Barriers and Facilitators of Physical Activity among Adolescents of Debre Berhan City Administration; Qualitative Study.

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Osman Yimer Mohammed, Esubalew Tesfahun, Abdurahman Mohammed This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.2.19649/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Most adolescents are insufficiently physically active and it contributes to 3.2 million deaths each year. Environmental and systemic factors influence the level of physical activity. Sedentary work and living environments, socioeconomic status and limited access to facilities are barriers ofphysical activity. Objectives: The main objective of this study was to explore barriers and facilitators of physical activity among adolescents of Debre Berhan City Administration. Methodology: School based qualitative study was conducted among 64 adolescents in Debre Berhan City Administration from June 1-20 2019. Data was collected using eight focus group discussions with a focus group guide. Inductive analysis was done using ATLA.ti version 7. Result: A total of eight focus group discussion were conducted from June 1-20/2019. Three out of the sixty-four participants reported that they do physical activity on a regular basis. Social and personal factors (lack of role model, absence of family or friend influence, bad example, shortage of time, lack of interest and financial constraints) and environmental(Lack of access to play ground, lack of access to gymnasium, lack of conducive environment, poor school environment, harsh (polluted) environment, not friendly (girls) environment, poor urban planning and developmental activities) factors were reported to be barriers of physical activity while being member of a club, improving self-image and maintaining fitness are facilitators of physical activity. Conclusion and Recommendation: Lack of social support, lack of access to play ground and poor construction and developmental activities are the main barriers of physical activity. Therefore, Debre Berhan City Administration should work towards improving urban planning and avail girls’ friendly playground and gymnasium for every resident. Key Words Physical activity, Qualitative Study, Barriers, Facilitators Physical Medicine & Rehab Nutrition & Dietetics Physical activity Qualitative Study Barriers Facilitators 1. Introduction Physical activity is defined as bodily movement caused by contractions of skeletal muscles. It includes exercise, sport, active play and walking (1–3). A minimum of 60 minutes moderate to vigorous-intensity daily physical activity is recommended for a healthy life (4). Physical activity has a protective effect against non-communicable diseases like cardiovascular diseases, stroke, type 2 diabetes, and colon and breast cancers (5). However, 81% of adolescents are insufficiently physically active which contributes to 3.2 million deaths each year (6). The impact of non-communicable diseases globally in general and in Ethiopia specifically increasing from time to time. In the year 2012 and 2015 it claimed the life of 2.7 million people, 3.1 million deaths respectively (7, 8). The Impact in Ethiopia is not any exception and it causes 34% and 405 of all deaths in the year 2008 and 2014 (9, 10). Quantitative studies identified factors like age, sex, education and family monthly income to be associated with physical activity status (11–17). Environmental and systemic factors influence the level of physical activity. Sedentary work and living environments, socioeconomic status and limited access to facilities are among the tips of the iceberg blocking physical activity (18). Qualitative studies also identified individual factors like interest or motivation, body image, time and convenience, lack of awareness; family upbringing, lack of modeling, poor social support, gender and culture; physical environment like availability and accessibility of facilities and opportunities as barriers of physical activity (19–24). Improving fitness or competence, Physical appearance or attractiveness, making friends, physical and mental health, supportive social environment, Interest, positive parent or peer modeling and access to safe play area are considered to be motivators of physical activity (21–24). While the impact of physical inactivity and non-communicable diseases is increasing from time to time the attempt to explore the stumbling block for active life style are not well studied in Ethiopia generally and in the study area specifically. Therefore, this study is aimed to explore the barriers and facilitators of physical activities among adolescents of Debre Berhan City Administration. 2. Methods Study design School based qualitative study using focus group discussions (FGD) was conducted to assess barriers and facilitators of physical activity among adolescents of Debre Berhan City Administration from June1-20/2019. Participants and setting A total of 64 (31 female and 33 male) eligible students age between 18 and 19 were purposively selected from two public and one private schools. For each FGD one class is selected randomly and from each class participants who were 18 and 19 years were selected from the name list until we get eight participants. Written consent was obtained after the objective of the study was explained for all participants. The college of health sciences review board in Debre Berhan University approved the research. Data collection A total of eight FGD were conducted. Each FGD contained eight participants and lasted from 30 up to 40 minutes. Data collection was conducted in two phases. In the first phase five focus group discussions in the public and two in the private schools were conducted. Transcription and coding of the data was conducted after every FGD to assess information saturation. Information saturation was reached after the seventh FGD but one more FGD was conducted in the second phase to ensure true information saturation. The data was collected using a focus group guide. The guide contains open ended question focusing on current physical activity engagement, barriers, facilitators and their recommendation. Two facilitators lead the FDG, one mainly interviewing and the other making records and taking notes. Data Analysis Descriptive summary was presented by summarizing the age, sex and grade level of participants (Table: 1). Qualitative data was transcribed verbatim and exported to ATLASti Version 7. The coding was conducted in to two phases. During the first phase the data was coded under 4 themes: engagement, facilitators, barriers and recommendation according to the study question. Furthermore, a second phase coding generated different subthemes under the main thematic areas. 