Facilitators Of Physical Activity Research Articles

Factors facilitating and hindering South Asian immigrant adults from engaging in exercise and physical activity - a qualitative systematic review.

Exercise and physical activity are key components of management in patients with rheumatic musculoskeletal diseases (RMD), but people of the South Asian communities have a lower level of engagement with these activities compared to their Caucasian counterparts. The aim of this qualitative systematic review was to determine the barriers and facilitators of exercise and physical activity in South Asian communities who have migrated and live in western countries, particularly in those who have RMD. Qualitative studies, published in English between 1999 and 2021 and including evaluation of barriers and/or facilitators to exercise or physical activity behaviour in people of South Asian adult communities who have migrated and/or lived in western countries were identified from Embase, MEDLINE, CINAHL, PsycINFO, Google Scholar and manual searches. The studies were appraised using the CASP checklist. Inductive thematic synthesis was used to identify common and global themes. A total of 32 studies that discussed barriers and facilitators of physical activity in South Asian communities who have migrated and lived in western countries were used for this review but there were no studies identified that focussed specifically on those with RMD. Following appraisal of the reporting of the studies, 30 studies were included in the pooling of the results. The facilitators and barriers to physical activities were broadly categorized into 'extrinsic' and 'intrinsic' factors. Extrinsic factors such as 'opportunity' included environmental factors such as weather and safety; socioeconomic factors such as education, language and literacy, and support in the form of social, psychological and resources. Intrinsic factors included cultural factors, such as life stages and family influence, beliefs and knowledge, which impacted attitudes and skills. This review has synthesised evidence of barriers or facilitators and identified potentially modifiable factors influencing physical activity and exercise engagement, which could form the basis of evidence-based interventions to promote participation in healthy behaviour change. Provision of a safe, comfortable and culturally acceptable environment together with culturally-aligned cognitive strategies to facilitate acquisition of exercise-efficacy skills could help engagement. The systematic review was registered on PROSPERO, registration no. 289,235.

“I think it was helpful but not as helpful as it could have been” - a qualitative study of the experiences and perspectives of using fitness apps among manual wheelchair users with spinal cord injury

Purpose To gain knowledge of the experiences and perceptions of using fitness apps by full-time wheelchair users with spinal cord injury (SCI) and to explore experiences and perceptions of using these apps in relation to barriers to and facilitators of physical activity (PA). Materials and Methods A qualitative design was employed. Semi-structured interviews were conducted with ten manual wheelchair users with SCI. Data were analysed using reflexive thematic analysis. Results Four themes were developed: 1) App functionality and experience, 2) Enhancing motivation, 3) Precursors to engagement and 4) Knowledge gaps. Experience and perception were strongly influenced by app design, particularly the presence or absence of features tailored for wheelchair users. Many apps incorporated the use wearable or mountable sensors. Fitness apps were perceived to increase motivation, although, this had its limitations. Conversely, apps were reported to have limited influence on commonly reported barriers to PA. Furthermore, the data highlighted gaps in knowledge which created barriers to effective app use. Conclusions Fitness apps were perceived to increase motivation to engage in PA in manual wheelchair users with SCI. However, more needs to be done to further develop app features for wheelchair users with SCI and to address remaining barriers to engagement.

Associations between green space availability and youth’s physical activity in urban and rural areas across Germany

Green space may be an important physical activity facilitator for children and adolescents. However, to date, most studies focused on urban green space, and few studies investigated associations between green space and physical activity across urban and rural areas, which was the goal of this study. Data were obtained from a German cohort study, including 1,211 youth aged 6–17 years. Residential green space was assessed within a 1000 m street-network buffer using land cover and land use data and divided into quartiles, urbanicity using the European Urbanization Degree, and moderate-to-vigorous physical activity (MVPA) using accelerometers. Associations were investigated via linear regression analysis stratified by urbanicity degree, controlling for relevant confounders. We found that in rural areas, compared to youth in the bottom green quartile, those within the middle (2nd) and upper (3rd) green quartiles engaged in less MVPA. This relationship was not observed for youth in towns and cities. Interactions occurred between green space and socio-demographic characteristics for children and adolescents in cities: Compared to the bottom green quartile, boys or younger children within the middle green quartile engaged in more MVPA. However, socially disadvantaged children and adolescents in cities engaged in less MVPA in the upper compared to the bottom green quartile. Our results show that associations between green space and MVPA do not only differ between urban and rural areas but also among youth sub-populations. These findings are important to consider for planning policies to create inclusive active living environments across urban and rural areas.

