A comprehensive, mixed methods inquiry into the physical literacy development of 8- to 12-year-old children living with chronic medical conditions


Physical literacy describes the physical, affective, and cognitive skills which facilitate an active lifestyle. Active lifestyles are essential for children living with chronic medical conditions (CMCs), but knowledge of physical literacy among this group is scarce. An explanatory, sequential design was applied to understand the current physical literacy of 91 paediatric Cardiology, Respirology/Cystic Fibrosis, Neurology, Hematology, and Endocrinology outpatients (mean age=10.0±1.3 years, 50% girls). All participants completed the Canadian Assessment of Physical Literacy (2nd Edition), and those with the highest and lowest scores were invited to a semi-structured interview. A deductive-inductive thematic analysis using Whitehead's (2010) conceptualization of physical literacy was applied. 80.2% of the 91 children assessed were beginning/progressing in overall physical literacy (mean score=56.0±13.4/100). Children scored highly on motivation/confidence (mean=23.3±4.95/30) but obtained low physical competence (mean=11.5±5.56/30) and daily behaviour scores (n=72, mean=14.9±6.80/30). Interview participants with the highest scores (n=11 of 21 eligible, age=10.0±1.5 years, 58% girls) communicated a strong desire to try new things ("I love learning new things so I can use it in games as strategies"). Those with the lowest scores (n=10 of 21, age=9.7±1.7 years, 50% girls) struggled to apply their skills/strengths to navigate game constraints ("I can't really learn, cause they're doing it so fast") and framed their physical activity within school-based and unstructured contexts. Overall, children with CMCs are motivated to be active but require additional support to develop physical literacy. Interventions should teach children with CMCs how to apply individual skills/strengths to diverse activities.

Acknowledgments: The participating families are thanked for their time and contributions to this research. We would also like to thank the research staff for their work on this project; Jenna Yaraskavitch, Javier Porras Gil, Vanessa Pinto and Busola Dehinbo