3. Result Physical activity Engagement All participants reflected good knowledge on the benefit and need of regular physical activity. It is said, physical activity helps to be healthy, control body weight, improve fitness, make brain active and improve academic achievement. However, only three students; two male and one female reported to have regular physical activity routine. A 12th grade female student said “ It is very important for health. Physical activity makes us active and inactivity will cause us get weight and even affect our brain functioning .” A grade 12th male student said “ Physical activity makes us active while inactivity reduce our capacity.” Facilitators of Physical activity . Facilitators of Physical activity are personal reasons like need to improve self-image, to be fit and healthy, and to improve performance in the club. Social reasons like friend modeling and family support are raised as facilitators of physical activity. A 11th grade female student said “I do exercise for one hour every day and my reason is to be fit and healthy .” A grade 12th male student said “I do exercise because I’m member of the Woreda basketball team. It helped me to stay in shape and keep my fitness. Being member of the team helped me to exercise regularly, I worked out every day .” Barriers of physical activity Different reasons are mentioned for not being physically active or play games. Social and personal factors (lack of role model, absence of family or friend influence, bad example, shortage of time, lack of interest and financial constraints) A 12 grade male student said “ No member of my family exercise and they did not ever tell me to go to gymnasium. I cannot go by myself because the payment is too much for my pocket money ” A 11 grade female student said “ Most member of the gymnasium around our residence are not good examples and my family discourage it. ” Environmental (Lack of access to play ground, lack of access to gymnasium, lack of conducive environment, poor school environment, harsh (polluted) environment, not friendly (girls) environment, poor urban planning and developmental activities) are the main reasons. An 11th grade male student said “ In our village we do not have free play ground and we are forced to use the high school playground after 11 local time .” A 12th grade male student said “ I Never done regular exercise due to lack of conducive environment .” A 12th grade male student said “ People do not do exercise due to lack of interest and time shortage. Furthermore, Lack of facility and partner and trainer .” A 11th grade female student said “ I sometimes exercise. My reason for not doing regularly is lack of time. The weather condition is also tough (it is cold at the morning ).” 12th grade female student said “ the play area around our residence are occupied by the industries. The remaining few are polluted by the industry and household wastes. Let alone playing passing by is difficult .” A 12th grade female student said “ The playgrounds are far from our residence and are not friendly for girls; the play grounds are overcrowded by boys and it is not safe to go there . ” A 11th grade male student said “ Playgrounds are not sufficient and most of them are converted to construction and industry site; There was a playground around our village but now it is fenced for construction . ” They are not doing physical exercise but also are engaged in risky behaviors due to lack of proper playground and gymnasium. Adolescents are playing in a less safe place, many become addicted for chat because they have nowhere to go. A 11th grade male student said “ Our youths are now addicted; many students now chew and smoke. If there was conducive environment no one would want to go to the unsafe environment .” Recommendation Different recommendations are given by the adolescents to improve the physical activity status. These includes, building girls friendly gymnasium and youth centers, make accessible play grounds and proper urban planning. A grade 10th Male student said “ Our government should work towards developing enough playgrounds and gymnasium and officials should be careful during planning for developmental activities and investments .” A 9th grade female student said “ All facilities should be girls friendly, we do not go out to play anything do to the less favorability of the environment . There should be a dedicated area for girls.” A 12th grade male student said “ Facilities for the youth to be engaged in regular physical activity and reduce sitting time should be opened at every Kebele .” A 11th grade female student said “ As much attention as the investment should be given to the health of the people and our government should work towards developing enough playgrounds and gymnasium in every Kebele .” 