Global concern surrounding declining outdoor play, physical activity, and children’s engagement with natural environments has prompted increased interest in nature-based early childhood education (ECE). Within such settings, outdoor spaces are positioned as central to learning, supporting embodied and authentic interaction with the natural world. Despite expansion in provision, limited research has examined how parents and practitioners conceptualise the value of nature-based ECE or how their perspectives intersect across ecological contexts. This qualitative study investigated the key perspectives of parents and practitioners in nature-based ECE settings in England. Following institutional ethical approval, 16 participants were recruited: seven parents (all female) of children aged three to five years attending nature-based ECE settings and nine practitioners (eight females, one male). Data were generated through in-depth semi-structured interviews and analysed using reflexive thematic analysis. Five themes were identified: Protecting children’s rights; Nature as a context for whole-child development; Risk, resilience, and physicality; Communities of learning; and Beyond the setting: systemic pressures and parental fears. Choosing nature-based ECE reflects a proactive, health-promoting decision grounded in parental values concerning children’s rights to nature and outdoor play. Practitioner commitment was similarly values-driven, centred on children’s freedoms and positioned in tension with prevailing societal norms. Key findings illuminate practitioners’ concerns regarding the perceived absence of outdoor-based provision across mainstream ECE and schooling, highlighting the need for clearer regulatory frameworks to establish quality outdoor play in nature as a systemic entitlement.

Background: Fundamental movement skills (FMS) underpin lifelong physical activity (PA) and health, yet many children are failing to meet age-appropriate standards. Caregivers hold a critical influence over children’s motor development, but little is known about what helps or hinders family participation, including messaging. This study explored the determinants of family FMS engagement in the United Kingdom (UK) during early childhood, addressing unexplored gaps in how guidance reaches families and the role of grandparents in supporting children’s motor development. Methods: Twenty-three semi-structured interviews were conducted with 15 caregivers and 8 educators, including 4 grandparents and 2 family hub practitioners who offered original insights. Eleven children aged 3–5 years completed a flexible draw-and-tell task, enabling inclusion of rarely represented 3-year-olds. Thematic analysis was deployed. Results: Families and outdoor spaces were pivotal to children’s movement opportunities. However, awareness and understanding of FMS and UK PA guidance were poor, even among educators, disrupting dissemination of information to families. Greater emphasis on PA and FMS concepts within professional development, alongside clearer signposting to resources, more visible public-facing campaigns, and digital formats, could improve how families receive these messages. Tensions emerged between parents’ concerns about grandparents’ physical capability and grandparents’ belief that they could adapt to support children’s development. Unexpectedly, no children drew technology despite screen time frequently displacing active play, hinting at its normalisation and regulatory role in children’s lives. Conclusions: To enhance family understanding, value, and participation in FMS, UK policy must evolve to become more visible, relatable, and responsive to diverse family needs.

Introduction:Physical literacy provides a compelling framework for understanding young children's skills, attitudes, and behaviours in relation to movement and physical activity. Assessment represents a crucial step for establishing conceptual and practical relevance. However, there is limited evidence to support how this multidimensional construct can be meaningfully assessed in early childhood, constraining both research advancement and applied intervention. Methods:This mixed-methods study primarily aims to establish evidence for the Physical Literacy Early Years (PLEY) Wheel, a novel assessment approach assessing physical, social, cognitive, and affective skills and behaviours in children aged 3-5 years. 234 children (74% White British; age 3.84 ± 0.70 years; 51% girls, IMD decile 3.70 ± 3.0) and 17 educators (88% female) from 15 early education settings participated across a multi-phase study design. Secondary analyses examine associations with key variables, including device-based measured physical activity, and explore profile-based representations to support interpretation. Results:The PLEY Wheel provides a valid, reliable, and practical approach to benchmarking and profiling physical literacy in early childhood. The results showed that physical literacy increased with age, with girls scoring higher in cognitive and social domains, and children with special education needs or disabilities demonstrating lower physical literacy and physical activity. Physical activity varied widely within and between early education settings and was associated with physical literacy. Five profiles were identified, based on domain strengths and weaknesses, that were sensitive to age, sex, and socio-economic context, but did not strongly differentiate physical activity levels. Discussion:These findings advance the understanding of physical activity and physical literacy in 3-5-year-old children and highlight the potential of a child-centred, data-led approach. Establishing a valid and reliable assessment tool for early childhood provides a methodological foundation for examining how physical literacy manifests, relates to physical activity, and can be meaningfully interpreted to support early intervention.

