title: Identifying solutions to increase participation in physical activity interventions within a socio-economically disadvantaged community: a qualitative study.
abstract: BACKGROUND
  There is an urgent need to increase population levels of physical activity, particularly amongst those who are socio-economically disadvantaged. Multiple factors influence physical activity behaviour but the generalisability of current evidence to such 'hard-to-reach' population subgroups is limited by difficulties in recruiting them into studies. Also, rigorous qualitative studies of lay perceptions and perceptions of community leaders about public health efforts to increase physical activity are sparse. We sought to explore, within a socio-economically disadvantaged community, residents' and community leaders' perceptions of physical activity (PA) interventions and issues regarding their implementation, in order to improve understanding of needs, expectations, and social/environmental factors relevant to future interventions.
  
  
  METHODS
  Within an ongoing regeneration project (Connswater Community Greenway), in a socio-economically disadvantaged community in Belfast, we collaborated with a Community Development Agency to purposively sample leaders from public- and voluntary-sector community groups and residents. Individual semi-structured interviews were conducted with 12 leaders. Residents (n = 113), of both genders and a range of ages (14 to 86 years) participated in focus groups (n = 14) in local facilities. Interviews and focus groups were recorded, transcribed verbatim and analysed using a thematic framework.
  
  
  RESULTS
  Three main themes were identified: awareness of PA interventions; factors contributing to intervention effectiveness; and barriers to participation in PA interventions. Participants reported awareness only of interventions in which they were involved directly, highlighting a need for better communications, both inter- and intra-sectoral, and with residents. Meaningful engagement of residents in planning/organisation, tailoring to local context, supporting volunteers, providing relevant resources and an 'exit strategy' were perceived as important factors related to intervention effectiveness. Negative attitudes such as apathy, disappointing experiences, information with no perceived personal relevance and limited access to facilities were barriers to people participating in interventions.
  
  
  CONCLUSIONS
  These findings illustrate the complexity of influences on a community's participation in PA interventions and support a social-ecological approach to promoting PA. They highlight the need for cross-sector working, effective information exchange, involving residents in bottom-up planning and providing adequate financial and social support. An in-depth understanding of a target population's perspectives is of key importance in translating PA behaviour change theories into practice.
authors.forename: Claire L
authors.initials: CL
authors.lastname: Cleland
authors.forename: Ruth F
authors.initials: RF
authors.lastname: Hunter
authors.forename: Mark A
authors.initials: MA
authors.lastname: Tully
authors.forename: David
authors.initials: D
authors.lastname: Scott
authors.forename: Frank
authors.initials: F
authors.lastname: Kee
authors.forename: Michael
authors.initials: M
authors.lastname: Donnelly
authors.forename: Lindsay
authors.initials: L
authors.lastname: Prior
authors.affiliation: UKCRC Centre of Excellence for Public Health (Northern Ireland), School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Clinical Sciences Block B, Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BJ, UK. m.cupples@qub.ac.uk.
authors.forename: Margaret E
authors.initials: ME
authors.lastname: Cupples
mesh_terms: D000328:Adult; D000368:Aged; D005069:Evaluation Studies as Topic; D005260:Female; D017144:Focus Groups; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007494:Ireland; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D012944:Social Support; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D035862:Vulnerable Populations; D055815:Young Adult