4. Discussion This explorative study tried to identify facilitators and barriers of physical activity among adolescents of Debre Berhan City Administration. Adolescent physical activity level is very minimal; three out of the sixty-four participants regularly exercise. Personal factors like health, body image and fitness are facilitators of physical activity. This is consistent with study in Australia and Canada which reported physical appearance and fitness as facilitators of physical activity (21, 22). In the contrary, Social and personal factors (lack of role model, absence of family or friend influence, bad example, shortage of time, lack of interest and financial constraints) and environmental (Lack of access to play ground, lack of access to gymnasium, lack of conducive environment, poor school environment, harsh (polluted) environment, not friendly (girls) environment, poor urban planning and developmental activities) were identified to be facilitators while being member of a club and improving fitness and self-image facilitate physical activity. The findings of this study are consistent with study in Belgium and Morocco which stated that personal, social and environmental factors like lack of motivation, lack of social support, lack of facilities and opportunities to be main barriers of physical activity. This might indicate the global nature of the problem and similar adolescent reaction to the aforementioned factors (19, 20). 5. Conclusion Physical activity is very minimal among study participants and self-image, health and fitness are among facilitators of physical activity. In the contrary, social (lack of role model, absence of family or friend influence, bad example, shortage of time, lack of interest and financial constraints) and environmental factors (access to facilities, poor urban planning and harsh environments) are barriers of physical activity. 6. Recommendation Debre Berhan City Administration, Schools and other stake holders should work towards availing friendly facilities and developing friendly resident and industrial sites. Schools should start club events to encourage student’s engagement towards physical activity. 7. Limitation This study used only one data collection method which might make it difficult to triangulate the conclusion. Study participants are only from high schools and only adolescents and this may affect the finding to explain the whole situation of the study area. 8. Declaration Ethics approval and consent to participate This research was approved by the review committee of Debre Berhan University, College of Health Sciences. Permission to conduct the study was obtained from each school administrators. All study participants were older than 18 year and gave written consent. Anonymity and confidentiality of the data were maintained throughout the data collection process. All participants were informed that they have the right to refuse participating in the study at any time. Consent to publish Not Applicable Availability of data and Materials The data set used in this study is available from corresponding author on reasonable request. Competing Interests The authors declared that they have no competing interests. Funding Not Applicable Authors’ contributions The first author [OY] is the principal investigator and involved in the designing, data collection, analysis and preparing the manuscript. The second author [ET] involved in the design, analysis and manuscript preparation. The third author [AM] involved in the analysis and writing the manuscript. All the authors had read and approved the final manuscript. Acknowledgments We would like to gratefully acknowledge Debre Berhan University, the high school principals, teachers and students for their support and participation in our study. References Caspersen CJ, et al. Physical activity, exercise, and physical fitness. Public Health Reports. ; 1985. Report No.: 100. US Department of Health and Human Services. Physical Activity and Health. A report of the Surgeon General. Atlanta, GA: Centers for Disease Control and Prevention, US Department of Health and Human Services. Foundation VHP. VicHealth. [Online].; 2016 [cited 2019 Feb 3. Available from: vichealth.vic.gov.au. Global recommendations on physical activity for health. [Online]. Geneva, Switzerland: WHO Press; 2010 [cited 2017 October 13. Available from: http://apps.who.int/iris/bitstream/10665/44399/1/9789241599979_eng.pdf . Miles L. Physical activity and health. British Nutrition Foundation. 2007: p. 314-363. GLOBAL STATUS REPORT on noncommunicable diseases 2014. ; 2014. Africa Check. Africa Check. [Online].; 2017 [cited 2017 October 16. Available from: https://africacheck.org/factsheets/factsheet-the-leading-causes-of-death-in-africa/ Vuuren PJV. [Online].; 2017 [cited 2017 October 16. Available from: https://africacheck.org/factsheets/factsheet-africas-leading-causes-death/ . WHO COUTRY COOPERATION STRATEGY 2012-2015, ETHIOPIA. Republic of Congo:, WHO Regional Office for Africa; 2013. Report No.: 978 92 9 023207 0. Awoke M, Damen HM, Tekebash A. The Double Mortality Burden Among Adults in Addis Ababa, Ethiopia, 2006-2009. CDC, Preventing Chronic Disease. 2012; 9(11_0142). Pengpid S, Peltzer K, Kassean HK, Tsala JP, Sychareun V, Müller-Riemenschneider F. Physical inactivity and associated factors among university students in 23 low-, middle-and high-income countries. International journal of public health. 2015 Jul 1; 60(5): p. 539-49. Micklesfield LK, Pedro TM, Kahn K, Kinsman J, Pettifor JM, Tollman S, Norris SA. Physical activity and sedentary behavior among adolescents in rural South Africa: levels, patterns and correlates. BMC Public Health. 2014 Dec; 14(1). Gorely T, Atkin AJ, Biddle SJ, Marshall SJ. Family circumstance, sedentary behaviour and physical activity in adolescents living in England: Project STIL. International Journal of Behavioral Nutrition and Physical Activity. 2009 Dec; 6(1 ). Poobalan AS, Aucott LS, Clarke A, Smith WC. Physical activity attitudes, intentions and behaviour among 18–25 year olds: A mixed method study. BMC public health. 2012 Dec; 12(1). Dias PJ, Domingos IP, Ferreira MG, Muraro AP, Sichieri R, Gonçalves-Silva RM. Prevalence and factors associated with sedentary behavior in adolescents. 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Ashton LM, Hutchesson MJ, Rollo ME, Morgan PJ, Thompson DI, Collins CE. Young adult males’ motivators and perceived barriers towards eating healthily and being active: a qualitative study. International Journal of Behavioral Nutrition and Physical Activity. 