Purpose: Physical activity (PA) is vital for everyone’s health and wellbeing; however, there is, a paucity of research amongst culturally deaf adults. Especially, to understand the needs of deaf adults and how to get them involved in shaping interventions that would help deaf people to be physically active. The current study aimed to explore barriers and facilitators for engaging in PA amongst deaf adults. Method: Focus groups involving nine culturally deaf adults communicating using British sign language were conducted and analysed using reflexive thematic analysis. Findings: Barriers including physical barriers, lack of deaf spaces and deaf awareness, and a lack of personal motivations were identified. Enablers included group/social support, deaf-led activities and health and wellbeing awareness. The findings highlighted a strong deaf identity. Conclusions: Deaf adults face barriers due to spaces being made for hearing people, leading to feelings of social exclusion and a lack of spaces to engage in activity and socialise, despite being personally and socially motivated to engage in PA. Deaf identity should be considered when promoting PA to deaf adults. The current paper highlights research and practice implications regarding how to engage and work with deaf people to develop appropriate interventions.

Contemporary physical activity (PA) strategies emphasise the PA needs of sedentary and inactive groups, with less emphasis placed on physically active groups. Understanding the needs of physically active groups is important in helping people to keep active. This study investigated the perspectives and experiences of physically active adults (‘Actives’) during the COVID-19 pandemic, including their PA levels, barriers and facilitators to/for PA, the strategies they deployed to keep active and their experiences of the messaging of Government health and PA guidelines. Following recruitment, thirteen in depth semi-structured interviews were undertaken with adult men and women who reported meeting the UK Chief Medical Officer’s PA guidelines before the COVID-19 pandemic commenced. Braun and Clarke’s thematic analysis identified five key themes and related sub-themes: (I) PA participation; (II) barriers to PA participation, including overcrowding of the PA space, conflict between different groups and negative mental health; (III) facilitators for PA, including place/residence, rural location, social support and good mental wellbeing; (IV) strategies to keep active, including improvisation, substitution of PA mode, scheduling PA, social support and goal setting; (V) guidance and messaging on the health guidelines, including PA promotion for strength and balance, mental health and where to receive information on PA. This study provides valuable insights for PA promotion for Actives at an unprecedented time.

INTRODUCTION:Self-compassion, which directs the awareness of suffering, sympathetic concerns and caring motives towards oneself, is an important psychological quality and resource for health and well-being. In the context of physical activity, self-compassion can help individuals overcome obstacles, recuperate from a setback or a lapse and engage in regular physical activity. The present research was the first to examine the longitudinal effects of self-compassion on physical activity and the mediation role of barrier self-efficacy of such effects. METHODS:We recruited a national representative sample of 654 UK adults and followed them over three timepoints across 9 months. At each time point, participants completed an online survey assessing levels of state self-compassion, barrier self-efficacy and physical activity behaviours. We examined the longitudinal effects of self-compassion on physical activity and the mediation role of barrier self-efficacy. RESULTS:Baseline state self-compassion consistently correlated with physical activity levels at Times 2 and 3. Barrier self-efficacy at Time 2 mediated the longitudinal effect of baseline state self-compassion on Time 3 physical activity, after controlling for within- (e.g., Time 1 on Time 2 self-compassion) and between-person variations (e.g., covariance of self-compassion and physical activity within a timepoint). CONCLUSIONS:Adopting a self-compassionate mind facilitates engagement and maintenance of physical activity. Future studies could consider accelerometer-based physical activity measures and develop and validate a more context-specific state self-compassion measure tailored for physical activity contexts. Researchers and practitioners should consider incorporating self-compassion to future interventions and education programmes for promoting physical activity.

