Boys, Transitions, and Physical (In)activity: Exploring the Socio-Behavioural Mediators of Participation

Abstract

Purpose: To explore the socio-behavioural mechanisms that motivate or dissuade boys' participation in physical activity (PA) as they transition into adolescence and their implications for physical therapy. Methods: This critical qualitative study involved in-depth interviews using active interviewing techniques with 15 adolescent boys. Data generation and analysis were driven by techniques of grounded theory and Bourdieu's sociology of practice. Results: The analysis identified intersectional relationships among emotions, the inherent pleasures of movement, and a sense of connectedness to PA, each of which acted as a mediating mechanism in motivating participation in PA. Analogously, body dissatisfaction, negative self-perceptions, and repeated instances of explicit and symbolic bullying intersected to dissuade boys from participating and created apathy toward PA. Conclusion: Identifying socio-behavioural mechanisms that motivate or dissuade physically active behaviour contributes new knowledge toward understanding PA attrition among boys transitioning to adolescence. As health advocates and movement experts, physiotherapists have an important role in helping adolescents of all abilities to participate in activities that provide them with meaning, inclusivity, and a sense of connectedness to PA.

Physiotherapists in Canada are essential partners in promoting physical activity (PA) of children and adolescents of all abilities, with the aim of optimizing lifelong health, well-being, and development.¹ Indeed, the importance of promoting physically active behaviours among children and adolescents is underscored by emerging research that has consistently associated PA with minimization of risk factors for the onset of cardiovascular disease,² increases in cognitive function and academic performance,³ positive effects on markers of mental health,⁴ and overall positive health outcomes.⁵ Yet, despite voluminous evidence for the significant benefits of engaging in regular PA,* participation among Canadian children and adolescents continues to decline,⁶ with the most significant decreases in participation observed among boys as they transition into adolescence (ages 12–17 years).^6–8 These reported decreases in PA participation among boys moving from childhood into adolescence (hereafter transitioning boys) are problematic because boys are more likely than girls to become overweight or obese,^9–11 and they are more likely to develop both acute and chronic health complications.^12,13 Given the many potential adverse health complications associated with physical inactivity and calls for more PA research to be conducted with boys,^14,15 there is a pressing need for research to investigate the various mediators prompting disengagement and withdrawal among transitioning boys

Notably, in much of the life transition research related to adolescent health care to date, participants have almost exclusively been adolescents with chronic conditions or disabilities that were once limited to childhood (e.g., muscular dystrophy, cystic fibrosis, spina bifida).¹⁶ Although some minimal literature has explored how these transitions influence physically active behaviours among adults without disabilities,¹⁷ we know of no Canadian research that has examined how complex social and behavioural mechanisms mediate physically active behaviours as boys transition into adolescence. Exploring how the transition from childhood to adolescence mediates physically active behaviours, therefore, can provide significant new insights into why boys are increasingly withdrawing from PA. By understanding the mechanisms that invite or dissuade active participation, physiotherapists can partner with others to motivate boys to be physically active.

The purpose of our study, therefore, was to provide a more nuanced understanding of the complex social and behavioural mechanisms that mediate participation in PA among transitioning boys. In what follows, we provide an overview of our research methods and conceptual approach. Then, in the Results section, we highlight that although some boys found pleasure and excitement in PA, other boys experienced abuse, degradation, and ignominy from peers and adults alike. These repeated negative experiences in PA in turn oriented the boys toward disengagement and withdrawal rather than active participation.

Our research suggests that although PA is often championed as an effective tool to positively affect adolescents' health and well-being, the negative psychosocial aspects of participation can be equally debilitating to their health and well-being. With little moral space for individuals to potentially prefer to be inactive in contemporary society, we suggest there is a need to problematize assumptions that promote PA as a universal panacea to the burgeoning global childhood obesity epidemic. To this end, we conclude the article by inviting physiotherapists to challenge value-laden normalizing practices and to promote the inherent pleasures of movement in an effort to maximize children's and adolescents' physical, social, and psychological potential.