2015 Dec; 12(1):93. Bélanger M, Casey M, Cormier M, Filion AL, Martin G, Aubut S, Chouinard P, Savoie SP, Beauchamp J. Maintenance and decline of physical activity during adolescence: insights from a qualitative study. International Journal of Behavioral Nutrition and Physical Activity. 2011 Dec; 8(1):117. Dwyer GM, Higgs J, Hardy LL, Baur LA. What do parents and preschool staff tell us about young children's physical activity: a qualitative study. International Journal of Behavioral Nutrition and Physical Activity. 2008 Dec; 5(1):66. Payán DD, Sloane DC, Illum J, Lewis LB. Intrapersonal and environmental barriers to physical activity among Blacks and Latinos. Journal of nutrition education and behavior. 2019 Apr 1; 51(4):478-85. Tables Table 1 Characteristics of participants of the focus group discussion participants in Debre Berhan City Administration. Grade Sex Frequency Percentage 11 Female 16 25.00 Male 16 25.00 12 Female 15 23.44 Male 17 26.56 Total 64 100 Table 2 Focus group discussion guide among adolescents of Debre Berhan City Administration No Guide question 1 Introduce yourself (name, age, sex, grade) 2 How far you are up to regarding physical activity (do you regularly exercise?) 3 What do you think encourage people to do regular exercise? 4 What do you think discourage people not to do physical activity? 5 What do you think should be done to increase physical activity level? Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Introduction","content":" \u003cp\u003ePhysical activity is defined as bodily movement caused by contractions of skeletal muscles. It includes exercise, sport, active play and walking (1\u0026ndash;3).\u003c/p\u003e \u003cp\u003eA minimum of 60 minutes moderate to vigorous-intensity daily physical activity is recommended for a healthy life (4). Physical activity has a protective effect against non-communicable diseases like cardiovascular diseases, stroke, type 2 diabetes, and colon and breast cancers (5). However, 81% of adolescents are insufficiently physically active which contributes to 3.2\u0026nbsp;million deaths each year (6).\u003c/p\u003e \u003cp\u003eThe impact of non-communicable diseases globally in general and in Ethiopia specifically increasing from time to time. In the year 2012 and 2015 it claimed the life of 2.7\u0026nbsp;million people, 3.1\u0026nbsp;million deaths respectively (7, 8). The Impact in Ethiopia is not any exception and it causes 34% and 405 of all deaths in the year 2008 and 2014 (9, 10).\u003c/p\u003e \u003cp\u003eQuantitative studies identified factors like age, sex, education and family monthly income to be associated with physical activity status (11\u0026ndash;17). Environmental and systemic factors influence the level of physical activity. Sedentary work and living environments, socioeconomic status and limited access to facilities are among the tips of the iceberg blocking physical activity (18).\u003c/p\u003e \u003cp\u003eQualitative studies also identified individual factors like interest or motivation, body image, time and convenience, lack of awareness; family upbringing, lack of modeling, poor social support, gender and culture; physical environment like availability and accessibility of facilities and opportunities as barriers of physical activity (19\u0026ndash;24). Improving fitness or competence, Physical appearance or attractiveness, making friends, physical and mental health, supportive social environment, Interest, positive parent or peer modeling and access to safe play area are considered to be motivators of physical activity (21\u0026ndash;24). While the impact of physical inactivity and non-communicable diseases is increasing from time to time the attempt to explore the stumbling block for active life style are not well studied in Ethiopia generally and in the study area specifically. Therefore, this study is aimed to explore the barriers and facilitators of physical activities among adolescents of Debre Berhan City Administration.\u003c/p\u003e "},{"header":"2. Methods","content":" \u003cp\u003e \u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eStudy design\u003c/span\u003e \u003c/p\u003e \u003cp\u003eSchool based qualitative study using focus group discussions (FGD) was conducted to assess barriers and facilitators of physical activity among adolescents of Debre Berhan City Administration from June1-20/2019.\u003c/p\u003e \u003cp\u003e \u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eParticipants and setting\u003c/span\u003e \u003c/p\u003e \u003cp\u003eA total of 64 (31 female and 33 male) eligible students age between 18 and 19 were purposively selected from two public and one private schools. For each FGD one class is selected randomly and from each class participants who were 18 and 19\u0026nbsp;years were selected from the name list until we get eight participants. Written consent was obtained after the objective of the study was explained for all participants. The college of health sciences review board in Debre Berhan University approved the research.\u003c/p\u003e \u003cp\u003e \u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eData collection\u003c/span\u003e \u003c/p\u003e \u003cp\u003eA total of eight FGD were conducted. Each FGD contained eight participants and lasted from 30 up to 40 minutes. Data collection was conducted in two phases. In the first phase five focus group discussions in the public and two in the private schools were conducted. Transcription and coding of the data was conducted after every FGD to assess information saturation. Information saturation was reached after the seventh FGD but one more FGD was conducted in the second phase to ensure true information saturation.\u003c/p\u003e \u003cp\u003eThe data was collected using a focus group guide. The guide contains open ended question focusing on current physical activity engagement, barriers, facilitators and their recommendation. Two facilitators lead the FDG, one mainly interviewing and the other making records and taking notes.