Early childhood education (ECE) settings play a crucial role in promoting physical and social development among children aged 3–7 years. This systematic review sought to examine the associations between characteristics of ECE outdoor environments, social interactions, physical activity, and motor competence. The secondary aim examines previously applied methods to capture children’s behaviour in the context of their social and physical environment. Methods: This review used the PRISMA framework and study quality was assessed using the mixed-methods appraisal tool (MMAT). Keyword searches were conducted in seven databases. Studies were eligible if children were aged 3–7 years in ECE; physical activity, social interactions and/or motor competence were measured; location and/or social context were measured. Results were synthesised using an effect direct plot, a table of associations, and narrative synthesis. Results: Twenty-three studies from eight countries met the inclusion criteria. Intervention and controlled cross-sectional studies (n = 9) favoured high-quality outdoor environments rich in affordances, portable play equipment, and natural features to increase children’s physical activity, social interactions, and cooperative play. Cross-sectional and descriptive studies (n = 14) positively associated open grassy space, portable and fixed equipment, wheeled toys, and paths with physical activity (p < 0.05). Based on limited evidence, playground size and active games in small groups were associated with greater MC. Conclusions: The findings highlight the benefit of creating diverse affordance rich outdoor environments in early childhood settings to promote physical and social development. Limitations include variability in study designs and protocols for conducting systematic observations, thus emphasising the need for standardised approaches to future research.

Background: Childhood obesity is a significant public health crisis that is exposing children to associated morbidities and premature mortality. However, parents can positively influence physical activity trajectories and improve health outcomes by nurturing fundamental movement skills (FMS) in children. This is the first study to explore the determinants of family FMS practice via a systematic synthesis of qualitative evidence. Methods: Keyword searches were completed in SPORTDiscus, PubMed, Scopus, Web of Science, and Embase. Studies that offered perspectives relating to influences on the FMS of 2–6-year-old children in the family context via qualitative approaches, including visual methodologies that provided an important voice to children, were included. A thematic analysis was used to establish key themes. Results: The emergent themes included parent knowledge and beliefs, self-efficacy of parents to teach, and the home environment. Parents often undervalued FMS and lacked the self-efficacy to teach due to poor understanding, conflicting priorities, and multifaceted societal influences. Children preferred autonomous play and socialisation but were negatively influenced by technology and restrictive household rules. Conclusions: Greater knowledge exchange between stakeholders is necessary to empower parents and enhance FMS application at home. More community initiatives could facilitate greater access to outdoor spaces, facilities, and equipment, which may improve family engagement with FMS.

Background: Physical literacy (PL) is increasingly recognised as essential for fostering lifelong engagement in physical activity (PA), particularly when nurtured in early childhood. Yet there remains limited understanding of how stakeholders in early years (EY) education perceive, value, and implement a PL-informed approach. This study aims to explore knowledge and beliefs regarding PL and PA in relation to 3-5-year-olds, investigating key questions around perceived importance, current practices, and barriers to implementation. Methods: A concurrent mixed-methods approach was used, incorporating semi-structured expert interviews (n = 11), focus groups (n = 22), and a survey (n = 210). Thematic analysis was used to identify key themes from qualitative data, and survey data were analysed to complement and triangulate the qualitative findings. Results: The findings revealed variation in stakeholders' awareness of PA recommendations and confusion over terminology. Whilst stakeholders acknowledged the importance of PL, there remains uncertainty about the connection between theory and practical application. Identified barriers included resource limitations, conflicting priorities, and insufficient training and policy support. Feedback on an educational PL-EY model was generally positive, suggesting strong potential as a tool to support PL understanding and application in early childhood contexts. Conclusions: Given the pivotal role of EY education in shaping children's behaviours, health, and wellbeing, this study highlights the necessity of a holistic approach to interventions, strong stakeholder involvement, and evidence-based practices to foster PL in EY children. The PL-EY model presents a promising direction for future resources and education and raises critical questions about what effective interventions to develop PL in this age group should consider and look like.