Obesity-related parenting practices, styles, and family functioning: A natural experiment comparing pandemic and nonpandemic data.

The COVID-19 pandemic resulted in substantial changes to family life. This study examined associations between pandemic conditions and mothers' and fathers' food, physical activity, and media parenting practices and whether these associations were moderated by parenting styles and family functioning. Two independent samples of Canadian parents (nonpandemic n = 270; pandemic n = 357) self-reported their obesity-related parenting practices, styles, and family functioning. Covariate-adjusted regression models compared parenting practices between the samples. Interactions tested the moderating effects of family functioning and parenting styles on mothers' and fathers' parenting practices separately. Compared to nonpandemic mothers, pandemic mothers reported more frequent family meals, more screen time negotiation, and lower modeling of healthy screen time. Both pandemic mothers and fathers reported lower physical activity facilitation than nonpandemic parents. Parenting styles moderated some of these associations; for example, pandemic authoritative parents used less physical activity monitoring (mothers) and screen time negotiation (fathers) as opposed to uninvolved and permissive parents who reported higher use of these practices. The association between pandemic and parenting practices was also moderated by family functioning, especially among fathers. Among high-functioning families, pandemic fathers reported greater engagement in food monitoring, emotional feeding, coercive feeding, healthy screen time modeling, and emotional compensation with screens than nonpandemic fathers and low-functioning family fathers. Pandemic conditions may have negatively affected obesity-related parenting practices, but most associations were moderated by the familial context. The extent to which this will have long-lasting effects on adolescents' health needs to be further explored. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Perceived Facilitators of Physical Activity Following Coronary Artery Bypass Graft Surgery: A Qualitative Study

Purpose: Following coronary artery bypass graft (CABG) surgery, people are required to navigate the majority of their physical recovery, including progressive engagement in physical activity, after they leave hospital. However, there are many physical and psychological challenges to physical activity during the early recovery period. The aim of this study was to identify facilitating factors that help overcome such challenges to physical activity following CABG surgery. Methods: A qualitative descriptive study using semistructured interviews (n = 22) was undertaken. Data analysis was informed by the COM-B model and Theoretical Domains Framework (TDF) and performed using the Framework Method. Interview data were first inductively coded to identify factors that facilitated physical activity followed by a deductive analysis to group these facilitators under the relevant COM-B and TDF headings. Results: Facilitators relevant to all 6 COM-B elements and 13 of 14 TDF domains were identified. Although having physical capability and physical opportunity were important, the most prevalent facilitators identified by participants as being helpful related to psychological capability (for example, knowledge, having a plan, identifying barriers and coming up with solutions, and listening to their body), reflective motivation (for example, goals, experiencing positive benefits from activity, and being optimistic and determined), and social opportunity (for example, support from family, health professionals, and peers). Conclusions: Psychosocial facilitators play a large role in overcoming barriers to physical activity following CABG surgery. The findings provide insight for clinicians regarding potential factors to address when preparing and supporting people to engage in physical activity.

Exploring the Benefits, Barriers, and Facilitators of Physical Activity and Interest in Intergenerational Physical Activity Programming Within a Hispanic/Latino Community in the Midwest

Hispanic/Latino individuals across the lifespan generally do not engage in enough physical activity. Intergenerational programming is an innovative solution that could improve opportunities for physical activity across the lifespan in a culturally relevant manner; however, few studies have explored perceptions of intergenerational physical activity programming among Hispanic/Latino communities. This pre-implementation study aimed to: (a) explore the perceived benefits, barriers, and facilitators of physical activity among an intergenerational sample of Hispanic/Latino community members and stakeholders and (b) assess interest in intergenerational physical activity programming. This qualitative study consisted of a total of eight focus groups (N = 45 participants): Hispanic/Latino youth (2 groups), their parents (2 groups), older Hispanic/Latino adults (3 groups), and community stakeholders who work with older adults (1 group). We used thematic analysis techniques integrating the Framework Method to compare and contrast perspectives between participant groups. We found that all groups identified physical, mental, and/or social benefits to physical activity. Primary barriers included limited physical accessibility, environmental considerations, and time constraints. Primary facilitators included physical accessibility, programming format, environmental supports, and social support. Overall, there was general interest in intergenerational physical activity programming across all groups. Practitioners are encouraged to: (a) be aware of how different age groups may view and respond to program context, fit, and communications; (b) reflect on their capacity for high-quality implementation, and (c) weigh the costs and benefits of various programming decisions. Findings can be used to design culturally, linguistically, and contextually relevant intergenerational physical activity programming and to promote health equity.

