Mixed-Methods Systematic Review to Identify Facilitators and Barriers for Parents/Carers to Engage Pre-School Children in Community-Based Opportunities to Be Physically Active

Background: Low physical activity levels in young children is a major concern. For children aged 0-5 years, engagement with opportunities to be physically active are often driven by the adults responsible for the child's care. This systematic review explores the barriers and facilitators to parents/caregivers engaging pre-school children in community-based opportunities for physical activity, within real-world settings, or as part of an intervention study. Methods: EBSCOhost Medline, CINHAL plus, EBSCOhost SPORTDiscus, Web of Science, ProQuest, and ASSIA were systematically searched for quantitative and qualitative studies published in English between 2015 and 16 May 2022. Data extracted from 16 articles (485 parents/carers; four countries) were quality-assessed using the Mixed Methods Assessment Tool and coded and themed via thematic analysis. Results: Nine themes (eight core, one minor) were identified and conceptualised into a socio-ecological model, illustrating factors over four levels: Individual-beliefs and knowledge (and parental parameters); Interpersonal-social benefits, social network, and family dynamic; Community-organisational factors and affordability; and Built and Physical Environment-infrastructure. Discussion: The findings provide valuable insights for practitioners and policy makers who commission, design, and deliver community-based physical activity opportunities for pre-school children. Developing strategies and opportunities that seek to address the barriers identified, as well as build on the facilitators highlighted by parents, particularly factors related to infrastructure and affordability, are imperative for physical activity promotion in pre-school children. The perspectives of fathers, socioeconomic and geographical differences, and the importance parents place on physical activity promotion all need to be explored further.