Fundamental motor skills (FMS) are the cornerstone of a child’s motor development, but concerns remain on the current level of FMS competencies, and intervention is required. This evaluation investigated if a targeted Early Years FMS intervention, delivered by a specialist physical education (PE) provider, improved the FMS of 4–5-year-old children across multiple sites. Methods: The Early Years FMS intervention ran for 18 weeks, 1 h/week, using a standardised programme of activities to develop FMS competencies across 219 children from 15 schools in the Midlands, UK. An adapted assessment was employed as a measure of FMS, assessing locomotor, object control, and stability skills at weeks 1, 9, and 18. The FMS were each rated as green = competent, amber = working towards, or red = not meeting the standards of the skill. A description of key programme implementation characteristics was described. Findings: Statistically significant increases in FMS competencies were achieved for 80% of participants at 18 weeks. Key implementation characteristics for the intervention included consistent staffing, a standardised programme, and a variety of pedagogical approaches delivered by specialist PE staff. Conclusion: This evaluation provided important insights into the effectiveness and implementation of the Early Years FMS intervention to improve FMS competencies in children aged 4–5 years.

BackgroundDespite physical activity (PA) providing specific health benefits during pregnancy and the postpartum period, many women report decreased PA during this time. Provision of PA advice has been found to be lacking amongst midwives due to a range of barriers. This study aimed to evaluate United Kingdom's midwives' current role and knowledge regarding the provision of PA advice to pregnant and postpartum women and identify the barriers and potential solutions.MethodsTen UK midwives (mean work experience ± SD: 15.5 years ± 10.2) participated in semi-structured interviews between May and July 2023. Data were analysed using a deductive thematic approach following Braun and Clarke's six steps. Demographic data were collected by Microsoft Forms then summarised using Microsoft Excel.ResultsSix themes with 25 subthemes were identified as barriers and solutions in delivering PA advice. The role of midwives in providing PA advice during pregnancy; the role of midwives in providing PA advice postpartum; intrinsic barriers that limit PA advice provision (confidence, safety concerns, knowledge, and midwife's personal body habitus); extrinsic barriers that limit PA advice provision (lack of time, education, PA not a priority in care); solutions to allow midwives to promote PA (including formal PA education, and dissemination of resources); and optimising delivery of PA advice (personalized approach, interprofessional collaboration, and linking to mental health benefits).DiscussionMidwives consider themselves ideally placed to provide PA advice to pregnant women, with many aware of the benefits PA provides. Despite this, there is a lack of PA advice provision and knowledge of PA guidelines. Postpartum PA advice appeared to be considered outside the remit of midwives, due to limited contact. Further research is needed to determine the current level of PA advice provision for pregnant and postpartum women and explore the role of other healthcare professionals involved in maternity care.

BackgroundDocumentation of research outcomes using impact case studies (ICS) is increasingly required to demonstrate the wider societal benefits of research. However, there is limited evidence of the best way to communicate research outcomes using ICS, especially when highlighting research impact that is not part of a research assessment programme. This study aims, for the first time, to analyse expectations, and methods of communicating impact from medical research across a varied set of stakeholders relevant to the Medical Research Council (MRC).MethodsImpact narratives about outcomes and impact from MRC research were evaluated using an online survey and in depth semi-structured interviews. Participants were recruited from internal MRC databases and included early career and senior management academics as well as representatives from industry, healthcare, charities, and the government. Informed consent was gained prior to data collection and the study was approved by the university's research ethics committee. Qualitative and quantitative analysis determined stakeholder preferences for ICS content, language and presentation as well as capturing themes and perspectives on the concept of research impact.Results193 participants responded to the online survey exploring definitions of impact and methods of communicating medical research outcomes. The work uncovered expectations of improved health and wellbeing as well as knowledge generation via publications and citations. In depth interviews with sixteen participants demonstrated preferences for clear, easy to read content that focused on facts and evidence and avoided both academic and hyperbolic language. Emergent themes from this work revealed that ICS need to quickly capture imagination and grab attention, while the views and expectations are quite different to press releases and are audience specific.ConclusionsThe content of ICS often focuses on non-academic impacts; however this work highlighted that evidence of academic impacts were outcomes highly valued by stakeholders relevant to the MRC. This work examined a new typology of ICS attributes, which emphasised that the language and presentation of impact narratives can influence the perception of research outcomes, providing useful information for individuals and organisations using ICS to showcase their research. It also shows that if ICS attempt to communicate challenges and issues around achieving impact from research, they may be more credible and useful to their intended audience.