Multilevel needs assessment of physical activity, sport, psychological needs, and nutrition in rural children and adults.

Physical activity yields significant benefits, yet fewer than 1 in 4 youth meet federal guidelines. Children in rural areas from low socioeconomic (SES) backgrounds face unique physical activity contextual challenges. In line with Stage 0 with the NIH Stage Model for Behavioral Intervention Development, the objective of the present study was to conduct a community-engaged needs assessment survey with middle school children and adults to identify perceptions, barriers, and facilitators of physical activity, sport, psychological needs, and nutrition from a multi-level lens. A cross-sectional survey data collection was conducted with children (n = 39) and adults (n = 63) from one middle school community in the Midwestern United States. The child sample was 33% 6th grade; 51% 7th grade and was 49% female. The adult sample was primarily between 30 and 39 years old (70%) and comprised predominantly of females (85%). Multi-level survey design was guided by the psychological needs mini-theory within self-determination theory and aimed to identify individual perceptions, barriers, and facilitators in line with the unique context of the community. At the individual level, 71.8% of children and 82.2% of the overall sample (children and adults) were interested in new physical activity/sport programming for their school. Likewise, 89.7% of children and 96.8% of adults agree that PA is good for physical health. For basic psychological needs in the overall sample, relatedness was significantly greater than the autonomy and competence subscales. Children's fruit and vegetable intake were below recommended levels, yet only 43.6% of children were interested in nutritional programming. Conversely, 61.5% indicated interest at increasing leadership skills. At the policy-systems-environmental level, the respondents' feedback indicated that the condition and availability of equipment are areas in need of improvement to encourage more physical activity. Qualitative responses are presented within for physical activity-related school policy changes. Interventions addressing children's physical activity lack sustainability, scalability, and impact due to limited stakeholder involvement and often neglect early behavioral intervention stages. The present study identified perspectives, barriers, and facilitators of physical activity, sport, psychological needs, and nutrition in a multi-level context and forms the initial campus-community partnership between scientists and community stakeholders.

Barriers to and Facilitators of Physical Activity: A Qualitative Study from the Perspective of Individuals Living with Sight Loss in Cambridgeshire.

Physical inactivity is a prevalent concern amongst adults living with sight loss. It is essential to understand why these individuals are inactive and how we can increase physical activity levels among them. Therefore, this study aims to explore the barriers and facilitators to physical activity for individuals living with sight loss. Seven individuals with self-reported sight loss living in Cambridgeshire were recruited for three focus groups. Focus group data were analysed using thematic analysis to identify key themes. Seven themes which represented a barrier, or a facilitator were identified: transport, accessing information, one size fits all, negative previous experience, visually impaired sport, women in disability sport, and taster days. To increase physical activity levels amongst those living with sight loss, interventions need to be focused on the organisational level. This includes producing more accessible environments that can be produced by providing training for sport and physical activity professionals and by ensuring the physical environment is inclusive for those living with sight loss.

Barriers and facilitators of physical activity, sedentary and sleep behaviours in 3 to 4-year-old children from low-income families: a study protocol

