Objective: To explore the barriers to physical activity behavior among overweight and obese children and adolescents, so as to provide evidence for developing physical activity intervention programs. Methods: From March to April 2025, 13 overweight or obese children and adolescents from one primary school and one secondary school in Nanjing were selected by purposive sampling for semi structured interviews. Guided by the capability, opportunity and motivation-behavior model, data were coded, categorized and analyzed using content analysis. Results: A total of 13 interviews were completed, with a cumulative duration of 358 minutes. Three themes and eight subthemes were identified:capability factors, including physical discomfort and limited physical fitness, weak exercise skills and insufficient behavioral regulation ability, and insufficient psychological capability; opportunity factors, including insufficient family support and negative influence, pressure from school and peer environments, and limited time resources and exercise conditions; and motivation factors, including low self efficacy and situations prone to giving up, and insufficient positive feedback and lack of attractiveness of exercise forms. Conclusions Barriers to physical activity among overweight and obese children and adolescents result from the combined effects of capability, opportunity and motivation. It is necessary to lower the threshold for initiating exercise, strengthen positive experiences and feedback, and build integrate family-school support environments to promote the initiation and maintenance of physical activity behaviors in children and adolescents.

Objective To explore the methods and strategies of nursing training promotion after integration of two hospital, so as to improve the effects of nursing training and promote the rapid integration of the class Ⅱ hospital to class Ⅲ hospitals.Methods In February 2015, Zhongda Hospital Southeast University hosted district level class Ⅱ Nanjing Dachang Public Hospital. Nursing department-area-department, a hierarchical management of three level of training management architecture has been formed by analyzing the difficulties in nursing training after the integration of the two hospitals. Hierarchical training and assessment has been applied in N0 to N4 nursing staff, combining scene simulation, video teaching and other diversity training and assessment methods. A self-designed satisfaction questionnaire was adopted, and quality control data was extracted and statistically analyzed by nursing management information system, so as to compare the nursing training effect of earlier integration (August 2015 to January 2016) and after integration (February to July 2016).Results The median score of nursing training satisfaction after integration was 96, which was higher than 92 before integration , and the difference was statistically significant (Z=-10.876,P<0.01). The qualification rate of special grade Ⅰ nursing, ward management, nursing technique, emergency medicine equipment, disinfection and sterilization was 98.38％, 95.00％, 93.38％, 95.70％ and 96.27％ respectively after integration, which were all higher than those before integration (92.88％, 92.85％, 91.01％, 93.04％, 93.48％), and the differences were statistically significant (χ2=28.923, 6.410, 8.446, 10.502, 12.596;P<0.01). The satisfaction of clinical ward, outpatient and operation theatre improved significantly after integration (97.36％ vs. 91.26％, 93.42％ vs. 90.35％, 97.68％ vs. 94.14％; χ2=94.373, 4.419, 4.131;P<0.05).Conclusions After the two hospitals' integration, diversified training helps to improve nurses' satisfaction with nursing training, nursing quality and patient satisfaction, which is worthy of further application in clinical nursing training.