Motivational Factors and Barriers Towards Initiating and Maintaining Strength Training in Women: a Systematic Review and Meta-synthesis

Abstract

Strength training (ST) or resistance training is important in the development and maintenance of musculoskeletal and cardiovascular health in women of all ages; however, uptake of ST amongst women is low. To improve female musculoskeletal health, it is vital that more women are encouraged to participate in ST to maintain musculoskeletal integrity. This systematic review aimed to identify motivators and barriers to women initiating and maintaining ST. Following protocol registration and systematic search, studies were included if they were primary qualitative or mixed-method studies reporting participant verbatim quotes, included adult women, and focused on motivators and barriers for ST. Searches generated 2534 articles from 3 databases, with 20 studies (N = 402 participants) meeting eligibility criteria. Participant quotes and authors’ interpretations were analysed using thematic synthesis. The most frequently observed barriers were gender-based stigmas, discouragement, and negative comments, particularly in women currently engaging in ST. Other factors associated with poor adherence included boredom, poor knowledge of ST, poor gym accessibility, lack of supervision or routine, and difficulty in balancing work and family life. Social support from friends and family, words of affirmation, and accompaniment facilitated ST, particularly in older women. Women who saw expected results such as weight loss were motivated to continue ST. Interventions aimed at increasing participation in ST amongst women should focus on the specific benefits valued by women and the dissemination of accurate information to counter misconceptions and increase knowledge. The adaptation of gym environments to make them more welcoming to women, and reduce gender-focused criticism, is especially important.

‘A Lot of People Just Go for Walks, and Don’t Do Anything Else’: Older Adults in the UK Are Not Aware of the Strength Component Embedded in the Chief Medical Officers’ Physical Activity Guidelines—A Qualitative Study

“…For example, our participants suggested that targeted, specific messages to older adults who consider themselves as active would increase their motivation to engage and meet the guidelines [ 37 ]. Thus, we have added to the growing number of reports suggesting that a lack of detailed guidance on exercise guidelines is a major barrier for older adults [ 23 , 38 , 39 , 40 , 41 ]. The strength component that is embedded within the CMO PAG infographic does not (yet) display important variables such as intensity of effort and session duration as it does for its well-known, and better adhered to aerobic guidelines [ 13 ].…”

“…The strength component that is embedded within the CMO PAG infographic does not (yet) display important variables such as intensity of effort and session duration as it does for its well-known, and better adhered to aerobic guidelines [ 13 ]. Not performing an evidence-based dose of strength training will result in an absence of substantial benefit, another barrier to strength training participation and adherence [ 38 ]. If older adults are not able to benefit from their strength training, they lose their (subjective and objective) ‘fitness,’ and subsequently become less willing and less able to participate in resistance training at intensities or durations that are required to maintain their strength and health [ 5 , 38 , 42 ].…”

“…Not performing an evidence-based dose of strength training will result in an absence of substantial benefit, another barrier to strength training participation and adherence [ 38 ]. If older adults are not able to benefit from their strength training, they lose their (subjective and objective) ‘fitness,’ and subsequently become less willing and less able to participate in resistance training at intensities or durations that are required to maintain their strength and health [ 5 , 38 , 42 ]. Thus, we would like to see the next set of older adult guidelines take more of a co-production approach to better meet the needs of diverse cohorts [ 43 ].…”

“…Previous physical activity can be directly related to self-efficacy and positive outcome expectations, demonstrated in psychological theories such as the Theory of Planned Behavior to influence exercise intention [ 67 , 68 ]. Since societal norms and stigma are also important determinants of physical activity, it would seem logical to ensure strength training becomes a normal and enjoyable occurrence in the lives of adults early in the life course [ 18 , 28 , 38 , 66 , 69 ].…”

“…Social support and accountability seem to be especially relevant to older adults [ 35 , 38 , 52 , 70 ]. In fact, strength training adherence has been shown to nearly double when it is performed in a group setting compared to an individual setting [ 70 ].…”