BackgroundThis study will evaluate the barriers and facilitators that families experience in adhering to the 24-hour movement behaviours guidelines as outlined by World Health Organisation (WHO).MethodsThe study is a mixed-methods study and will recruit between 20 to 30 low-income families with children aged 3- to 4-years living in Scotland. For the quantitative part, children will be asked to wear an Actigraph (GT3X +) accelerometer to measure physical activity, sedentary behaviour, and sleep. Parents/guardians will be asked to keep an activity diary outlining when their child has had to remove the device (i.e., showering, bathing, swimming) and record the child’s screen time each day. Once the data has been analysed, a unique activity profile chart will be sent out to each family illustrating their child’s 24-hour movement behaviours (i.e., time spent active, time spent sedentary and on screens, time spent sleeping). The activity profile will provide a day-by-day output as well as a weekly average for each of the 24-hour movement behaviours. Qualitative data will be collected using the Asynchronous Remote Communities method (ARC). The ARC involves participants completing activities using an online closed Facebook group. Parents/guardians of 3- to 4-year-old children will be asked to engage in group discussion tasks using the private and closed-group online platform (a minimum of 6 and a maximum of 8 families per discussion group). The quantitative data collated from the questionnaire and activity monitor will be presented through descriptive analysis and after the 6-week asynchronous process is complete, qualitative data will be collated and analysed using Braun and Clarke’s reflexive approach to thematic analysis.DiscussionThe data collected will provide an understanding of what barriers and facilitators parent’s/guardians’ experience in relation to adhering to the 24-hour movement behaviour guidelines. This could potentially lead to the design and implementation of support and interventions to help families struggling to adhere to the guidelines.

Physical Activity Characteristics and Barriers of University Students during the COVİD-19 Pandemic in Turkey

Background: Physical activity is an important factor for maintaining health and preventing many diseases. However, it is known that the physical activity level of individuals has decreased considerably due to the pandemic and mandatory restrictions. Purpose of the study: to investigate the physical activity characteristics and physical activity types of university students during the Covid-19 pandemic, the factors that facilitate and complicate their participation, and their sources of information about the subject. Material and Method: Students completed the sociodemographic information and data recording form online. The data enrollment form included questions about participation characteristics of students in physical activity before and during the COVİD-19 pandemic. Results: A total of 518 physiotherapy and rehabilitation undergraduate students (76.25% female and 23.75% male) were included in the study. During the pandemic period, 44.42% of the students had moderate physical activity. The daily sitting time of the students was 8.3±3.1 hours. During the pandemic period, walking was the most preferred activity except for weekends. Motivation and time from physical activity facilitors had changed during the pandemic period. Conclusion: As a result of our study, it was found that university students continued walking as a physical activity type, despite restrictions during the pandemic period. While time was not a significant factor that facilitates the participation in physical activity before the pandemic, it became the most important factor during the period of the pandemic. Motivation has lost its importance as a facilitator. We think that it would be a good idea to re-investigate physical activity levels, barriers and facilitators in order to see the effects of the pandemic in the future. KEYWORDS: Physical Activity, COVID-19, Students.

Identifying barriers and facilitators to self care in young adults with type 2 diabetes.

There is a rising trend of young-onset type 2 diabetes (YOD) occurring before the age of 40 years. Lower adherence to self care behaviours (diet, physical activity and taking medication) contributed to poorer glycaemic control and higher risk of complications. Young adults with YOD face unique challenges, and our study aimed to identify the main barriers and facilitators of self care behaviours in this population. A qualitative study was conducted in the National Healthcare Group Polyclinics, Singapore, using in-depth semi-structured interviews. Maximal variation sampling was employed to include participants with YOD of varied age, ethnicity, educational levels and marital status. Thematic analysis was conducted, and barriers and facilitators were identified and mapped to domains of the theoretical domains framework. Twenty-one participants aged 22-39 years were interviewed. We found patterns of intentions, self care behaviours and mindsets that were associated with different barriers and facilitators. Four patterns were identified and were named according to mindsets: avoidant, indifferent, striving and activated. In addition, experience of stigma and self-blame from having type 2 diabetes in young adulthood was common across all mindsets, contributing to poorer self care behaviours and increased psychological burden. Our study identified key barriers and facilitators of diet, physical activity and medication adherence in young adults with type 2 diabetes. Understanding barriers and facilitators, as related to mindsets, intentions and behaviours, will support a more individualised care approach.

Key Considerations When Addressing Physical Inactivity and Sedentary Behaviour in People with Asthma.

