Exploring experiences of swimming and aquatic exercise in individuals with long term health conditions: results from Swim England's 'England Swims' survey.

This study analyses data from Swim England's England Swims survey to explore perceptions of swimming and aquatic exercise among individuals with long-term health conditions (LTHCs) and to identify barriers to participation. This cross-sectional study involved analysis of responses collected during the 2022 'England Swims' survey. Demographic information was summarized using descriptive statistics. Participant responses were summarized descriptively. Free text responses were analysed thematically according to Miles and Huberman techniques of labelling, coding, categorizing and theme development. Constant comparative techniques were used to ensure all perspectives were represented in the analysis, and deviant cases examined. Of the 6608 individuals who opened the survey, a total of 4615 responses were received (70% response rate), of these, 816 (18%) reported having a LTHC. Of those with LTHCs, 606 (74%) reported that they could swim, 212 (26%) reported they could not. The three most common barriers reported amongst non-swimmers were a lack of disposable income (n = 208, 43%), it is too expensive (n = 191, 40%), and a lack of motivation (n = 178, 37%). Analysis of the free text responses identified four themes related to swimming: (i) Confidence, (ii) Fear of discrimination, stigma or unwanted attention, (iii) Availability, and (iv) Unwelcoming environment. The findings reveal that despite generally positive perceptions of swimming, multiple barriers prevent many from engaging. Targeted interventions to make swimming more accessible and appealing to individuals with LTHCs are needed. Future research would be valuable for informing policy decisions and should explore the effectiveness of specific interventions aimed at addressing these barriers.