\u003c/p\u003e \u003cp\u003e \u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eData Analysis\u003c/span\u003e \u003c/p\u003e \u003cp\u003eDescriptive summary was presented by summarizing the age, sex and grade level of participants (Table: 1). Qualitative data was transcribed verbatim and exported to ATLASti Version 7. The coding was conducted in to two phases. During the first phase the data was coded under 4 themes: engagement, facilitators, barriers and recommendation according to the study question. Furthermore, a second phase coding generated different subthemes under the main thematic areas.\u003c/p\u003e "},{"header":"3. Result","content":" \u003cp\u003e \u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003ePhysical activity Engagement\u003c/span\u003e \u003c/p\u003e \u003cp\u003eAll participants reflected good knowledge on the benefit and need of regular physical activity. It is said, physical activity helps to be healthy, control body weight, improve fitness, make brain active and improve academic achievement. However, only three students; two male and one female reported to have regular physical activity routine.\u003c/p\u003e \u003cp\u003eA 12th grade female student said \u0026ldquo;\u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eIt is very important for health. Physical activity makes us active and inactivity will cause us get weight and even affect our brain functioning\u003c/span\u003e.\u0026rdquo;\u003c/p\u003e \u003cp\u003eA grade 12th male student said \u0026ldquo;\u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003ePhysical activity makes us active while inactivity reduce our capacity.\u0026rdquo;\u003c/span\u003e\u003c/p\u003e \u003cp\u003e \u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eFacilitators of Physical activity\u003c/span\u003e.\u003c/p\u003e \u003cp\u003eFacilitators of Physical activity are personal reasons like need to improve self-image, to be fit and healthy, and to improve performance in the club. Social reasons like friend modeling and family support are raised as facilitators of physical activity.\u003c/p\u003e \u003cp\u003eA 11th grade female student said \u0026ldquo;I \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003edo exercise for one hour every day and my reason is to be fit and healthy\u003c/span\u003e.\u0026rdquo;\u003c/p\u003e \u003cp\u003eA grade 12th male student said \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003e\u0026ldquo;I do exercise because I\u0026rsquo;m member of the Woreda basketball team. It helped me to stay in shape and keep my fitness. Being member of the team helped me to exercise regularly, I worked out every day\u003c/span\u003e.\u0026rdquo;\u003c/p\u003e \u003cp\u003e \u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eBarriers of physical activity\u003c/span\u003e \u003c/p\u003e \u003cp\u003eDifferent reasons are mentioned for not being physically active or play games. Social and personal factors (lack of role model, absence of family or friend influence, bad example, shortage of time, lack of interest and financial constraints)\u003c/p\u003e \u003cp\u003eA 12 grade male student said \u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003e\u0026ldquo;\u003c/span\u003eNo member of my family exercise and they did not ever tell me to go to gymnasium. I cannot go by myself because the payment is too much for my pocket money\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003e\u0026rdquo;\u003c/span\u003e\u003c/p\u003e \u003cp\u003eA 11 grade female student said \u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003e\u0026ldquo;\u003c/span\u003eMost member of the gymnasium around our residence are not good examples and my family discourage it.\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003e\u0026rdquo;\u003c/span\u003e\u003c/p\u003e \u003cp\u003eEnvironmental (Lack of access to play ground, lack of access to gymnasium, lack of conducive environment, poor school environment, harsh (polluted) environment, not friendly (girls) environment, poor urban planning and developmental activities) are the main reasons.\u003c/p\u003e \u003cp\u003eAn 11th grade male student said \u0026ldquo;\u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eIn our village we do not have free play ground and we are forced to use the high school playground after 11 local time\u003c/span\u003e.\u0026rdquo;\u003c/p\u003e \u003cp\u003eA 12th grade male student said \u0026ldquo;\u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eI Never done regular exercise due to lack of conducive environment\u003c/span\u003e.\u0026rdquo;\u003c/p\u003e \u003cp\u003eA 12th grade male student said \u0026ldquo;\u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003ePeople do not do exercise due to lack of interest and time shortage. Furthermore, Lack of facility and partner and trainer\u003c/span\u003e.\u0026rdquo;\u003c/p\u003e \u003cp\u003eA 11th grade female student said \u0026ldquo;\u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eI sometimes exercise. My reason for not doing regularly is lack of time. The weather condition is also tough (it is cold at the morning\u003c/span\u003e).\u0026rdquo;\u003c/p\u003e \u003cp\u003e12th grade female student said \u0026ldquo;\u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003ethe play area around our residence are occupied by the industries. The remaining few are polluted by the industry and household wastes. Let alone playing passing by is difficult\u003c/span\u003e.\u0026rdquo;\u003c/p\u003e \u003cp\u003eA 12th grade female student said \u0026ldquo;\u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eThe playgrounds are far from our residence and are not friendly for girls; the play grounds are overcrowded by boys and it is not safe to go there\u003c/span\u003e.\u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003e\u0026rdquo;\u003c/span\u003e\u003c/p\u003e \u003cp\u003eA 11th grade male student said \u003cspan type=\"BoldItalic\" class=\"BoldItalic\" name=\"Emphasis\"\u003e\u0026ldquo;\u003c/span\u003e\u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003ePlaygrounds are not sufficient and most of them are converted to construction and industry site; There was a playground around our village but now it is fenced for construction\u003c/span\u003e.