People with asthma tend to be less physically active and more sedentary than people without asthma. This narrative review aimed to present key considerations when addressing physical inactivity and sedentary behaviour in people with asthma by identifying barriers and facilitators, determinants and correlates, and intervention approaches. Using a search strategy, electronic databases were searched for relevant studies. Data extracted from studies were qualitatively synthesised. A total of 26 studies were included in the review. Six studies reported asthma symptoms as a barrier to physical activity, while four studies reported having a supportive network as a physical activity facilitator. Across studies, physical activity correlates/determinants were pulmonary function, exercise capacity, body mass index, dyspnoea, psychological health, and asthma control. Interventions that effectively improved physical activity in the short term were a step-based prescription programme, a weight loss programme incorporating aerobic and resistance training, and a weight loss lifestyle intervention, while a high-intensity interval training pulmonary rehabilitation program was effective in the long term. The collective findings suggest that a personalised physical activity programme incorporating different strategies is needed. There was minimal evidence to provide recommendations to optimise sedentary behaviour in asthma, and more research is needed on the topic.

S9-4 Retirement as the starting point of active ageing? A mixed-methods study to identify barriers and facilitators of physical activity when retiring

Abstract Purpose The transition from work to retirement implies changes in daily activities and might constitute an opportunity to increase physical activity (PA). While qualitative studies reported that retirees mainly perceived increases in PA during this life transition, quantitative studies observed decreases in total PA. Moreover, changes in total PA seem to depend on socio-economic status, with mostly lower socio-economic groups decreasing their total PA. Therefore, the goal of this study is (1) to investigate subjective changes in PA during the retirement transition and the perceived determinants of these changes, including barriers and facilitators to increasing or maintaining PA; (2) to link this subjective information to device-based measurements of PA. Methods This study is part of a mixed-methods study with a parallel structure using quantitative and qualitative methods. In the quantitative, longitudinal part of this study (n = 93), PA is measured with accelerometers prior to retirement, and at three, six and twelve months post-retirement. In addition, one-on-one, semi-structured interviews are being conducted with a subsample six months after retirement (n = 30, stratified on gender and education, randomly selected from the total sample). Thematic analysis is used to analyse the interview data with an inductive approach. The emerged themes will be mapped on the COM-B (Capability, Opportunity, Motivation and Behaviour) and TDF (Theoretical Domains Framework) models. Results The data collection is ongoing and more than half of the interviews have been conducted. Based on preliminary analyses of the first 10 interviews, it seems that most participants perceive to have more PA post-retirement, and that time is a main facilitator. Those participants who report having become less physically active were never interested in PA and/or did not value it. Moreover, some participants report having other competing activities, including grandchild-care or sedentary leisure activities. Further analyses will provide more specific conclusions and link qualitative and quantitative results. Conclusions The experience of retiring is highly individual and interventions should be personalized to specific target groups. This study will provide useful information on potential keys to develop effective lifestyle interventions for adults during or near the retirement transition.

O.3.3-4 Development and validation of the obesity-specific decisional balance for Physical Activity questionnaire

Abstract Purpose Despite the crucial role of physical activity in obesity management, many patients remain insufficiently physically active. The decisional balance, from the transtheoretical model, represents the facilitators and the barriers associated with behavior change (e.g., engaging in regular physical activity). Studies have identified barriers to and facilitators of physical activity specific to the context of obesity. However, to date, there is no scale to measure them. The objective of this study was to develop and validate a preliminary version of the Obesity-specific Decisional Balance for Physical Activity (O-DBPA). Methods A series of studies was conducted with a total sample of 350 adults with obesity (Mage=44.3, SD = 14.7 years; MIMC=44.4, SD = 14.7 kg.m2). First, the clarity of the 50 items developed by the expert committee was examined. Second, the dimensionality of the scale was examined through confirmatory factor analyses. Third, reliability tests were performed (i.e., Cronbach's alphas, test-retest reliability). Fourth, theoretical validity of the O-DBPA was examined through its correlations with other theoretically related constructs (i.e., motivation, self-esteem). Results Clarity assessment revealed acceptable scores for all items (M = 6.2/7, SD = 1.1). Dimensionality testing led to reduce the scale to 21 items divided into two factors: facilitators of and barriers to physical activity. Each of these factors was composed of three subscales: physical, psychological, and environmental. The confirmatory two-factor model had the best fit indices: χ2(166)=323.67, CFI=0.95, TLI=0.93, RMSEA=0.052. Cronbach's alphas were acceptable or marginally acceptable (i.e., [0.61-0.88]). Temporal reliability, measured with a 4-week interval, was satisfactory. The O-DBPA subscales were significantly related to the motivation and self-esteem constructs in the expected directions, attesting to the theoretical validity of the scale. Conclusion The O-DBPA, composed of 21 items, presented good psychometric qualities. This new instrument allowed to examine the obesity-specific barriers to and facilitators of physical activity in French-speaking samples. This new scale offers promising clinical and research perspectives for the promotion of physical activity in adults with obesity.

