Introduction and aim
Globally, over 80% of adolescents do not achieve the recommended levels of daily physical activity, increasing their risk of non-communicable diseases (such as heart attacks and diabetes) and mental health problems (King et al., 2019, Bull et al., 2020, van Sluijs et al., 2021).
Adolescents in vulnerable life situations often face extra challenges to being active, often linked to socioeconomic and environmental disadvantages. Physical inactivity is influenced by many connected factors – from individual habits to social and environmental conditions – and can’t be solved with one single type of intervention.
To tackle this complexity, the Youth-Centered Participatory Action (YoPA) project – carried out in Denmark, the Netherlands, Nigeria, and South Africa – combines participatory action research (PAR) and systems thinking with the aim of optimally tailor, implement, and evaluate social and physical environmental interventions that support structural improvements in the lifestyle of adolescents (12–18 years) in vulnerable life situations.
In Denmark, YoPA takes place in two youth clubs in the city of Aalborg, where adolescents and local stakeholders work together to create a systems map that identifies the main drivers and barriers to outdoor activity.
This brief presents key findings from the first Danish article (2025) published within the project, led by PhD student Line Madsen from the World Playground Research Institute. The insights are relevant for researchers, practitioners, and anyone working to involve adolescents in tackling complex public health issues using systems thinking and participatory action research.
Key results
This study shows how combining participatory action research and systems thinking can reveal what influences adolescents’ outdoor physical activity in youth clubs.
The adolescents from the Danish youth clubs were organized into two ‘action teams’ working side by side on the same issue, following the same process and methods. The final systems map included 28 connected factors, forming feedback loops that illustrate the drivers influencing each other.
From this, five key drivers were identified.
The action teams emphasized that a sense of belonging and self-confidence are critical factors to getting involved in outdoor physical activity.
Feeling part of a community fosters inclusion and acceptance. This strengthens their self-confidence and well-being, and makes them feel more comfortable with their body image.
When confidence grows, participation in organized activities often increases. Shared activities create common ground across different social subgroups.
The adolescents highlighted that maintenance of outdoor spaces are essential for both physical activity and social interaction. Poorly maintained spaces make it harder for adolescents to access and engage in outdoor physical activity.
Adolescents generally see maintenance as the responsibility of youth club staff, who reported limited capacity due to competing pedagogical tasks. Staff argued that with increased resources, they could prioritize upkeep, making the spaces more usable and appealing.
The action teams identified that having friends who are supportive of, or interested in, being physically active helps shape a positive group culture. Participation often mirrors their peers’ behavior, which encourages them to stay involved in physical activity.
Peer influence also shapes how adolescents perceive what counts as “suitable” weather for being active outdoors.
Adolescents explained that accessible, attractive, and inclusive outdoor spaces increase engagement in physical activity and social interaction.
Lighting and accessibility for people of all abilities create a sense of safety, make the spaces easier to use, and encourage repeated visits.
Staff participation as role models encourages adolescents to join in and strengthens their sense of belonging. Clear communication about organized activities increases awareness and engagement.
Staff engagement can also help overcome weather-related barriers, creating more opportunities for outdoor physical activity.
teams and local stakeholders in YoPA Denmark
Recommendations
Promoting outdoor physical activity among adolescents, particularly in underserved neighborhoods, is a complex health challenge influenced by many connected factors. To address this challenge, we need actions that target several areas of the system at the same time.
The study shows that it is both possible and useful to combine participatory action research (PAR) and systems mapping into youth health promotion research. The co-creation process with adolescents identified five core drivers central to shaping outdoor physical activity:
- Sense of belonging
- Maintenance of outdoor spaces
- Peer influence
- Accessible and attractive spaces
- Role of youth club staff
For practitioners, the findings from YoPA Denmark offer locally grounded insights into how adolescents experience and engage in outdoor physical activity. While these findings are context-specific, the participatory systems approach can be applied in other settings to identify local drivers and co-create relevant interventions.
- First, interventions should adopt a youth-centered, complex systems approach that views adolescents as experts in their own lives and actively involves them as co-researchers. Practitioners should focus on creating safe, youth-friendly spaces where adolescents feel confident, build social connections, feel motivated to get involved.
- Second, the local systems map developed in YoPA Denmark identified five key drivers that can guide others in designing targeted actions for adolescent engagement: fostering a strong sense of belonging; ensuring staff actively participate as role models and communicate clearly about activities; maintaining outdoor spaces to keep them attractive and accessible; designing inclusive, well-equipped environments with appropriate lighting; and leveraging peer influence to reinforce group norms for physical activity.
This study also has important implications for both research and practice:
- By combining PAR and systems thinking, it becomes possible to explore complex health challenges and develop solutions that are sensitive to local contexts and created together with adolescents. It highlights overlooked factors such as belonging and staff engagement, demonstrates the value of process outcomes, like empowerment and strengthened social connections, and supports equity-oriented strategies for adolescents in vulnerable situations.
- Finally, the resulting systems map serves as a practical, evidence-informed blueprint for co-developing tailored interventions that aim to improve outdoor physical activity by changing how the system works within youth clubs.
Literature
Primary
Madsen, L., Pawlowski, C., Schipperijn, J., Paw, M. C. A., & Altenburg, T. (2025). Co-Creating a Systems Map with Adolescents: Combining Participatory Research and Systems Thinking in YoPA Denmark. Health Promotion International, 40(5), Article daaf174. https://doi.org/10.1093/heapro/daaf174
Secondary
Bull, F. C., Al-Ansari, S. S., Biddle, S., Borodulin, K., Buman, M. P. et al. (2020). World Health Organization 2020 guidelines on physical activity and sedentary behaviour. British journal of sports medicine, 54(24), 1451–1462. https://doi.org/10.1136/bjsports-2020-102955
King, A. C., Whitt-Glover, M. C., Marquez, D. X., Buman, M. P., Napolitano, M. A. et al. (2019). Physical Activity Promotion: Highlights from the 2018 Physical Activity Guidelines Advisory Committee Systematic Review. Medicine and science in sports and exercise, 51(6), 1340–1353. https://doi.org/10.1249/MSS.0000000000001945
van Sluijs, E. M. F., Ekelund, U., Crochemore-Silva, I., Guthold, R., Ha, A. et al. (2021). Physical activity behaviours in adolescence: current evidence and opportunities for intervention. Lancet (London, England), 398(10298), 429–442. https://doi.org/10.1016/S0140-6736(21)01259-9
