Abstract
BACKGROUND: The time spent physically active outside of school (e.g., extracurricular physical activity) is an important contributor to children's total daily physical activity for health and well-being. Little is known about the opportunities available to children to engage in extracurricular physical activity from low- to middle-income countries. This study aims to answer the question: What are the main perceived barriers and facilitators of extracurricular physical activity among school-age children in Mexico? METHODS: A multi-method cross-sectional study was performed. Six focus groups with children (aged 9-12 years), six focus groups with parents, 10 one-on-one interviews with parents, 12 interviews with teachers, and six interviews with head teachers were conducted across Campeche, Morelos, and Mexico State, Mexico. A questionnaire was applied to explore children's physical activity frequency and preferences for time inside and outside of school. Qualitative data analyses were performed with inductive thematic analysis supported with NVivo software. Quantitative data were analysed with descriptive statistics using IBM SPSS 26. RESULTS: Three main themes summarise the study's findings: (1) how children spend their time outside of school, (2) the places that children access, and (3) the social environment for physical activity outside of the school. The data suggest that children in Mexico dedicate their spare time to screen, work, do housework, or perform unstructured physical activity mostly at home instead of playing sports or actively outdoors. Family support, enjoyment of physical activity, access to programs and facilities, time, living in a housing complex with open common areas, and mild weather were important facilitators identified. 69.4% of children engage in extracurricular physical activity, none of which was provided by schools. More children commute by walking than riding a bike to and from school. Children living inland spent three times more time at home compared to those in seafront areas. CONCLUSIONS: Children rely on their families to partake in extracurricular structured physical activity. Policies targeting children's health and well-being should include school-based extracurricular physical activity programs.