Barriers and facilitators of physical activity among Latina immigrant and Mexican mothers living in the US and Mexico: A qualitative study.

Latina immigrant women are among the least physically active when compared with women in other racial/ethnic groups in the US. Similarly, Mexican mothers in Mexico have low rates of physical activity. Motherhood and immigration experiences are recognized barriers to engage in physical activity among Latina immigrant mothers. Less is known about the factors that promote and limit physical activity engagement among Mexican mothers in Mexico, and how their experiences compare with their immigrant counterparts. This transnational qualitative study aimed to investigate the barriers and facilitators of physical activity of 25 Latina mothers in Mexico and the US. Low-income Mexican mothers of kindergarten aged children and Latino mothers of similar aged children were recruited in San Luis Potosí, Mexico and central Illinois, US. Semi-structured interviews were administered by two bilingual and bicultural researchers in participants language of preference. Interviews were transcribed verbatim and analyzed using a thematic network approach and multi-stage coding analysis guided by the Socio-Ecological Model framework. We found that at the macro-level: 1) familial obligations, and 2) cold weather after migrating; at the mezzo-level: 1) changes in walking patterns, and 2) social cohesion (e.g., lack of an invitation to engage in activities); and at the micro-level: 1) individual perceptions, particularly unattainable perceptions of physical activity and 2) shift exhaustion were perceived as barriers and occasionally facilitators of physical activity by mothers in both countries. Context-specific interventions are needed to increase women's physical activity levels in the US and Mexico.

Barriers and facilitators for physical activity on acute geriatric and rehabilitation wards: a survey study

ABSTRACT Objectives During hospitalisation, physical inactivity is common among older patients and is associated with adverse outcomes, e.g. functional decline. This study identified barriers and facilitators of physical activity with geriatric patients during hospital admission. Methods This is a cross-sectional descriptive study, on two acute geriatric units and one rehabilitation unit, using a researcher-administered survey methodology in patients 70 years or older. A new questionnaire was developed based on a literature review, and was administered bedside and face-to-face with the older patients. Results 72 patients, mean age 83.6 years, completed the questionnaire. 88.9% of the participants found physical activity important during hospitalisation. The main patient-related determinants were fear of falling and symptoms of current illness (e.g. pain). The main environmental-related determinants were the presence of medical devices, and the availability of walking aids. Half of the patients felt motivated by the hospital staff, and one out of six participants felt discouraged. Receiving more assistance for walking and having access to other types of physical activity was expected to increase physical activity. Additionally, motivation from family would be a facilitator for 44.4% of the participants. Conclusion Promoting physical activity on acute geriatric units will require interventions at different levels. Most importantly, focusing on interpersonal motivators and positive reinforcement by hospital staff could be beneficial strategies to increase the physical activity of older hospitalised patients.

Barriers and facilitators to physical activity among informal carers: a systematic review of international literature

Physical activity is beneficial for overall health; however, informal carers may have lower levels of physical activity than non-carers. The primary aim of this systematic review was to identify barriers and facilitators to physical activity from the perspective of carers internationally, excluding the UK. The study found that barriers to physical activity include lack of time, fatigue, lack of motivation and lack of support. Facilitators of physical activity include health and well-being as a motivator, using physical activity as a coping mechanism, and social support. Participating with the care recipient and care duties were both barriers and facilitators depending on the study or participant.

Barriers and facilitators of physical activity in adults with severe haemophilia: A qualitative study.

