Physical Activity Barriers Research Articles

Psychology of physical activity: a 30-year reflection on correlates, barriers, and theory

ABSTRACT Over a 30-year period, we have authored five versions of the textbook Psychology of Physical Activity. This provides us with more than three decades of experience to reflect on the field of the psychology of physical activity. Typically, the book has been structured around the three themes of determinants/correlates and theory, mental health outcomes, and behaviour change interventions. In the current paper, we delimit our reflections to physical activity correlates and barriers, and the use of theory. Overall, the field has expanded greatly. Physical activity is central to most national preventive health policy initiatives and is now highly visible. Over the 30 years of our book writing, we have seen trends in the correlates and barriers for physical activity that reflect an increasing recognition of the different types and intensities of physical activity, some reflecting in a “systems thinking” approach that recognises the natural complexity of the behaviour and its settings. But further work is recommended in gaining clarity on the frequently stated barrier of “lack of time” and assumed physical activity correlate of enjoyment. Moreover, the move to a dual-process approach to theory is one that will continue to develop but may need more work in its application to behaviour change. A reflection across recent editions of the book suggest that some good progress has been made, but not universally so.

Validity and reliability of the Turkish version of the parent perceptions of physical activity scale.

The Parent Perceptions of Physical Activity Scale (PPPAS) is a scale developed to measure the physical activity perceptions of parents of children with neurodevelopmental disorders about their children. Turkish version of the PPPAS has yet to be established. The purpose of the present study is to examine the validity and reliability of the Turkish version of the PPPAS. The study included 130 parents with neurodevelopmental children. In the validity analyses of PPPAS, language validity, content validity analysis, and confirmatory and explanatory factor analysis were performed for construct validity. In the reliability analyses, Cronbach alpha analysis was used for internal consistency analysis, and intraclass correlation (ICC) analysis was used for test retest. The validity index was calculated as 0.94. Since the factor loading of the three questions in the survey remained below 40%,these questions were removed. Construct validity was achieved for two primary subscales of the PPPAS. It was found that the ICC valuesfor the reliability analysis of the PPPAS showed a perfect fit at the level of 0.918 for the benefits of the physical activity subdimension, and the physical activity barriers subdimension showed a perfect fit at the level of 0.916 (p = 0.001). The Turkish PPPAS, which consists of two subscales, namely the benefits and barriers of physical activity, is valid and reliable. This tool can measure the physical activity perceptions of parents with preschool-age children with neurodevelopmental disorders in the Turkish population.

Comparison of Physical Activity, Exercise Barriers, Physical Performance, and Fall Risks in Frail and Nonfrail Older Adults

Objectives: The present research aimed to identify the difference between physical activity, physical performance, balance, fall risk, and exercise barriers in frail and nonfrail older adults. Methods: One hundred nineteen voluntary individuals older than 65 years and living in Kırıkkale were enrolled in the research. The Clinical Frailty Scale was employed to evaluate the frailty level of the individuals included in the study. In line with the data obtained after the evaluation, individuals were separated into 2 groups as frail and nonfrail individuals. Exercise barriers were evaluated with the Exercise Benefits/Barriers Scale (EBBS), physical activity level was evaluated with the Physical Activity Scale for the Elderly (PASE), lower extremity physical performance was assessed with the Short Physical Performance Battery (SPPB) test, and fall risk was assessed with the Self-Rated Fall Risk Questionnaire (FRQ). Results: Ninety-three of the individuals enrolled in the study were found to be nonfrail and 26 to be frail older adults. The mean age of the individuals in the nonfrail group was 70.36 ± 6.10 years, and the mean age of the individuals in the frail group was 76.53 ± 7.37 years. In the statistical analysis, the difference was revealed between the groups in terms of the exercise barriers subscore, EBBS total score, PASE leisure activity score, PASE total score, FRQ total score, and SPPB total result (P < .05). In the correlation analysis, there was a negative correlation between the frailty scale score and SPPB and a positive correlation between the frailty scale score and FRQ in nonfrail older adults (P < .05). However, there was a positive correlation between the frailty scale score and exercise barriers subscore, EBBS and FRQ total scores, and a negative correlation between the PASE leisure activities, work activities and PASE total score, and SPPB score in frail individuals (P < .05). Conclusions: Our results demonstrated that the physical activity levels of frail older adults were poorer, they had a higher fall risk, and their activity performance, including the lower extremity, was poorer than that of nonfrail older adults.

Physical activity barriers and team cohesiveness of Angeles City volleyball players during the pandemic

Physical activity barriers, particularly for the volleyball players of Angeles City, are one of the elements that hinder team cohesiveness for all athletes during this pandemic. According to research, there are many areas where the pandemic influences physical activity and team cohesiveness. The purpose of this study is to ascertain whether physical activity barriers have a direct impact on volleyball players' ability to work together as a team. Based on related literature on how it affects physical activity barriers, an online Cross-Sectional, Descriptive-Survey research was conducted on the volleyball players around Angeles City. Respondents were chosen based on specific qualities and criteria and provided unbiased selection. In analyzing the data, the pandemic practices and communication are the areas that impact the volleyball players in the middle of the pandemic. The findings showed that physical activity barriers have no association with the team cohesiveness of the volleyball player. It is suggested to the trainers, coaches, school administrators, and players that they can apply the findings of this study to their training amidst this pandemic. For further validation, the same research is needed to identify the other areas or factors that affect physical activity barriers to team cohesiveness.

