Teachers’ perceptions of physical activity in children and young people with type 1 diabetes: a qualitative systematic review protocol

Abstract

Abstract Background Type 1 diabetes is a lifelong condition usually diagnosed in childhood. It requires daily management to control blood glucose and avoid complications. Physical activity brings important physical and emotional benefits, but children with the condition are often less active than their peers. Schools have a key role in encouraging active lifestyles, yet managing diabetes around physical activity can be difficult and requires specific knowledge. Teachers are central to enabling participation, but many feel unprepared owing to limited training, low confidence, and persistent misconceptions. Exploring their views is vital for improving school-based support. This review aims to assess and summarise qualitative research on teachers’ knowledge, attitudes, and experiences in supporting children with type 1 diabetes in physical activity, to guide future training, policy, and practice. Methods This review will follow the Joanna Briggs Institute methodology for qualitative evidence synthesis, using meta-aggregation. A comprehensive search will be conducted across multiple databases: MEDLINE, Embase, CINAHL, PsycINFO, ERIC, ProQuest, and TRIP Database. The SPIDER tool will guide the search strategy and inclusion criteria. All records will be independently screened and appraised by at least two reviewers using the Joanna Briggs Institute critical appraisal tool, with discrepancies resolved through discussion. NVivo 15 qualitative data analysis software will be used to support data management, organisation, and analysis. Confidence in the findings will be assessed using the GRADE-CERQual approach. The review will follow PRISMA 2020 guidelines to ensure transparency and methodological rigour. Discussion This review addresses a key evidence gap and considers practical and contextual challenges across school settings. Practical and contextual challenges, including variations in study reporting, educational systems, and school-level policies, will be considered. A multidisciplinary review team will ensure methodological rigour and support nuanced interpretation. While the exclusion of non-English studies may introduce language bias and systemic factors influencing teacher perspectives may not always be fully captured, the review adopts a transparent and robust methodology. The findings will inform tailored training, school-based strategies, and policy recommendations to improve teacher confidence and enable safer, more inclusive physical activity participation. Systematic review registration PROSPERO 2025 CRD420251071101