Barriers and facilitators to physical activity for young adult women: a systematic review and thematic synthesis of qualitative literature

Abstract

Background Physical activity (PA) has many benefits in preventing diseases and maintaining physical and mental health. Women, in particular, can benefit from regular PA. However, women’s PA did not increase over the past decade globally, and the situations faced by women are often gender-specific. Healthy young adult women's PA does not receive as much attention as older women and adolescent girls, yet, they face the same situation of low level of PA. This review aims to explore and synthesise the self-identified barriers and facilitators to young adult women's participation in PA from qualitative research studies and offer suggestions for future studies and programs designed for this population. Methods A systematic search was conducted in Pubmed, Web of Science, Scopus, Medline, and SPORTDiscus for studies published between January 2000 to February 2022 to identify qualitative studies on the barriers and facilitators of young adult women’s PA between ages 18 to 40. The search yielded 694 studies initially, of which 23 were included. The research quality of included studies was appraised using the Critical Appraisal Skills Programme (CASP) tool. Data were extracted and thematically analysed based on the tenets of the social-ecological model (SEM). Results Identified barriers and facilitators were grouped into different levels of the SEM, with the most frequently cited factors being time, body image and societal beauty standards, family duty and social support, religious and cultural norms, organisation and community facilities and environment, safety issues and physical environment. Descriptive data were thematically analysed and synthesised in line with the five levels: body image, health and beauty; multiple roles, support, and PA; religious identity, cultural identity, and PA; safety issues and women’s fears. Conclusions This qualitative synthesis revealed in-depth information on barriers and facilitators influencing young adult women’s PA. It highlighted that the factors young adult women face are diverse at different levels yet holistic and intertwined. Future studies on young adult women’s PA should address the social-cultural influence and would benefit from applying multilevel strategies employing the SEM model. It is critical to create an open and inclusive environment and offer more opportunities for women. Trial registration PROSPERO CRD42021290519.

Comparison of time‐matched aerobic, resistance or combined exercise training in women living with obesity: The EXOFFIT study

“…Fear of injury, pain and failure are known barriers to exercise engagement in women with obesity, 46,47 while professional support is a strong facilitator. 48 Training using a women-specific program with women similar to themselves and without men, 37,49 alongside exercising in a private space, an environment which potentially feels safe and non-judgmental are factors that are likely to have addressed some of the feelings and fear of stigmatization and judgment that are negatively correlated with exercise engagement with this cohort. 46,49 Overall study attrition (21%) was comparable with dropout rates observed in previous obesity and sedentary adult exercise literature.…”

“…48 Training using a women-specific program with women similar to themselves and without men, 37,49 alongside exercising in a private space, an environment which potentially feels safe and non-judgmental are factors that are likely to have addressed some of the feelings and fear of stigmatization and judgment that are negatively correlated with exercise engagement with this cohort. 46,49 Overall study attrition (21%) was comparable with dropout rates observed in previous obesity and sedentary adult exercise literature. 40,42,50,51 Similar to other research, the main reasons for dropouts were ill health, lack of time and changed mind.…”

“…51 While health issues were the most common reason for attrition, other factors, including low social support and exercise self-efficacy, may have contributed to recruitment and retention challenges. 49,52 With weight loss often cited as the primary motivator for women with obesity to engage in exercise, 52 the focus on health and wellbeing as opposed to weight loss during the intervention may have been a…”

Descriptive epidemiology of prevalence of exercise habits among participants with hypertension: The National Health and Nutrition Survey 2013–2018

“…Regarding age groups, the 20–64 years age group showed the lowest proportion of participants with adequate exercise habits. Since exercise is often considered a leisure‐time activity in high‐income countries, 29 lack of time is a major barrier to engaging in exercise, 30 especially in young adults and women 31 . Indeed, more than one‐third of Japanese adults aged ≥20 years reported feeling like their jobs or household chores hamper engagement in exercise 32 .…”

Exploring the mediating role of motivational regulations in the relationship between body image and physical activity by sex: a structural equation modelling approach

“…Otherwise, our results differ from those by More and Phillips [41], who only reported a direct association between BI and cardiovascular activity for women. A common explanation could be that individuals who place a high subjective importance on physical appearance feel satis ed with their current state may perceive less incentive to engage in MVPA, as they do not see a pressing need to alter or maintain their appearance through exercise [75]. On the other hand, an expected direct positive effect of subjective importance of physical shape on MVPA was found.…”