An Irish Multi-Centre Study of Behaviours, Attitudes and Barriers to Exercise in Inflammatory Bowel Disease, a Survey from the Patient’s Perspective

Background: Physical activity (PA) in inflammatory bowel disease (IBD) has many potential favourable outcomes including anti-inflammatory effects, improvement in quality of life and improvements in patient body composition. It is recognised that patients with IBD have a significantly decreased exercise tolerance. Aim: 1. To assess physical activity levels, behaviours and barriers to PA in IBD. 2. To assess the likelihood of patients with IBD to engage in a community-based exercise programme. 3. To examine the presence of body image concerns in IBD. Method: Patient surveys were distributed in Beaumont and Connolly Hospitals between October and December 2021. Descriptive statistics, Chi-squared testing and Pearson’s correlations were completed using Minitab. p < 0.05 denoted statistical significance. Results: Data were recorded for a total of 203 patients. Out of all patients, 62% (n = 126) had Crohn’s disease (CD). Over half of the cohort were male (n = 115). Mean weight among females was 75 kg and 83 kg among males. Exercise behaviours: Out of all patients, 71% exercise regularly, on average for 59 min, 3.2 days/week. Walking was the most common form of PA (74%). A post-diagnosis change in exercise behaviour was found in 66% with three-quarters exercising less. The primary barrier to exercise was fatigue (54%). Female gender (p = 0.007) and age < 45 years (p = 0.02) were associated with body image dissatisfaction reported in 62% of patients. Conclusion: These data demonstrate the patient-reported impact of IBD on patient participation in PA. Concerns regarding body image were common and associated with gender and age. A feasibility study of a physician-derived exercise programme in patients with active IBD is underway in Beaumont Hospital to determine the effect on patient response to therapy, inflammation and body composition outcomes (NCT05174754).

Motives and Barriers for Regular Physical Activity among Medical Students from the Western Balkans (South-East Europe Region)

Regular physical activity (PA) has multiple beneficial effects on students' health, effectively reducing the risk of various non-communicable diseases. Various factors play a role in an individual's motivation to engage in and maintain regular PA. So far, no research dealing with the motives and barriers for regular PA among medical students has been conducted in the countries of the Western Balkans. The aim of this study was to identify the motives and barriers related to regular PA and compare them with different demographic, socioeconomic, and individual lifestyle factors among Western Balkans medical students. The research was conducted in a form of a cross-sectional study. It included 2452 medical students from 14 faculties in five countries (Slovenia, Croatia, Bosnia and Herzegovina, North Macedonia, and Serbia). The most commonly reported motive of medical students for regular PA is to feel better, followed by stress reduction, to look better, the desire to lose weight, and to control chronic disease. PA improvement motives are more frequently associated with the female gender, more advanced years of study, a normal weight, above average household income, and a non-smoking status. Faculty obligations are the most common barrier for regular PA among medical students, followed by other barriers, such as financial situation, current life situation, and health conditions. Barriers are more frequently reported by male students who are overweight or obese, who have a below average income, and are smokers. It is necessary for public health authorities to examine and take into account the perceived motives and barriers when forming activities and policies that aim at increasing the level of PA, in order to enhance the health of the student population.

Barriers for physical activity in Chinese patients with type 2 diabetes: a qualitative study

article: Barriers for physical activity in Chinese patients with type 2 diabetes: a qualitative study - Gazzetta Medica Italiana - Archivio per le Scienze Mediche 2022 October;181(10):758-68 - Minerva Medica - Journals

Barriers and facilitators to comprehensive, school-based physical activity promotion for adolescents prior to and during the COVID-19 pandemic: a qualitative study.

This study aimed to identify barriers and facilitators to comprehensive, school-based physical activity (PA) promotion among adolescents prior to and during the coronavirus disease of 2019 (COVID-19) pandemic, considering the perspectives of students, parents, and school staff. Data were collected from 2020 to 2021 using semi-structured individual interviews with students (n = 15), parents (n = 20), and school staff (n = 8) at a Title I middle school (i.e.high percentage of students from low-income families). Two theoretical frameworks guided analysis: the Comprehensive School Physical Activity Program framework and Bronfenbrenner's ecological systems theory. Using an iteratively developed codebook, data were coded, thematically analyzed, and synthesized. PA barriers and facilitators were present throughout the school day, at home, and in the community. Key determinants included pandemic-induced challenges (e.g. COVID-19 exposure); neighborhood characteristics/weather (e.g. neighborhood safety); school-family communication/collaboration; implementation climate (i.e.school staff's support for programming); time, spatial, and monetary resources (e.g. funding); staffing capacity/continuity and school champions; staffing creativity and adaptability; PA opportunities before, during, and after school; and child's motivation/engagement. Efforts to improve school-based PA programs, irrespective of pandemic conditions, should include strategies that address factors at the community, school, family and individual levels. School-family communication/collaboration, school staff programming support, and PA opportunities throughout the day can help promote comprehensive, school-based PA.