Methods

Conceptual approach

The interview data presented here were drawn from a larger multi-method critical qualitative study examining the mechanisms of engagement and disengagement among adolescent boys in a health and physical education class.¹⁸ The study was approved by the Office of Research Ethics at the University of Toronto, and the research took place between January 2013 and March 2014 at a private boys' school in Toronto. The research design, data generation, and data analysis used a grounded theory approach, which simultaneously discovers, develops, and provisionally verifies collected data through concomitant analysis¹⁹ and is a significant resource to “explore and conceptually develop research areas that have been under-researched and are devoid of an empirical, conceptual or substantive basis.”^20(p.244)

Data generation

In an effort to capture a spectrum of PA experiences, adolescent boys of all physical abilities and interests in PA who were in Grade 8 (i.e., transitioning to secondary school) were invited to participate in an interview. Of 32 potential participants, 15 consented to participate (for participant demographics, see Table 1).

Table 1.

Participant Demographics

Participant pseudonym	Age, y	PA participation at time of interview	Self-identified perceived physical ability level
Khanseb	13	Tae kwon do, parkour	Low
John	12	Cross-country, track and field, squash, hockey	High
Sebastian	12	Kung fu	Low
Frank	13	Hockey	High
Peter	12	Tennis, golf	High
Hugg	13	Gaelic football, rugby	Low
Snazzy Cats	13	No formal participation in PA	Low
Storm	13	Nordic skiing	High
Penny	13	Hockey, parkour	High
Eli Silver	13	No formal participation in PA	Low
A-Rod	14	Hockey	High
Anonymous	13	No formal participation in PA	Low
Derek	13	Basketball	High
Aloysius	13	Hockey	High
AJ	13	Squash	Low

PA=physical activity.

Face-to-face interviews were conducted by the primary author (PJ), who had previous experience interviewing children using structured, semi-structured, and open interview methods. An active interviewing strategy was used and has been described in detail elsewhere.²¹ In accordance with an interpretivist epistemology, active interviewing acknowledges that researchers and participants co-construct knowledge in the context of the interview.²² Thus, the interview is an active dialectical process in which social dynamics, identities, and characteristics such as race,²³ social class,²⁴ ability or disability,²⁵ and gender mediate the “content, breadth and quality of interviews.”^21(p.569)

In this study, we acknowledge that the primary author's gender and embodied physicalities (i.e., physical traits congruent with stereotypical notions of athleticism and masculinity) served as both a problem and a resource. Boys who did not identify with him as a White man who conforms to stereotypical notions of athleticism and masculinity may have been reticent to share their negative or humiliating experiences with PA. Equally, although the primary author's social identities and position of power and privilege may have been problematic for some boys, these identities also served as a valuable resource because some boys readily identified with his experiences as a former provincial high-performance athlete and spoke about their PA experiences without much prompting. Since an interviewer's positionality can influence the data in unpredictable ways,²⁵ reflexivity was used during study design, analysis, and write-up to examine the influence of the aforementioned social dynamics on the generated data.

The active interviewing strategy was used to move participants beyond merely describing PA experiences to explaining how social practices, processes, and structures mediated dispositions and behaviours. Supported by an interview guide, semi-structured interviews were conducted to examine how various individual, pedagogical, and environmental mechanisms influenced boys' participation. In addition, as a method of further unpacking how individual physically active behaviours were shaped by the broader social environment, boys were asked to self-identify their physical ability level as either high or low (see Table 1) and to explain how their perceived ability level corresponded with their current participation in PA.

Data analysis procedures

All interviews were digitally audio-recorded and transcribed for analysis. Drawing on Glasser's²⁶ grounded theory techniques, we analyzed data concurrently throughout the entire process of data collection (constant comparison). All data were therefore analyzed first using open coding (attributing preliminary ideas to the captured data) and then using axial coding (identifying relationships between open codes) to understand how the data related to the study's purposes. As more data were generated, axial codes were reduced to the core categories (selective codes) of enjoyment and apathy, and further data generation²⁷ was aimed at exploring these core categories through constant comparison.

