Understanding how to promote physical activity among early adolescents living in Kuwait

Background and Aims

The World Health Organisation recommends at least 60 minutes of daily physical activity for children aged 13 years to 17 years old. However, 58.6% of children aged 13 to 17 years old in Kuwait engage in less than 30 minutes of physical activity daily. Almost three?quarters of female and less than half of male adolescents do not meet the recommended physical activity guidelines. This research aimed to examine the factors influencing children's ability and decision to engage in physical activity or sedentary behaviour from the perspectives of both the children and multi-level stakeholders in Kuwait. Additionally, the study sought to gather and analyse data from key stakeholders to provide strategic recommendations to enhance physical activity levels among school-aged children in Kuwait, particularly in AlAhmadi governorate.

Methods

A mixed-methods approach was employed, incorporating the Community Readiness Model (CRM) (n=32), photovoice (n=24), and a modified Delphi method (n=10 round 1, n=37 round 2 and n=36 round 3). Participants included stakeholders from various government sectors, private entities, non-governmental organisations, community members, and children. The study focused on AlAhmadi Governorate, which has the highest number of Kuwaiti residents among the six governorates in Kuwait. Multiple individual meetings and group discussions were held to gather in-depth information about factors influencing early adolescents’ active lifestyles in various environments (home, school, neighbourhood).

Results

In the Community Readiness Model study, results indicated that AlAhmadi Governorate is at the preplanning stage of readiness to address physical activity issues, with an overall score of 4.7 ± 0.5. The readiness scores ranged from 3.9 ± 1.5 (vague awareness) to 5.1 ± 1.4 (preparation). Increased awareness of the importance of physical activity, especially after COVID-19, and cultural conservatism regarding women, along with limited or poorly maintained public facilities, contributed to this mid-level readiness. The photovoice method identified facilitators and barriers to physical activity for children in three main areas: home (i.e. household activities that involve PA, family/social gatherings), school (i.e. school-related spaces and activities, school and studying related activities), and neighbourhood (i.e. recreational sports fields and centres, unpreferred weather). The modified Delphi method identified and ranked the top ten priorities for promoting physical activity within the school environment; the top three priorities were effective policies, monitoring and evaluation, changing non-mandatory policies and pursuing mandatory implementation challenges, and schools’ PA policies devolved to the school.

Conclusions

The findings suggest that the community recognises the issue of low physical activity but is uncertain about the next steps. The combined methods provided a deeper understanding of the multilevel factors influencing physical activity behaviour, offering valuable insights for policymakers to develop culturally appropriate interventions. The suggested strategies, particularly those derived from the qualitative analysis of community input, offer practical and socially relevant solutions to improve physical activity levels in Kuwait. The modified Delphi method also provided ten actionable priorities for promoting physical activity in schools.