People with haemophilia (PWH) tend to be less physically active than the general population, but there is a lack of research on the specific barriers and facilitators affecting their participation in physical activities. This study aims to explore perceived barriers and facilitators to physical activity in severe PWH. An explorative qualitative study based on focus groups. Four focus groups including 16 participants (severe haemophilia A patients) were conducted to examine the factors perceived as facilitators or barriers to haemophiliacs engaging in physical activity. One researcher conducted a thematic analysis of all data. Three themes were identified: body function, personal factors, and environmental factors. Key facilitators identified were access to prophylaxis treatment to reduce the risk of bleeding(s), the enjoyability of physical activity, fitness and health motives, social interaction, support, and low cost. PWH faced additional barriers to being physically active including hurtful joints, mobility issues, haemophilic arthropathy, dislike or disinterest, lack of motivation, fear of injury, tiredness, lack of time, lack of guidance, negative social influence, restriction, and lack of coordination of prophylaxis treatment. This exploratory study demonstrated that participation in physical activity in PWH is influenced not only by their own abilities and attitudes, but also by external variables, including family, friends, healthcare professionals, structures, and communities. The results of this study may be used to assist caregivers and health professionals, inform programs, interventions, and policies to promote physical activity and health in severe PWH.

‘A Different Ball Game’: Adaptation of a men’s health program for implementation in rural Australia

BackgroundMen residing in rural areas are less likely to participate in weight management interventions than women, and few men-specific programs target rural areas. Aussie-Fans in Training (Aussie-FIT) is an evidence-based weight management intervention that uses professional Australian Football club affiliations and settings as a ‘hook’ to engage urban-residing men. The aim of this study is to report on how findings from rural stakeholder focus groups were used to inform the adaptation of Aussie-FIT for implementation in rural areas.MethodsSeven focus groups with stakeholders (n = 24) in three rural towns explored existing weight management and physical activity provisions, barriers and facilitators to engaging men, and considerations for adapting Aussie-FIT for implementation in rural contexts. Qualitative data were analysed using the framework approach. Adaptations made to the Aussie-FIT program and strategies to implement the program in rural contexts were reported using a structured framework.ResultsThemes generated from our analysis include limited appealing services for men, Australian Football as a ‘common language’, the influence of the ‘smaller fishpond’(population), considerations for program inclusivity, and the importance of local partner organisations for sustainability. We adapted the recruitment and marketing strategies, delivery settings, football program theme and partnerships for rural implementation. Stakeholders advised that an Australian Football program theme without specific local club affiliations would be important to avoid alienating men with differing club allegiances or non-sporting backgrounds. A multi-component recruitment strategy utilising local trusted sources, and program marketing that aligns with masculine ideals were considered important by stakeholders in small communities where ‘people talk’.ConclusionsRural areas were described as ‘a different ball game’ due to limited local services and resources in comparison to metropolitan areas. Study findings have synergies with previous studies undertaken in rural contexts including in relation to the power of word of mouth, the importance of trust, and local partner organisations. Findings have implications for engaging rural men in health interventions in rural contexts where professional sporting contexts are not available. Assessing the extent to which the adapted Aussie-FIT program can reach and engage men in rural Australia, and exploring the barriers and facilitators to delivering the program in rural contexts is required.

Exploring physical activity experiences, barriers, and facilitators among individuals of South Asian heritage living with and beyond cancer

ABSTRACT Objectives: The purpose of this study was to understand the physical activity (PA) experiences, as well as preferences, barriers, and facilitators to exercise, among individuals of South Asian heritage diagnosed with cancer. Design: A qualitative descriptive design was used. Individuals of South Asian heritage were recruited via a mix of convenience sampling and purposive sampling, with outreach via radio, posters in community settings, and from outreach to participants in current exercise oncology studies. Inclusion criteria included being over the age of 18; diagnosed with any cancer type and stage; pre, during, or post-treatment; able to speak English, Hindi, or Punjabi; and self-identified as South Asian. Data for this study was collected via semi-structured interviews conducted in the participants language of choice. Interviews were transcribed verbatim in the original language and then analyzed using conventional content analysis. For non-English interviews, the codes created through analysis were subsequently translated into English, and back-translated into the original language, to ensure accuracy. These codes were then organized into themes and categories. Results: Eight participants were recruited, with 5 interviews conducted in Punjabi and 3 interviews in English. The three themes that were created from the participant interviews include: (1) Culture, (2) Informational Needs, and (3) The Nature of Exercise Oncology Interventions. Within these themes, categories included barriers and facilitators to PA, as well as PA needs. Conclusion: Participants’ perspectives provided insights into the PA experiences, barriers, facilitators, and needs of people of South Asian heritage living with and beyond cancer. These results can be used to inform the tailoring of exercise oncology resources to better support physical activity and exercise for this population.