Assessing Barriers and Enhancers to Increasing Physical Activity during the School Day in Children on an American Indian Reservation: A Qualitative Research Study

Objective: We attempted to determine factors that enhance or limit physical activity (PA) in children living on an American Indian (AI) reservation. Methods: Six audio-recorded focus groups (FGs) were conducted. Each group included 6 - 8 participants (N = 42) with 3 grade specific FGs (4^th - 6^th grade students) and 3 adult FGs. Results: FG analysis identified 4 main barriers to PA: school environment; community and school resources; electronic devices; and the role of parents and family. Analysis revealed 3 main strategies to increase PA: structured/non-competitive activities; structured/competitive activities; and increasing school and community-wide capacity. Conclusion: The results from this study provide a school health perspective on the 4-day school week.