\u003cspan type=\"BoldItalic\" class=\"BoldItalic\" name=\"Emphasis\"\u003e\u0026rdquo;\u003c/span\u003e\u003c/p\u003e \u003cp\u003eThey are not doing physical exercise but also are engaged in risky behaviors due to lack of proper playground and gymnasium. Adolescents are playing in a less safe place, many become addicted for chat because they have nowhere to go.\u003c/p\u003e \u003cp\u003eA 11th grade male student said \u0026ldquo;\u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eOur youths are now addicted; many students now chew and smoke. If there was conducive environment no one would want to go to the unsafe environment\u003c/span\u003e.\u0026rdquo;\u003c/p\u003e \u003cp\u003e \u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003eRecommendation\u003c/span\u003e \u003c/p\u003e \u003cp\u003eDifferent recommendations are given by the adolescents to improve the physical activity status. These includes, building girls friendly gymnasium and youth centers, make accessible play grounds and proper urban planning.\u003c/p\u003e \u003cp\u003eA grade 10th Male student said \u0026ldquo;\u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eOur government should work towards developing enough playgrounds and gymnasium and officials should be careful during planning for developmental activities and investments\u003c/span\u003e.\u0026rdquo;\u003c/p\u003e \u003cp\u003eA 9th grade female student said \u0026ldquo;\u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eAll facilities should be girls friendly, we do not go out to play anything do to the less favorability of the environment\u003c/span\u003e. \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eThere should be a dedicated area for girls.\u0026rdquo;\u003c/span\u003e\u003c/p\u003e \u003cp\u003eA 12th grade male student said \u0026ldquo;\u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eFacilities for the youth to be engaged in regular physical activity and reduce sitting time should be opened at every Kebele\u003c/span\u003e.\u0026rdquo;\u003c/p\u003e \u003cp\u003eA 11th grade female student said \u0026ldquo;\u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eAs much attention as the investment should be given to the health of the people and our government should work towards developing enough playgrounds and gymnasium in every Kebele\u003c/span\u003e.\u0026rdquo;\u003c/p\u003e "},{"header":"4. Discussion","content":" \u003cp\u003eThis explorative study tried to identify facilitators and barriers of physical activity among adolescents of Debre Berhan City Administration. Adolescent physical activity level is very minimal; three out of the sixty-four participants regularly exercise. Personal factors like health, body image and fitness are facilitators of physical activity. This is consistent with study in Australia and Canada which reported physical appearance and fitness as facilitators of physical activity (21, 22). In the contrary, Social and personal factors (lack of role model, absence of family or friend influence, bad example, shortage of time, lack of interest and financial constraints) and environmental (Lack of access to play ground, lack of access to gymnasium, lack of conducive environment, poor school environment, harsh (polluted) environment, not friendly (girls) environment, poor urban planning and developmental activities) were identified to be facilitators while being member of a club and improving fitness and self-image facilitate physical activity. The findings of this study are consistent with study in Belgium and Morocco which stated that personal, social and environmental factors like lack of motivation, lack of social support, lack of facilities and opportunities to be main barriers of physical activity. This might indicate the global nature of the problem and similar adolescent reaction to the aforementioned factors (19, 20).\u003c/p\u003e "},{"header":"5. Conclusion","content":" \u003cp\u003ePhysical activity is very minimal among study participants and self-image, health and fitness are among facilitators of physical activity. In the contrary, social (lack of role model, absence of family or friend influence, bad example, shortage of time, lack of interest and financial constraints) and environmental factors (access to facilities, poor urban planning and harsh environments) are barriers of physical activity.\u003c/p\u003e "},{"header":"6. Recommendation","content":" \u003cp\u003eDebre Berhan City Administration, Schools and other stake holders should work towards availing friendly facilities and developing friendly resident and industrial sites. Schools should start club events to encourage student\u0026rsquo;s engagement towards physical activity.\u003c/p\u003e "},{"header":"7. Limitation","content":" \u003cp\u003eThis study used only one data collection method which might make it difficult to triangulate the conclusion. Study participants are only from high schools and only adolescents and this may affect the finding to explain the whole situation of the study area.\u003c/p\u003e "},{"header":"8. Declaration","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research was approved by the review committee of Debre Berhan University, College of Health Sciences. Permission to conduct the study was obtained from each school administrators. All study participants were older than 18 year and gave written consent. Anonymity and confidentiality of the data were maintained throughout the data collection process. All participants were informed that they have the right to refuse participating in the study at any time.