Promoting Physical Activity for Disabled Students Inside and Outside of Secondary Schools in Saudi Arabia: A mixed-methods Approach using Accelerometry and Stakeholder Insights

Abstract

This study investigates strategies to enhance physical activity (PA) participation among children and adolescents with disabilities (CAWD) in Saudi secondary schools, aiming to support their physical and mental development. Using an inclusive, adaptive, and evidence-based approach, the research adopts a socio-ecological framework to examine the complex interplay of factors influencing PA behaviour in this population. The study addresses significant knowledge gaps through six interrelated objectives: (1)exploring perceived barriers and facilitators of PA among CAWD, (2) objectively assessing whether CAWD meets the UK PA guidelines of 120–180 minutes of moderate to vigorous physical activity (MVPA) per week, (3) analysing associations between socio-ecological variables (SEV) and PA participation, (4) developing practical and contextually relevant PA-promoting strategies, (5) leveraging intelligent systems to identify behavioural patterns and stakeholder preferences, and (6) contributing to disability-inclusive health promotion and policy development. Using wrist-worn accelerometers, PA levels were measured over seven days (five weekdays and two weekend days), including two sessions of semi-structured physical activities. Socio-ecological data were collected through tailored questionnaires, and the results were analysed using intelligent data processing models to identify patterns and predictors of PA behaviour. The findings reveal that while CAWD face various personal, social, and environmental barriers to PA, school environments offer a more equitable platform for engagement, particularly for girls. However, most participants fell short of the recommended moderate-to-vigorous physical activity (MVPA) levels. Notably, PA participation was influenced by a range of SEVs, including family involvement, school support, peer relationships, and community accessibility. This research offers a novel contribution to knowledge by integrating objective PA measurement, socio-ecological analysis, and technology-assisted evaluation in the context of disability. It proposes a set of practical school-based recommendations for enhancing PA participation among CAWD in Taif, Saudi Arabia. It highlights the need for inclusive curriculum policies and family engagement to ensure sustainability. Ultimately, it supports sustainable improvements in CAWD’s participation in PA and physical education (PE), helping to close gaps in health equity and educational access.