Pacific Island adolescent girls with a physical disability: health and wellbeing through physical activity
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As is well documented, health and wellbeing is positively associated with participating in physical activity. However, the little research available suggested that Pacific adolescents generally, are participating in less physical activity than adolescents of other ethnic groups. Furthermore, there was even less evidence pertinent to the physical activity participation of Pacific girls who experience a physical disability. This presents a health and equity issue for these girls and a group at risk that needs to be prioritised to promote healthier lifestyles. The purpose of this thesis was to address the dearth of research with the focus specifically on Pacific adolescent girls with a physical disability, and their physical activity participation and sedentary behaviours. Despite the well-known benefits of participating in physical activity, this population is at risk of not partaking due to underlying factors including their gender, ethnic group, financial constraints, and physical disability. To increase participation, and reduce sedentary behaviours, factors influencing both participation and non-participation need to be considered. A mixed methods approach comprised of a series of studies which endeavoured to identify and explore factors that influence (facilitate or inhibit) physical activity participation or sedentary (screen time) behaviour in Pacific adolescents. Moreover, the aim was to gain insight into these factors, relevant to Pacific adolescent girls with a physical disability. The first study, a cross-sectional study, utilised data from a 2012 regional study comparing Pacific adolescent boys and girls with and without a physical disability. The study participants included 1,201 Pacific adolescents who were randomly selected and participated in the survey. Frequency of participation in physical activity, active transport (to and from school), and sedentary (screen time) behaviours were examined and measures of association between factors that enable or inhibit participation in physical activity, sedentary (screen time) behaviours, and active transport (to and from school) were explored. Findings from quantitative study presented demographic characteristics of the sample group. The results showed that from the overall sample group for this study, the ethnic groups included 48% Samoan, 20.6% Cook Island Maori, 25.7% Tongan, 8.3% Niuean, 3.6% Tokelauan, 13.7% Fijian and 6% other Pacific peoples. Moreover, 56.6% of the Pacific adolescents were female and the average age was reported as 14 years with the age ranging from under 12 to 19 years. Associations between the outcome measures on physical activity, active transport (to and from school), and sedentary (screen time) behaviours and associated variables, were presented. The results showed that the Pacific adolescents without a physical disability were predominately not meeting the recommended physical activity guidelines, and that 7.2% of the Pacific adolescents reported a long-term health disability. The Pacific adolescents with a disability (3.2%) who reported experiencing a difficulty as a result of their disability, also reported less sedentary (screen time) behaviours than those without a disability or difficulty. Other factors that showed associations with the outcome measures included socioeconomic influences, neighbourhood safety, peer groups, eating behaviours, enjoying competing and valuing physical activity, time spent on activities such as computer and electronic games. If the adolescents without a physical disability lived within 30 minutes of their school, the results also showed they were more likely to undertake active transport (to and from school). The second study comprised of seven interviews with Pacific adolescent girls and their mothers in a family setting while study three included the providers of services to Pacific girls with a physical disability. The providers of services conveyed a further insight into complexities of participation for the Pacific adolescent girls and their families. The focus of the talanoa (face-to-face informal interview) for study two and three was to explore participation and factors influencing partaking in physical activity, and to hear the voices of the participants themselves. An in-depth understanding of the factors that inhibited or facilitated participation in physical activity for the Pacific girl who experiences a physical disability, was gained through the participants' stories. The findings suggested that these girls wanted to participate in physical activity and clearly indicated the physical activities they preferred. However, their participation was influenced by the interplay of a range of gender, cultural, age-related (adolescence) and socio-economic factors alongside policy and structural related constraints. The main themes which were identified from the interviewees included: enjoyment, peers, health benefits, their family, and restrictions to participation, financial difficulties, access, travel complications, policy implications, and their physical disability. The imminent health and wellbeing of Pacific adolescents with a physical disability, is dependent on addressing initiatives and recommendations as outlined in this thesis. In order to make change, it is imperative this populace be given priority, while considering the multitude of factors which impact on participation.