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to publish\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot Applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and Materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data set used in this study is available from corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declared that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot Applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe first author [OY] is the principal investigator and involved in the designing, data collection, analysis and preparing the manuscript. The second author [ET] involved in the design, analysis and manuscript preparation. The third author [AM] involved in the analysis and writing the manuscript. All the authors had read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe would like to gratefully acknowledge Debre Berhan University, the high school principals, teachers and students for their support and participation in our study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eCaspersen CJ, et al. Physical activity, exercise, and physical fitness. Public Health Reports. ; 1985. Report No.: 100.\u003c/li\u003e\n\u003cli\u003eUS Department of Health and Human Services. Physical Activity and Health. A report of the Surgeon General. Atlanta, GA: Centers for Disease Control and Prevention, US Department of Health and Human Services.\u003c/li\u003e\n\u003cli\u003eFoundation VHP. VicHealth. [Online].; 2016 [cited 2019 Feb 3. Available from: \u003ca href=\"www.vichealth.vic.gov.au.\"\u003evichealth.vic.gov.au.\u003c/a\u003e\u003c/li\u003e\n\u003cli\u003eGlobal recommendations on physical activity for health. [Online]. Geneva, Switzerland: WHO Press; 2010 [cited 2017 October 13. Available from: \u003ca href=\"http://apps.who.int/iris/bitstream/10665/44399/1/9789241599979_eng.pdf\"\u003ehttp://apps.who.int/iris/bitstream/10665/44399/1/9789241599979_eng.pdf\u003c/a\u003e.\u003c/li\u003e\n\u003cli\u003eMiles L. Physical activity and health. British Nutrition Foundation. 2007: p. 314-363.\u003c/li\u003e\n\u003cli\u003eGLOBAL STATUS REPORT on noncommunicable diseases 2014. ; 2014.\u003c/li\u003e\n\u003cli\u003eAfrica Check. Africa Check. [Online].; 2017 [cited 2017 October 16. Available from: \u003ca href=\"https://africacheck.org/factsheets/factsheet-the-leading-causes-of-death-in-africa/\"\u003ehttps://africacheck.org/factsheets/factsheet-the-leading-causes-of-death-in-africa/\u003c/a\u003e\u003c/li\u003e\n\u003cli\u003eVuuren PJV. [Online].; 2017 [cited 2017 October 16. Available from: \u003ca href=\"https://africacheck.org/factsheets/factsheet-africas-leading-causes-death/\"\u003ehttps://africacheck.org/factsheets/factsheet-africas-leading-causes-death/\u003c/a\u003e.\u003c/li\u003e\n\u003cli\u003eWHO COUTRY COOPERATION STRATEGY 2012-2015, ETHIOPIA. Republic of Congo:, WHO Regional Office for Africa; 2013. Report No.: 978 92 9 023207 0.\u003c/li\u003e\n\u003cli\u003eAwoke M, Damen HM, Tekebash A. The Double Mortality Burden Among Adults in Addis Ababa, Ethiopia, 2006-2009. CDC, Preventing Chronic Disease. 2012; 9(11_0142).\u003c/li\u003e\n\u003cli\u003ePengpid S, Peltzer K, Kassean HK, Tsala JP, Sychareun V, M\u0026uuml;ller-Riemenschneider F. Physical inactivity and associated factors among university students in 23 low-, middle-and high-income countries. International journal of public health. 2015 Jul 1; 60(5): p. 539-49.\u003c/li\u003e\n\u003cli\u003eMicklesfield LK, Pedro TM, Kahn K, Kinsman J, Pettifor JM, Tollman S, Norris SA. Physical activity and sedentary behavior among adolescents in rural South Africa: levels, patterns and correlates. BMC Public Health. 2014 Dec; 14(1).\u003c/li\u003e\n\u003cli\u003eGorely T, Atkin AJ, Biddle SJ, Marshall SJ. Family circumstance, sedentary behaviour and physical activity in adolescents living in England: Project STIL. International Journal of Behavioral Nutrition and Physical Activity. 2009 Dec; 6(1 ).\u003c/li\u003e\n\u003cli\u003ePoobalan AS, Aucott LS, Clarke A, Smith WC. Physical activity attitudes, intentions and behaviour among 18\u0026ndash;25 year olds: A mixed method study. BMC public health. 2012 Dec; 12(1).\u003c/li\u003e\n\u003cli\u003eDias PJ, Domingos IP, Ferreira MG, Muraro AP, Sichieri R, Gon\u0026ccedil;alves-Silva RM. Prevalence and factors associated with sedentary behavior in adolescents. Revista de saude publica. 2014 Apr; 48(2): p. 266-74.\u003c/li\u003e\n\u003cli\u003eMielke GI, Brown WJ, Ekelund U, Brage S, Gon\u0026ccedil;alves H, Wehrmeister FC, Menezes AM, Hallal PC. Socioeconomic position and sedentary behavior in Brazilian adolescents: A life-course approach. Preventive medicine. 2015 Feb 1; 107: p. 29-35.\u003c/li\u003e\n\u003cli\u003eWasilewska M, Bergier J. Physical activity and associated socio-demographic factors in adolescents from the eastern region of Poland. Roczniki Panstwowego Zakladu Higieny. 2018; 69(1): p. 55-61.\u003c/li\u003e\n\u003cli\u003ePhysical inactivity and diabetes. 2015.\u003c/li\u003e\n\u003cli\u003eDeliens T, Deforche B, De Bourdeaudhuij I, Clarys P. Determinants of physical activity and sedentary behaviour in university students: a qualitative study using focus group discussions. BMC Public Health. 2015 Dec; 15(1).\u003c/li\u003e\n\u003cli\u003eAbdelghaffar EA, Siham B. Perspectives of adolescents, parents, and teachers on barriers and facilitators of physical activity among school-age adolescents: a qualitative analysis. Environmental health and preventive medicine. 2019 Dec; 24(1):21.\u003c/li\u003e\n\u003cli\u003eAshton LM, Hutchesson MJ, Rollo ME, Morgan PJ, Thompson DI, Collins CE. Young adult males\u0026rsquo; motivators and perceived barriers towards eating healthily and being active: a qualitative study. International Journal of Behavioral Nutrition and Physical Activity. 2015 Dec; 12(1):93.\u003c/li\u003e\n\u003cli\u003eB\u0026eacute;langer M, Casey M, Cormier M, Filion AL, Martin G, Aubut S, Chouinard P, Savoie SP, Beauchamp J. Maintenance and decline of physical activity during adolescence: insights from a qualitative study. International Journal of Behavioral Nutrition and Physical Activity. 2011 Dec; 8(1):117.\u003c/li\u003e\n\u003cli\u003eDwyer GM, Higgs J, Hardy LL, Baur LA. What do parents and preschool staff tell us about young children's physical activity: a qualitative study. International Journal of Behavioral Nutrition and Physical Activity. 2008 Dec; 5(1):66.\u003c/li\u003e\n\u003cli\u003ePay\u0026aacute;n DD, Sloane DC, Illum J, Lewis LB. Intrapersonal and environmental barriers to physical activity among Blacks and Latinos. Journal of nutrition education and behavior. 