhances health and wellbeing; however, fewer than 15% of adolescents with chronic kidney disease (CKD) meet physical activity recommendations. Developing interventions to increase physical activity requires identifying CKD-specific barriers and facilitators to physical activity. Digital tools have shown potential to increase physical activity in other chronic disease populations but have not been applied to interventions for children with CKD. This study sought to identify the barriers and facilitators to physical activity experienced by adolescents with CKD and to identify how digital tools can be used to promote physical activity to this population in a relevant and acceptable way.

A qualitative study using semi-structured interviews.

Twelve adolescents with CKD stages 2-5 not receiving kidney replacement therapy, and 8 of their caregivers, from a quaternary care pediatric hospital.

Interviews were audio-recorded, transcribed, and evaluated using thematic analysis.

Adolescents' median age was 16 years (IQR range = 13.5-17) with a median CKD duration of 10.5 years (IQR:3.5-13). Social relationships were the primary domain elicited for facilitating physical activity. Fatigue and lack of time related to school obligations were the primary barriers. Adolescent and caregiver participants expressed concerns that physical activity could negatively impact kidney health, which led some adolescents to adjust or limit sports' participation. To promote physical activity, participants thought that wearing a physical activity tracker and earning financial incentives and rewards would be helpful.

Response bias, most participants lived in suburban neighborhoods, and exclusion of non-English speaking participants.

Social engagement was a primary facilitator to physical activity, whereas fatigue and schoolwork were primary barriers. These findings reveal potential specific targets to guide the development of a digital intervention, tailored to adolescents with CKD, to promote physical activity and improve their health-related outcomes.