Factors influencing adolescents' participation in school recess activities in urban and rural schools: A qualitative study.

Objectives: School recess activities provide opportunities to enhance physical activity levels among adolescents. This study aims to explore factors influencing Chinese adolescents' participation in recess activities in urban and rural schools. Methods: A total of 49 participants (33 students, 16 teachers) were interviewed. Semi-structured interviews were used to collect primary data, including 2 focus group interviews and 36 one-on-one interviews. Data analysis was conducted using a grounded theory approach comprising three steps: open coding, axial coding, and selective coding. Results: The framework derived from the data analysis aligned closely with the social ecological model (SEM), with identified factors spanning four levels of the SEM. Fifteen factors are distributed across the individual level (motivation to participation, body condition, academic pressure, and gender), interpersonal level (peer influence, teacher influence, and social interaction), physical environment level (equipment and facilities, accessibility of activity spaces, weather, and safety), and organizational and policy level (organized activities, physical activity design, recess duration, and school rules and regulations) of the SEM. Beyond these shared factors, we further identified 1 unique factor influencing urban schools (space size) and 2 unique factors influencing rural schools (motor skills and policy). Conclusions: The SEM provides a reference framework for understanding the factors influencing adolescents' participation in recess activities in urban and rural schools. Building on these identified factors, schools can design targeted recess activities and interventions to promote adolescents' participation. Notably, no relevant factors were found at the community level. Therefore, future research should examine potential factors at the community level.