Throughout the iterative process of analysis and interpretation, we used extensive analytic memos,²⁸ multiple coding cycles, and a reflexive diary to educe potential relationships in the data and enhance the rigour of the interpretations.²⁹ Once the interviews no longer yielded new data on enjoyment and apathy (i.e., data or theoretical saturation), we turned toward theoretical abstraction. In this phase of analysis, we used Bourdieu's conceptual tools of habitus, field, and capital to further interpret the processual relationships and to develop physical cultural capital¹⁸ as a substantive theoretical tool.

A Bourdieusian approach to interpretation

Pierre Bourdieu's conceptual tools of habitus, field, and capital provide analytical procedures to critically examine how a person's or group's behaviour is mediated by his or her social environment.³⁰ In our study, Bourdieu's central concept of habitus served as a tool to further interpret the social mechanisms that mediate physically active behaviour among this particular group of transitioning boys. As a relational concept, habitus can be understood as a set of dispositions that guide thought, action, and behaviour in a specific context that becomes inculcated through repeated exposure to a particular set of social conditions and experiences.³¹ Although the habitus becomes internalized within the individual, it functions only in relation to a social context or field.³² Fields can be understood as formative “social microcosms, such as the family, the education system, and rehabilitation,”^30(p.475) that have their own embedded logics of expected roles, activities and behaviours.

In our study, transitioning boys traversed the fields of sport and PA, with their inherent scientific, meritocratic, and hierarchical logics and practices. It is important to note that fields are not value-neutral spaces³¹ because each field valorizes or discredits particular forms of capital. Capital is defined as any resource (economic, social, cultural, or physical) that may empower or subordinate individuals³³ in a given social field. As we illustrate, boys transitioning to adolescence who possess particular forms of valued capital, such as high physical ability or muscular, fit bodies, enjoy a higher status in these fields and are thus more likely to participate.

Results

Here, organized by themes emanating from the core categories of enjoyment and apathy, we examine the socio-behavioural mechanisms that invite and dissuade participation in PA among transitioning boys. Among our participants, the intersectional relationships among emotions, the inherent pleasures of movement, and a sense of connectedness to PA acted as mediating mechanisms in motivating participation, and body dissatisfaction, negative self-perceptions, and repeated instances of explicit and symbolic bullying intersected to dissuade participation and created apathy toward PA. All names mentioned in our analyses are pseudonyms selected by participants.

Socio-behavioural mechanisms that motivate activity participation

Quest for excitement in physical activity

As they transitioned toward adolescence, the boys in this study remarked that they increasingly sought novel and exciting physical activities that attracted and maintained their interest. This quest for excitement in PA was located in both structured and unstructured activities and served as an integral antecedent to motivating participation. As perhaps best expressed by Penny,

For guys our age, as soon as we get bored of something, we'll no longer do it and that was the case for me dropping out of competitive soccer. Soccer is the exact same thing over and over again, same rules, same teams, same purpose. Now an activity like parkour is the total opposite where the purpose is to just run outside and be free, think for yourself, and create new movements out of nothing. That's what really gets me excited and even though I'm always dead tired after running, thinking, and jumping, I feel so much better and honestly feel like parkour allows me to experience physical, emotional, and mental challenges that I didn't get playing hockey or soccer or even gym class. More and more of my friends are starting to do parkour with me because they're just tired of doing the same old thing over and over again and parkour just gives that edge of risky, exciting, but still kind of safe behaviour that boys our age look for.

Acknowledging that the habitus is the product of history that becomes “inscribed in their bodies by past experiences,”^32(p.138) boys were motivated to be active when fields and activities were centred on opportunities to have fun, socialize with friends, and experience competition among peers. These positive social experiences in physically active fields provided a sense of physical development, vitality, and emotional liberation as the boys embraced human movement as a way of life and a complete state of being. Actively promoting this quest for participation and excitement in PA, Storm remarked,

Hanging with the boys and competing with or against them when skateboarding is the best way to be active…. [Skateboarding] not only keeps me active but really is a full way of life where you constantly try to learn new tricks and go down the rabbit hole a little deeper to figure out what you're really made of. Unless you get hurt, not only do you have fun, but you learn about pushing your own physical and mental boundaries which kind of gets you excited and makes you want to try, and try again. Even though we fail doing some of the tricks, we still come out feeling positive about ourselves which motivates me to keep skating.

