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Introduction: Preliminary research suggests that rurally residing children with a disability seldom participate in the recommended 60 minutes of moderate-to-vigorous physical activity per day and face multiple barriers to participation. The purpose of this study was to explore parents' perceptions of physical activity participation of rurally residing children with a disability, including barriers and any factors that may facilitate their participation.Methods: Participants were parents or carers of a school-aged child with a disability residing in a rural or remote area of the state of New South Wales, Australia. Data were collected using semi-structured focus group interviews, which were audio-recorded and transcribed. Qualitative data were analysed inductively using qualitative content analysis.Results: Focus group interviews were conducted with 10 parents. Thematic analysis yielded the overarching description of the study, surviving, not thriving, which described the participants' limited success in augmenting the health of their child with a disability, despite their desire to do so. Within this description, three main themes emerged. (1) A parent's predicament described the parents' struggle to support their child's participation in physical activity, despite understanding its numerous benefits. (2) Barriers to participation described the various barriers to physical activity participation that were perceived to be hampering their child's potential to thrive. Some of these barriers were related to the child's disability, while others were specific to the rural context. (3) Facilitators to participation described the factors that served to motivate and enable children with a disability to participate in physical activity.Conclusions: This investigation of parents' perceptions suggests that the physical activity participation of rurally residing children with a disability is currently insufficient to adequately support the health of this population. It appears service providers need to address the factors that impede participation, including issues surrounding access, ability and isolation, but should also support the parents' behaviours, community opportunities and the child's own drive to participate. Existing support structures aimed at promoting physical activity should be enhanced and more inclusive, and accessible strategies should be developed.

Preliminary research suggests that rurally residing children with a disability seldom participate in the recommended 60 minutes of moderate-to-vigorous physical activity per day and face multiple barriers to participation. The purpose of this study was to explore parents' perceptions of physical activity participation of rurally residing children with a disability, including barriers and any factors that may facilitate their participation.Participants were parents or carers of a school-aged child with a disability residing in a rural or remote area of the state of New South Wales, Australia. Data were collected using semi-structured focus group interviews, which were audio-recorded and transcribed. Qualitative data were analysed inductively using qualitative content analysis.Focus group interviews were conducted with 10 parents. Thematic analysis yielded the overarching description of the study, surviving, not thriving, which described the participants' limited success in augmenting the health of their child with a disability, despite their desire to do so. Within this description, three main themes emerged. (1) A parent's predicament described the parents' struggle to support their child's participation in physical activity, despite understanding its numerous benefits. (2) Barriers to participation described the various barriers to physical activity participation that were perceived to be hampering their child's potential to thrive. Some of these barriers were related to the child's disability, while others were specific to the rural context. (3) Facilitators to participation described the factors that served to motivate and enable children with a disability to participate in physical activity.This investigation of parents' perceptions suggests that the physical activity participation of rurally residing children with a disability is currently insufficient to adequately support the health of this population. It appears service providers need to address the factors that impede participation, including issues surrounding access, ability and isolation, but should also support the parents' behaviours, community opportunities and the child's own drive to participate. Existing support structures aimed at promoting physical activity should be enhanced and more inclusive, and accessible strategies should be developed.

Introduction: The birth of a premature infant is a stressful and emotionally challenging time for parents. Families living in rural areas often have reduced access to the specialist services premature infants require, and different concerns from their metropolitan counterparts. Rural families may have to spend extended periods of time at a metropolitan centre while their child is in a neonatal intensive care unit (NICU). Regular return trips to hospital may be required for follow up. Parental experience of this unexpected event and the resultant intensive health service involvement requires further examination; most studies focus on the NICU experience. This exploratory study was undertaken from the rural paediatric allied health perspective. Because there are few accounts of rural families' experiences in the literature, this hermeneutic phenomenological qualitative study focused on the rural parent's experience of having a premature infant in a rural area during the first 12 months of the child's life.Method: Participants were selectively recruited from the case lists of paediatricians in a rural/regional hospital. Seven parents (5 mothers and 2 fathers) of premature infants consented to participate in semi-structured interviews. Interviews were of 60-90 min duration per parent, and were audiotaped and transcribed verbatim. The transcripts were analysed thematically using a phenomenological approach. Process and reflection diaries were maintained in order to provide an audit trail.Results: The participant group reflected a range of experiences. Parents described being initially shocked and then gradually adjusting to being the parent of a premature child. Three major themes emerged: (1) 'Coping through optimism' when parents consistently spoke positively about even stressful and difficult aspects of their experience; (2) 'Stoic survival' where parents did not emotionally deal with their experience, often citing others' needs as having higher priority; and (3) 'Striving for normal' when parents focussed on the aspects of their child's medical care or development that was closer to that of a full term child. Parents described feeling devastated if they felt their infant regressed or was progressing too slowly, and elated whenever a new milestone was achieved.Conclusion: Gaining insight into the experience of parents of premature infants can help health professionals ensure services more effectively meet the needs of these families. Rural families were pleased with their local services although they indicated that travelling to a metropolitan centre was extremely burdensome. While the families interviewed had access to some local specialist services, they expressed concern that if they resided in a more remote area there would be reduced access to services and greater personal strain. Further research is required to determine the experiences of Indigenous families, separated or divorced parents and families living in remote areas.