Key influences on university students’ physical activity: a systematic review using the Theoretical Domains Framework and the COM-B model of human behaviour

Abstract

Background Physical activity is important for all aspects of health. Most university students are not participating in the level of activity required to realise these benefits. Understanding the factors that influence physical activity in the context of behaviour change theory is valuable to inform the development of effective evidence-based interventions to increase university students’ participation in physical activity. The current systematic review a) identified barriers and facilitators to university students’ physical activity, b) mapped these factors to the Theoretical Domains Framework (TDF) and COM-B model, and c) ranked the relative importance of TDF domains. Methods Data synthesis included qualitative, quantitative and mixed-methods research published from 2010–2023. Four databases were searched to identify publications on the barriers and facilitators to university students' physical activity. Data regarding study design and key findings (i.e., participant quotes, qualitative theme descriptions, and survey results) were extracted. Framework analysis was used to code barriers and facilitators to the TDF and COM-B model. Within each TDF domain, thematic analysis was used to group similar barriers and facilitators into descriptive theme labels. TDF domains were ranked by importance based on frequency, elaboration, and evidence of mixed beliefs. Results Thirty-nine studies involving 17,771 participants met the inclusion criteria. Fifty-six barriers and facilitators mapping to twelve TDF domains and the COM-B model were identified as relevant to university students’ physical activity. Three TDF domains, environmental context and resources (e.g. time constraints), social influences (e.g. exercising with others), and goals (e.g. prioritisation of physical activity) were judged to be of greatest importance (identified in > 50% of studies). TDF domains of lower relative importance were intentions, reinforcement, emotion, beliefs about consequences, knowledge, physical skills, beliefs about capabilities, cognitive and interpersonal skills, social/professional role and identity, and behavioural regulation. No barriers/facilitators relating to the TDF domains of memory, attention and decision process, or optimism were identified. Conclusions The current findings provide a foundation to enhance the development of theory and evidence informed interventions to support university students’ engagement in physical activity. Interventions that include a focus on the TDF domains 'environmental context and resources,' 'social influences,' and 'goals,' hold particular promise for promoting active student lifestyles. Registration Prospero ID - CRD42021242170