Pleasures of movement

Echoing Csikszentmihalyi's³⁴ description of flow, a state of full immersion with complete focus and absorption into the current state of being, participants described experiencing PA in particular ways that contributed to developing dispositions of the habitus. When they experienced opportunities to develop skill mastery, experience frequent participation, and achieve success in the given activity, the pleasures of movement actively developed motivational schemes of perception (habitus) toward PA participation. Anonymous described,

I'm no athlete. Never was, never will be, but when I get chances to participate, to try on my own to get better, and to see that I'm getting better, sometimes I just get so caught up in what I'm doing that I don't want the activity to end. There really is no better feeling than being active and I just love moving where I just feel so relaxed and don't have to worry about anything, especially my schoolwork.

Since the habitus is not an innate capacity³⁵ but rather the internalization of social practices and experiences that can generate dispositions toward future schemes of perception, action, and behaviour,³² boys who developed a habitus of participation in childhood were inclined to remain active during adolescence and adulthood as well. This was reflected in their accounts. As demonstrated by Aloysius—who stated, “I've had great experiences being active as kid and I honestly can't see myself not being active. Sports and physical activity is life!”—it appears that positive childhood experiences had a formative role in laying the physical, social, and emotional groundwork for future participation.

Sense of connectedness and identity

The notion of developing a sense of connectedness to and among peers recurred across participants' accounts and was located in both individual (kung fu) and collective (Gaelic football) PAs. With respect to motivating participation in PA, a sense of connectedness for this group of boys referred to feelings of acceptance by peers, sentiments of inclusion and belonging in that particular physically active space, and the development of a physically active social identity. Illustrating how a sense of connectedness contributed to the formation of a habitus that guided active participation, AJ remarked,

The major reason why I keep coming back to play squash is because I feel good about myself here. I come to the squash club knowing that I belong here, my squash friends accept me for who I am and how well or badly I can play, and I leave playing squash feeling good about myself. Knowing that I'll be accepted time and time again is important for me because it helps me stay excited to play squash as often as I can. Until any of these things change, I will keep coming back here for more because it feels like a safe place for me.

Echoing sentiments similar to AJ's, Sebastian was very reflective concerning how his participation in PA constructed a socially connected identity that carried significant social importance as he transitioned into adolescence. Because PA participation was lauded and valorized by teachers and peers at the private school at which this research took place, a physically active social identity served as a form of capital that endowed boys with social status and a sense of belonging. The pursuit of a socially connected physically active identity motivated Sebastian's participation in kung fu. He stated,

Even though it sounds kind of soft, I think guys our age all just want to feel accepted and you don't want to be that guy who isn't being active because you don't fit in with the rest. No one really cares about how well you can sing or draw, so guys our age look for physical activities that kind of bring you attention so that you feel accepted by your peers. I went from zero to hero only because I started kung fu and now teachers and students call me the kung fu master. To be honest, what really motivates me to stay active is that I always want to be known as the kung fu master at school and with my friends so yeah that's why I still participate.

As this analysis illustrates, PA participation confers social and symbolic distinction as boys transitioning to adolescence pursue field-specific bodily and social capital that, as Sebastian said, “bring you attention.” This pursuit of social distinction in conjunction with positive formative experiences that provide boys with meaning, pleasure, and excitement is an integral disposition that formulates a habitus oriented toward PA enjoyment and participation.

Socio-behavioural mechanisms dissuading activity participation

Fitness, fatness, and body image

In fields of sport and PA, in which a fit and muscular body is an important source of physical capital, the boys in our study demonstrated an increased prevalence of body image concerns as they transitioned into adolescence. Deeply woven into the narratives of boys who self-identified as having low physical ability were consistent expressions of significant dissatisfaction about being too fat or too thin. Their dissatisfaction contributed to the development of negative self-perceptions of their bodies and PA more broadly because they internalized the notion that their bodies deviated from the value-laden healthy mesomorphic body that is socially valued in physically active fields. Often bullied by his peers because of his failure to cultivate a buff, muscular body, Snazzy Cats reflected that he found little motivation to be physically active because his body had no place in physically active fields:

