Physical Activity Conversations Among Adolescents With Comorbid Asthma and Obesity

Background: Health-focused conversations are associated with better adolescent health and psychosocial outcomes compared to conversations focused on weight. Research has not identified the content and adolescent perspectives of conversations about physical activity (PA) with their parent(s). Characterizing these conversations will help inform effective ways to communicate about PA among adolescents with comorbid asthma and overweight/obesity (OW/OB). Methods: Twenty adolescents (45% Black, 35% White, 10% Hispanic; 10% biracial; Mage=16; 55% male) with asthma and OW/OB and a primary caregiver (90% mothers; Mdn income: $16-$24.9k) participated in separate semi-structured interviews about factors influencing physical activity. Caregivers and youth were asked how often they discussed PA, what the conversations involved, and the impact of the conversations on adolescents PA and emotions. Interviews were analyzed with NVivo. Two authors created a codebook, conducted thematic analysis (20% double coded), and final kappa was 0.62. Authors independently divided and coded the remainder of transcripts, reviewed each others codes, and met to discuss agreement. Results: Dyads (30%) indicated they talk about PA frequently (e.g., daily, weekly), and 15% said they do not. The remainder (40%) were mixed (e.g., caregiver/adolescent says frequent while other said not frequent). Themes regarding the content of PA conversations included: implications and importance of PA (25%), weight and PA (65%), asthma and PA (60%), and practical reasons (e.g., reminders, ideas; 90%). Themes regarding the impact of conversations on adolescent PA included: conversations make it harder (20%), easier (50%), and no impact (45%). Themes regarding impact on adolescent emotions included: stress or negative reaction (20%), and no strong feelings/feel fine (55%). Conclusions: Most adolescents with comorbid asthma and OW/OB explained that conversations about PA made it easier or had no impact on their PA. They believed the conversations did not negatively impact their emotions. Themes regarding PA conversations inform next steps to assess how different types of conversations impact adolescents health and psychosocial outcomes. Future research should examine discrepancies in caregiver and adolescent perceptions of these conversations.