A mixed methods exploration of the experiences of physical activity providers in supporting children and adolescents with type 1 diabetes in the UK.

Children and adolescents with type 1 diabetes mellitus (T1D) are less active than recommended and than their peers without T1D. Several barriers to physical activity have been reported, including lack of confidence in the support received from those who facilitate physical activity such as sports coaches and PE teachers (physical activity providers). This study aims to explore the experiences and needs of physical activity providers in supporting children and adolescents with T1D to engage in structured physical activity. A mixed-methods study, including an online survey and semi-structured interviews, was conducted to provide a broad understanding of the current context along with more in-depth exploration of strategies implemented. Thirty-four participants completed the survey and nine participated in semi-structured interviews. Survey data were summarised descriptively. Qualitative data were analysed using a reflective thematic approach. Fewer than one-third of respondents had received T1D-related training, and only 12% were aware of relevant policies at their institution. Despite moderate confidence among half of the respondents in supporting children and adolescents with T1D, nearly all expressed a need for specific training. Two overarching themes emerged from the interviews: the existing context within which providers operate and effective strategies to support T1D-related physical activity.

conclusionFindings suggest improvements can be made to (1) training for physical activity providers to allow them to better support children and adolescents with T1D to participate in physical activity and (2) policies to help ensure a supportive and safe environment for children and adolescents with T1D. WHAT IS KNOWN: • Children and adolescents with type 1 diabetes are less physically active than peers, partly due to limited support and knowledge among physical activity providers. WHAT IS NEW: • Most physical activity providers lack formal training on type 1 diabetes and rely on ad hoc communication with families or clinical teams for support. • There is a clear need for targeted training and policy development to improve safe and inclusive physical activity for children and adolescents with type 1 diabetes.