title: Stages of change in physical activity behavior in children and adolescents with cerebral palsy.
abstract: OBJECTIVE
  To identify facilitators and barriers frequently experienced by families of children with cerebral palsy (CP) and associated with being at the pre-intention, intention and action stages for physical activity.
  
  
  METHODS
  Qualitative study involving in-depth focus group interviews with 33 ambulatory children and adolescents with CP and their parents (n = 33). These interviews were followed by questionnaires to determine stage of behavior change (i.e. pre-intention, intention and action) related to the child's participation in physical activity.
  
  
  RESULTS
  Families who were classified in the intention stage of behavioral change were more likely to identify environmental barriers related to the social environment and the facility or program than parents at the pre-intention stage. Families who were classified into intention and action stages were more likely to identify facilitators related to parental factors than families at the pre-intention stage. Moreover, at the action stage facilitators were related to the facility/program.
  
  
  CONCLUSIONS
  The identified facilitators and barriers, organized according to three stages of change (pre-intention, intention and action), provide important theoretical insights into how and why children and adolescents with CP and their parents might change their physical activity behavior.
  
  
  CONCLUSIONS
  Understanding the barriers and facilitators of physical activity for children and adolescents with CP is essential for designing effective interventions to promote participation in this group. Using the three stages of change and the identified barriers and facilitators for participation can result in tailored advice to increase physical activity behavior.
authors: Rudolf Magnus Institute of Neuroscience and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and Rehabilitation Center De Hoogstraat, Rembrandtkade 10, Utrecht, The Netherlands. o.verschuren@dehoogstraat.nl
authors: Olaf
authors: O
authors: Verschuren
authors: Lesley
authors: L
authors: Wiart
authors: Marjolijn
authors: M
authors: Ketelaar
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D002547:Cerebral Palsy / Q000503:physiopathology* / Q000523:psychology / Q000534:rehabilitation*; D002648:Child; D015444:Exercise / Q000523:psychology; D005260:Female; D017144:Focus Groups; D015438:Health Behavior; D006801:Humans; D033182:Intention; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D010290:Parents / Q000523:psychology*; D036301:Qualitative Research; D012931:Social Environment; D058992:Social Participation; D012944:Social Support; D013177:Sports / Q000523:psychology; D011795:Surveys and Questionnaires; D055815:Young Adult