https://www.mdu.se/

Participation, encompassing both attendance and involvement in daily and physical activities, is vital for the development and health of children and adolescents. Combinations of activities, places, people, objects, and time create contexts for participation. Participation varies with disabilities, socioeconomic status, gender, and age, factors which individually or collectively interact with these contexts. While assessments of participation commonly focus on activities, it is necessary to understand the contexts to promote participation. It remains unclear which contexts for daily activities are assessed by the Swedish participation instrument FUNDES-Child-SE, and how participation in moderate to vigorous physical activity (MVPA) contexts is distributed and shaped among adolescents. Therefore, this thesis aims to explore contexts for participation in daily activities, and the patterns and conditions for adolescents’ participation in MVPA contexts.

Two studies were conducted and presented in four articles. In Study I, data from 163 caregivers of 6-18-year-olds with disabilities were analyzed. Exploratory and confirmatory factor analysis, and coefficient alpha, were used to assess the structural validity of the FUNDES-Child-SE and identify contexts for participation in daily activities. In Study II, data from 3494 adolescents were analyzed through cluster analysis and coincidence analysis to explore patterns of and conditions for participation in MVPA contexts of sports and physical exercise.

Study I found that FUNDES-Child-SE assesses participation in both informal (activities within and outside the home) and formal contexts (activities at school and in society). In Study II, two clusters characterized by participation in sports were associated with having a disability. Among older adolescents, most of the identified clusters were associated with sex, with female sex being linked to half of the non-participation clusters in MVPA. The conditions for the non-participation cluster in physical exercise differed for girls and boys. While socioeconomic status was a key condition for girls, boys had several interrelated conditions for belonging to this cluster.

The discussion focuses on access to contexts through accommodation and affordability. To facilitate participation in formal contexts such as sports, adolescents with disabilities may need accommodations including aids, organizational adaptations, and peer support. Organizational adaptations and peer support may also accommodate girls’ participation. The influence of socioeconomic status on girls’ participation in MVPA may be due to gender stereotypes affecting affordability. Researching contexts for organized activities is complex, as these activities may be inseparable from other contextual factors such as people or places. 

In conclusion, this thesis emphasizes the importance of considering contexts broadly to promote adolescents' participation in daily and physical activities. Facilitating access and participation involves more than simply focusing on the activities. Future research should employ interdisciplinary multi-method designs to further investigate the participation construct, to examine the sports and physical exercise contexts for MVPA more deeply, and to investigate the acceptability of MVPA contexts, specifically for adolescents with disabilities and for girls.