Experiences of children with obesity and their parents of participating in a physical activity on prescription intervention: a qualitative study

Introduction The prevalence of childhood overweight and obesity has increased substantially in recent decades. Physical activity is a key component in improving metabolic and overall health in children with obesity. The Swedish Physical Activity on Prescription (PAP) is an established method for promoting physical activity, yet knowledge regarding its applicability and acceptability in paediatric populations is scarce. This study explored children's and parents’ experiences of PAP, including perceived barriers, facilitators, and any changes in physical activity behaviour. Methods Twenty-two children and parents were purposively recruited from a previous intervention study at paediatric and rehabilitation clinics in Region Västra Götaland, Sweden. Semi-structured, in-depth interviews were conducted at locations chosen by participants, audio-recorded, and transcribed verbatim. Data were analysed using inductive qualitative content analysis, including coding, categorisation, and development of an overarching theme. Researcher triangulation was applied throughout the analytical process to strengthen credibility. Results The analysis resulted in the main theme Physical activity on prescription spanning healthcare and everyday life, supported by five categories, each with three to five sub-categories. The category The clinical encounter describes the overall experience of PAP as part of a larger whole; Finding “your thing” addresses activity selection as a process with several factors influencing the choice, and Fitting activities into everyday life concerns adoption of activities, engaging the family, and strategies to sustain activities. The category Motivation through monitoring and f ollow-up describes three different types of follow-up important for motivation: a digital diary, healthcare contacts, and wearing a accelerometer waistband. The last category, Changes beyond physical activity, captures experiences of development in both activity, behaviour, health and emotion. Discussion The findings suggest that children with obesity and their parents experience PAP as a supportive, person-centred, intervention extending across healthcare, everyday life, and organised sports. The intervention was perceived as combining conversational guidance with shared responsibility, with engagement facilitated by fun, tailored activities aligned with family routines, while financial and practical barriers could limit participation. Overall, the findings suggest that individually adapted, family-inclusive PAP is a feasible and acceptable strategy in Swedish paediatric obesity care, with potential broader benefits for children's health and well-being.