When you look at active people like athletes, they're all buff and stuff and only if you are buff as a guy my age, you don't get bullied. I've tried a bunch of different physical activities and instead of looking at how good or bad I am at the activity, the only thing that mattered to coaches and other guys was the extra blubber I had laying around. When I used to play baseball, the buff guys always joked that I needed a bra to support my boobs and coaches would make me run extra laps so that they could whip me into shape, as they would say. When you keep hearing this stuff eventually you start hating how your body looks, moves, and feels and you learn that you just don't fit in. And being active then is just not worth the pain and suffering that you experience so quitting just makes sense.

Although Grogan and colleagues³⁶ argued that body dissatisfaction can sometimes motivate PA participation, our participants' accounts conveyed how the constant focus on their body perpetuated by peers, coaches, doctors, and teachers can prompt boys to withdraw from activities. As with Snazzy Cats, another participant, Eli Silver, remarked that he experienced a medicalized preoccupation with his body weight, size, and shape at the height of an apparent childhood obesity epidemic. This preoccupation served as a major source of shame, perpetuated his body dissatisfaction, and dissuaded his participation. Loathing PA, he expressed,

What doctors and teachers don't realize is that focusing so much only on body weight and not being fat makes guys like me who are technically overweight feel constantly on edge. We get overwhelmed and worry so much that our body isn't what it is supposed to be according to the BMI [body mass index] or other fitness tests, so you just feel so ashamed of how you look. And because physical activity follows these fat-free rules that come from the people who make and use the BMI, the last thing guys like me want to do is to be active because we're consistently told that we're a ticking time bomb that needs to [be] fixed.

In addition to identifying the relationship between body image challenges and PA participation, participants expressed that they felt it was inappropriate and “soft” to disclose and or discuss body image challenges with their peers and adults. Emerging research has suggested that body image is a significant factor mediating health practices among men,³⁷ and Anonymous highlighted the need to encourage discussion about body image challenges and to jettison the emphasis placed on valuing fit muscular bodies and teaching boys that they should all look like this in physically active fields to improve participation. He remarked,

Boys like me aren't naturally born lazy, it's the complete opposite. We look for activities that are exciting and fun like everyone else but when you realize that the way your body looks, moves, and feels is a misfit from what science class and society tells you, it's hard to feel good about yourself. So pulling out of being active is sometimes the best solution. If you really want kids to be more active, we need to stop putting so much value and attention on fit muscular bodies [and] teaching boys that we all should look like this because it's not realistic. We also need to start teaching boys that they should feel comfortable in their own skin and that [it] is okay to talk to other people about how they feel about their bodies and any body image worries they are having.

Bullying and apathy toward physical activity

In presenting their experiences of PA, boys who self-identified as having low physical ability noted that as they were transitioning to adolescence, they were increasingly being subjected to bullying and exclusion by peers and coaches, respectively. Bullying was often explicit in nature (name calling, social humiliation and mocking, and social ostracism) and had debilitating emotional effects that created and sustained a habitus of apathy toward mainstream sport and PA altogether. It is perhaps not surprising, then, that these boys lamented that bullying served as a significant mechanism of disengagement and that their withdrawal from mainstream PA presented a logical solution. As perhaps best expressed by Khanseb,

I didn't mind playing hockey and soccer, loved it actually, but when you keep getting bullied by guys who tell you that you suck, blame you for everything when we lose, and when the coach says that you play like a girl and need to learn how to play like a man, quitting both sports was my best decision because I don't have to put up with their shit anymore. You can only ignore things like this for so long until you realize that you just don't belong there and that quitting is the best and only solution.

