P-167: Paediatric meanings of physical activity in type 1 diabetes: early experiences, lifelong stigma, and behavioural outcomes
E V Richardson, C Bright, D Farrow, N HilaryAbstract
Introduction
Physical activity (PA) is a key component of Type 1 Diabetes (T1D) management, yet children and adolescents with T1D experience disproportionately low participation due to complex clinical and psychosocial barriers. Existing research has prioritised biomedical outcomes, with limited attention to how paediatric populations make meaning from PA engagement. and how this influences lifelong engagement.
Objectives
To explore meanings of PA across the life course in people with T1D, with a specific focus on meaning and experiences among paediatric populations (0–17 years).
Methods
An exploratory qualitative study was conducted using open-ended survey responses from 311 individuals with T1D in the United Kingdom, with 129 participants aged 0-17. Data were analysed using reflexive thematic analysis within age-stratified case studies.
Results
Paediatric participants’ experiences were dominated by the need to remain “always plugged in” to diabetes technologies. Specifically, technology shaped show children made meaning from PA through (1) logistics and compatibility; (2) responses from others; and (3) identity formation. Logistical issues included device incompatibility with certain activities, fear of device damage, and disruption to performance and enjoyment. Other people’s responses were critical; inadequate knowledge, and derogatory comments among pracitioners, and peers frequently resulted in exclusion, stigma, and reduced participation. This group also experienced a complex negotiation of selfhood, normalcy, exclusion, empowerment and disempowerment through PA. Importantly, these early experiences were foundational in shaping internalised ableism and influencing PA behaviours into adulthood.
Conclusions
Early experiences of stigma and exclusion appear to have lasting impacts, shaping lifelong relationships with PA. Interventions should prioritise paediatric-focused education for PA practitioners, inclusive policy, and psychosocial support to enable safe, equitable, and meaningful PA for young people with T1D.