INTRODUCTION:There continues to be an imbalance of research into weight loss and weight loss maintenance (WLM), with a particular lack of research into WLM in young people under 18 years. Failure to coherently understand WLM in young people may be a potential contributor to the underdeveloped guidance surrounding long-term support. Furthermore, no research has investigated young people's preferences around WLM support following the attendance of a residential intensive weight loss intervention from a qualitative perspective. This study explored the influences of WLM in young people following a residential intensive weight loss intervention, considered how interventions could be improved and sought to develop recommendations for stakeholders responsible for designing WLM interventions. METHODS:The context in which this research is framed was taken from a residential Intensive Weight Loss Intervention for young people aged 8-17 years in England. Six semi-structured interviews were carried out to understand the lived experience of WLM, including barriers and enablers influencing WLM, adopting an interpretative phenomenological analysis design. FINDINGS:Three superordinate themes were developed to explain the barriers and enablers to WLM; (1) Behavioural control and the psychosocial skills to self-regulate WLM; (2) Delivering effective social support; and (3) Conflicting priorities and environmental triggers. CONCLUSION:The findings of this research mirror that of other studies of WLM in young people, with the majority of young people struggling to maintain weight loss. However, by exploring the experience of WLM in young people through qualitative means, it was possible to understand the specific motivators and barriers influencing WLM behaviours in this context, providing recommendations to support WLM. PATIENT OR PUBLIC CONTRIBUTION:The interview guide was developed in consultation with a young person from the intervention, and through discussions with the intervention stakeholders (delivery staff and management staff). The interview guide included topics such as knowledge and skills; experience of weight loss; reflections on weight maintenance, and experiences of daily life postintervention. We piloted the interview schedule with one young person who had consented to take part in the research. This first interview was used to check for understanding of questions and to assess the flow of the interview.

The Healthy Ageing Challenge aims for people to enjoy at least five extra healthy, independent years of life by 2035, while narrowing the gap between the experiences of the richest and poorest [...]

Unlike other personality traits or dispositions, self-compassion can be nurtured and is likely a driving source for physical activity. Emerging research has started to examine self-compassion in physical activity contexts; however, most existing studies were underpowered and overlooked the psycho-behavioural factors underlying the link between self-compassion and physical activity. In a sample of 569 UK adults (mean age = 41.92 years, SD = 13.70; 47.8% female), we examined the hypothesis that self-compassion's positive influence on physical activity operates through reduced psychological distress and subsequently increased barrier self-efficacy. Results supported the prediction, with the positive influences of self-compassion being more prominent in more vigorous physical activity. The findings suggest that self-compassion is a good source of emotional resources (i.e., attenuated psychological distress) and confidence to overcome challenges and obstacles (i.e., increased barrier self-efficacy) in the context of physical activity. Future interventions and programs could consider incorporating self-compassion for physical activity adoption and maintenance.

Type 1 diabetes (T1DM) is a public health issue for children, young people, and families (CYPF) and requires innovative interventions. The DigiBete app is a self-management and educational app to help CYPF and healthcare professionals (HCPs) manage T1DM, featuring educational advice and resources such as guidance, quizzes, and educational and instructional videos on how to manage T1DM. To assess the impact and implementation of the app, the service-level evaluation deployed a mixed-methods design. App data were captured via the DigiBete platform and an online survey with a non-probability sample of HCPs (N = 178) and CYPF (N = 1165) = 1343. Overall, 55.7% (n = 512/919) of app users were female, and 4855 videos were viewed across the participating areas, with an average of 1213 videos per site (range 776-1679) and 4.4 videos per app user. The most popular videos were how to give a glucagon injection and "My Sick Day Rules", which showed what to do when CYPF were unwell due to T1DM. Interviews (n = 63) were undertaken with 38 CYPF and 25 HCPs. The findings indicate that CYPF and HCPs found the app an essential tool in the management of T1DM. CYPF and HCPs felt the app provided a valuable educational resource in a central location that was invaluable in an emergency or unknown situation. The app was a trusted and bona-fide source of information that could be accessed at any time. HCPs validated DigiBete in helping CYPF to manage their T1DM. At the same time, the app saved HCPs' service time and money and helped CYPF take back some of the control in managing their diabetes.