Our data revealed that, equally as damaging as explicit bullying, symbolic forms of bullying tacitly recurs in changing room spaces as well. With increasing emphasis on high-performance sport competition, winning, and meritocratic or performance-based achievement as boys transition into adolescence, boys who did not acquire and perform valorized field-specific capital were symbolically sanctioned and ostracized in the changing room by their peers. Given that the habitus is formed through social experiences that are observed and internalized,³² repeated exposure to these negative socio-emotional experiences in fields of sport and PA can contribute to a habitus of PA withdrawal. As Hugg illustrated,

Every week before we had practice when I was in swimming classes, the popular guys would hold kangaroo court and they would assign the not-cool kids like me to the loner corner of the change room. If the kangaroo court judge decided you were going to the loner corner, you changed into and out of your swim gear in the corner away from everyone else, kept your mouth shut and were always chosen last in all swim practice activities. This song and dance happened almost every week so I quit swimming cause it wasn't fun anymore, and if anything, it became torture and hell.

An alarming finding was that victims of bullying in physically active fields described bullying, derision, and ignominy as just “part of sports” and “part of becoming a man,” and out of fear of reprisal, they did not report these damaging behaviours to adults. This naturalization and suppression of bullying provided boys with little comfort in PA. The participants' assumptions that this is just the way it is demonstrate the function of the habitus that, formed in childhood, conforms to the logic(s) of the field and guides lifelong schemes of perception, thought, action, and behaviour.³¹ Perhaps it is not surprising that these boys did not anticipate being physically active during adolescence and adulthood.

Discussion

Grounded in an inductive critical qualitative approach and Bourdieu's conceptual tools, we explored some of the complex socio-behavioural mechanisms that motivate or dissuade boys' participation in PA as they transition into adolescence. Our analysis suggests that the relationships among emotions, the inherent pleasures of movement, and a sense of connectedness to PA are intersectional socio-behavioural mechanisms that motivate participation. Tellingly, boys of all abilities sought both structured and unstructured physically active fields, activities, and opportunities that elicited excitement, novelty, a sense of inclusion, and pleasurable experiences. Those who could obtain or sustain valued forms of capital (e.g., buff bodies) in physically active fields developed a habitus of active participation that, in turn, motivated them to remain physically active in adolescence.

Although research exploring the relationship between body image and health practices has predominantly been conducted with girls and women,³⁸ our findings show that body image concerns were very prevalent among boys in our sample and mediated their participation in PA as they approached adolescence. Although Sallis and colleagues³⁹ reported inconclusive evidence of a relationship between body image and PA participation among children and adolescents, boys in our study who self-identified as having low physical ability also revealed negative self-perceptions and body dissatisfaction and had internalized the idea that their (too fat or thin) bodies had no place in mainstream sport and PA. Because their bodies deviated from the value-laden, singular, quantified, and normalized healthy mesomorphic body that is socially⁴⁰ and medically valued,⁴¹ they were not afforded cultural, symbolic, or physical forms of capital. Their bodies were, in turn, vilified as carrying social risk and needing medical intervention and rehabilitation. It is unsurprising, therefore, that participants who self-identified as having low physical ability developed a strong distaste for PA and that some subsequently withdrew from participation altogether.

Furthermore, consistent with Labre's⁴² findings, not only were body image concerns prevalent and debilitating, boys' body image concerns were individually suppressed and regarded as a taboo issue that should not be discussed with peers or adults. In light of the burgeoning trend toward body dysmorphia among adolescent boys^43,44 and the routine failure of health professionals and media to acknowledge boys' body image challenges,⁴⁵ our findings highlight the need to rethink physiotherapy practices^46,47 that strictly value and promote the mesomorphic healthy, active body.

The study findings also suggest that repeated instances of explicit and symbolic bullying work to create dispositions of apathy toward PA. As illustrated, bullying was rife in physically active fields, became more prevalent during the transition to adolescence, and was problematically rationalized by participants as an expected and accepted rite of passage from childhood to adolescence. Consistent with previous research exploring the interrelationship between bullying and participation in PA,^48–51 boys in our study who were repeatedly bullied withdrew from PA and did not anticipate participating in PA in adolescence and adulthood.

Given the findings of this study, our research points to the need for educators, coaches, scholars, and health professionals to provide positive and supportive formative PA experiences and instill value of bodies of all abilities and sizes to support the health and well-being of transitioning boys. In line with research by O'Reilly and colleagues⁵² and by Strean,⁵³ our study suggests that formative experiences in PA during childhood and adolescence can help create behavioural dispositions that guide lifelong participation. Considering that physiotherapists in Canada are expected to promote PA for leisure, health promotion, and intervention purposes,¹ we conclude with some suggestions for how physiotherapy practice and education could facilitate, and potentially augment, PA participation among boys of all abilities who are transitioning to adolescence.