2019 Apr 1; 51(4):478-85.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":" \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cdiv class=\"SimplePara\"\u003eCharacteristics of participants of the focus group discussion participants in Debre Berhan City Administration.\u003c/div\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eGrade\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eSex\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eFrequency\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003ePercentage\u003c/div\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cdiv class=\"SimplePara\"\u003e11\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eFemale\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e16\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e25.00\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eMale\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e16\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e25.00\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cdiv class=\"SimplePara\"\u003e12\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eFemale\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e15\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e23.44\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eMale\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e17\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e26.56\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eTotal\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e64\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e100\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cdiv class=\"SimplePara\"\u003eFocus group discussion guide among adolescents of Debre Berhan City Administration\u003c/div\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eNo\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eGuide question\u003c/div\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003e1\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eIntroduce yourself (name, age, sex, grade)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003e2\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eHow far you are up to regarding physical activity (do you regularly exercise?)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003e3\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eWhat do you think encourage people to do regular exercise?\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003e4\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eWhat do you think discourage people not to do physical activity?\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003e5\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eWhat do you think should be done to increase physical activity level?\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e "}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Physical activity, Qualitative Study, Barriers, Facilitators","lastPublishedDoi":"10.21203/rs.2.19649/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.2.19649/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eBackground: Most adolescents are insufficiently physically active and it contributes to 3.2 million deaths each year. Environmental and systemic factors influence the level of physical activity. Sedentary work and living environments, socioeconomic status and limited access to facilities are barriers ofphysical activity. \u003c/p\u003e\u003cp\u003eObjectives: The main objective of this study was to explore barriers and facilitators of physical activity among adolescents of Debre Berhan City Administration. \u003c/p\u003e\u003cp\u003eMethodology: School based qualitative study was conducted among 64 adolescents in Debre Berhan City Administration from June 1-20 2019. Data was collected using eight focus group discussions with a focus group guide. Inductive analysis was done using ATLA.ti version 7. \u003c/p\u003e\u003cp\u003eResult: A total of eight focus group discussion were conducted from June 1-20/2019. Three out of the sixty-four participants reported that they do physical activity on a regular basis. Social and personal factors (lack of role model, absence of family or friend influence, bad example, shortage of time, lack of interest and financial constraints) and environmental(Lack of access to play ground, lack of access to gymnasium, lack of conducive environment, poor school environment, harsh (polluted) environment, not friendly (girls) environment, poor urban planning and developmental activities) factors were reported to be barriers of physical activity while being member of a club, improving self-image and maintaining fitness are facilitators of physical activity. \u003c/p\u003e\u003cp\u003eConclusion and Recommendation: Lack of social support, lack of access to play ground and poor construction and developmental activities are the main barriers of physical activity. Therefore, Debre Berhan City Administration should work towards improving urban planning and avail girls’ friendly playground and gymnasium for every resident. Key Words Physical activity, Qualitative Study, Barriers, Facilitators\u003c/p\u003e","manuscriptTitle":"Barriers and Facilitators of Physical Activity among Adolescents of Debre Berhan City Administration; Qualitative Study.","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2019-12-30 21:14:57","doi":"10.21203/rs.2.19649/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"f2426b93-5e34-4212-9b51-f90f22096fea","owner":[],"postedDate":"December 30th, 2019","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":45667,"name":"Physical Medicine \u0026 Rehab"},{"id":45668,"name":"Nutrition \u0026 Dietetics"}],"tags":[],"updatedAt":"","versionOfRecord":[],"versionCreatedAt":"2019-12-30 21:14:57","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-10262","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"identity":"rs-10262","version":["v1"]},"buildId":"_2-kVJe1T_tPrBINL-cwx","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}