Implications for physiotherapy

As movement experts who seek to enhance the health and well-being of children and adolescents, physiotherapists need to consider not only the frequency, intensity, type, and duration of PAs but also the social forces that shape motivation and participation. Physiotherapists have an important role in helping children transitioning into adolescence to participate in activities that provide them with meaning, excitement, novelty, inclusion, and a sense of connectedness to PA. As our findings illustrate, the affective meanings and inherent pleasures of movement accorded to PA are significant socio-behavioural mechanisms that mediate participation and, as such, can potentially motivate boys (and girls) transitioning to adolescence to participate in PAs. We suggest that a more nuanced understanding of these mechanisms is crucial to effective PA education and prescription. Moreover, future research should be directed at including girls and boys with a range of social identities to further capture how intersectionalities such as gender, class, race, and disability mediate participation in PA.

Our research responds to recent calls for physiotherapists to develop a reflexive stance by questioning the assumptions and rehabilitation ontologies that guide their practices.^54,55 Setchell and colleagues,⁴⁷ for example, have shown that an overt focus on classifying bodies into norm-referenced standards of body size, shape, and weight explicitly and implicitly contributes to weight stigma projected by physiotherapists, which can negatively affect communication with clients as well as clients' treatment choices. Similarly, the boys interviewed in our study told us that the medicalization of their putatively unfit bodies dissuaded them from participating in PA, which suggests that these ideologies and practices are reflected and reproduced in health communication with children and adolescents. We encourage physiotherapists to rethink practices and assumptions that tacitly or explicitly value and promote the singular mesomorphic healthy active body; to problematize assumptions that promote PA as a universal panacea to the childhood obesity epidemic; and to approach instrumentalist notions of PA participation and prescription with caution.

Finally, our findings call for a critical conversation about educating transitioning boys (and girls) in critical health literacy. Because body image concerns and bullying become more prevalent during the transition into adolescence and may ultimately dissuade participation in PA, physiotherapists can further engage as health advocates by teaching skills that encourage boys to question and challenge dominant representations of mesomorphic bodies that are valorized in the media, in health practices, and in physically active fields. By equipping transitioning boys with critical health literacy skills, we can create a space for boys of all abilities to speak the unspoken and openly share body image experiences, challenges, fears, and concerns and potentially challenge and change socio-cultural assumptions that position body image challenges a taboo issue among boys.

Conclusion

This article developed a preliminary understanding of the socio-behavioural mechanisms that motivate and dissuade boys from participating in PA as they transition into adolescence. Although our findings are limited to research conducted at one boys' private school, they nevertheless suggest that the relational interactions among social environments, scientific and pedagogical practices, and internalized life experiences in physically active fields shape the habitus toward participation or withdrawal as boys transition into adolescence and adulthood. This nuanced discussion of the socio-contextual factors that influence PA participation serves as an empirical point of departure for attempts to understand and address the significant decreases in participation observed among transitioning boys. In an effort to motivate PA participation among boys, we propose that physiotherapists as health advocates have a unique role in maximizing children's and adolescents' physical, social, and psychological potentials and can have an important impact on PA participation among girls and boys of all abilities.

Key Messages

What is already known on this topic

Canadian children and youths are increasingly withdrawing from sport and PA, and significant decreases in participation have been observed among boys as they enter adolescence. What remains unclear are the various mediators prompting disengagement and withdrawal.

What this study adds

This study offers preliminary insights into a more nuanced understanding of the complex social and behavioural mechanisms that mediate physically active behaviours as boys enter adolescence. Our results suggest that although boys transitioning into adolescence do seek opportunities to be active, they may be dissuaded by pervasive social mechanisms that devalue their bodies and abilities. As movement experts, physiotherapists can play an important role in helping adolescents of all abilities to participate in activities that offer them meaning, inclusion, and a sense of connectedness to PA.