Domesticating the condition: Design lessons gained from a marathon on how to cope with barriers imposed by type 1 diabetes.

Through analytical autoethnographic analysis of marathon preparation, this study examines challenges faced by people with Type 1 Diabetes (T1D) who engage in high-performance sports. Autoethnographer and second-person perspectives (T1D runners, family members, and health providers) were collected through introspective activities (autoethnographic diary and in-depth interviews) to understand the T1D runner's coping experience. Six insights involved in T1D self-management were identified and analyzed with reference to related design tools (prototyping, archetyping and journey mapping). Finally, we conclude with a discussion of how endurance physical activity (PA) such as running helps to "domesticate" T1D, a term coined to reflect the difficulties that T1D presents for PA accomplishment and how T1D runners' experiences give them an opportunity to overcome PA barriers promoting physical culture and enriching further health psychology studies.

Exploring Opportunities to Improve Physical Activity in Individuals with Spinal Cord Injury Using Context-Aware Messaging

Spinal cord injury (SCI) affects the mobility of 250,000 people per year worldwide. Physical activity (PA) in individuals with SCI is positively associated with improved mental and physical health outcomes. Mobile technologies have been developed to motivate individuals with SCI to increase PA using activity tracking and real-time feedback. We conducted semi-structured interviews and participatory design sessions with 15 manual wheelchair users with SCI and eight of their family members/friends to investigate user impressions of future technologies that might use computer-mediated, sensor-triggered communication to motivate PA. We assessed barriers to PA and how context-aware communication could help overcome them. Participants with SCI expressed that PA tracking and communication technologies must be tailored to their specific needs. Further analysis revealed that context-aware messaging could help participants with SCI connect with others to initiate timely conversations about overcoming PA barriers, and to provide encouragement to meet their PA goals. We discuss opportunities to empower individuals with SCI with regards to PA using tailored, context-aware communication.

Barriers to physical activity in pregnant women living in Iran and its predictors: a cross sectional study

Background and aimsDespite the benefits of physical activity (PA) on maternal and fetal health, the level of PA is low among pregnant women globally. The aim of this study was to determine the barriers to PA and its predictors in Iranian pregnant women specifically.MethodsThis cross-sectional study included 300 pregnant women referred to the Ilam health centers of Iran. The sampling strategy used stratified random proportional allocation sampling from both comprehensive health centers and health bases. Data were collected from September to December 2018 in relation to individual characteristics. Data collection tools used included the Pregnancy Physical Activity Questionnaire and the Barriers to Physical Activity during Pregnancy Scale. To analyze the data, descriptive statistics and statistical tests of analysis including variance, independent t-test and multiple linear regression were used.ResultsThe mean and SD of the total score of PA barriers was 88.55 and 19.28, respectively. The highest and lowest mean scores of the subscale of PA barriers were related to interpersonal and environmental barriers, respectively. Among the intrapersonal barriers related to pregnancy; fear of pregnancy complications, drowsiness, and nausea and vomiting, heaviness or swelling barriers scored higher than other barriers. Lack of regular schedule, insufficient time, and lack of motivation received the highest score in terms of intrapersonal barriers non-related to pregnancy. In the interpersonal subscale; lack of knowledge about how to be physically active during pregnancy, forbiddance of PA by friends and family, as well as lack of advice from physicians and midwives scored higher than other barriers. Lack of adequate facilities and air pollution were identified as barriers to PA in the environmental subscale. PA barriers were significantly associated with pre-pregnancy or early pregnancy body mass index (B = − 14.643), level of education (B = 17.215), and habitual exercise pre-pregnancy (B = − 7.15).ConclusionInterpersonal barriers were reported to be the most common barriers to PA during pregnancy. Perinatal care providers should encourage, educate and reassure pregnant women, their spouses and their families about the benefits, type and frequency of safe PA in pregnancy. PA interventions focused on women with lower levels of education and income in particular are required.

Parent and child perceptions of physical activity with type 1 diabetes

IntroductionType 1 diabetes (T1D) is a lifelong illness that affects over 2500 children in Ireland. Management involves complex daily regimens including frequent blood glucose monitoring, pharmacotherapy, dietary management, and physical...

Patient-reported outcomes evaluation and assessment of facilitators and barriers to physical activity in the Transplantoux aerobic exercise intervention.

Transplantoux's MVT exercise intervention prepares organ transplant recipients to cycle or hike up France's Mont Ventoux. We aimed to assess (i) MVT's effects on patient-reported outcomes (PROs) and (ii) perceived barriers and facilitators to physical activity. Using a hybrid design, a convenience sample of transplant recipients participating in MVT (n = 47 cycling (TxCYC); n = 18 hiking (TxHIK)), matched control transplant recipients (TxCON, n = 213), and healthy MVT participants (HCON, n = 91) completed surveys to assess physical activity (IPAQ), health-related quality of life (HRQOL; SF-36 and EuroQol VAS), mental health (GHQ-12), and depressive symptomatology, anxiety, and stress (DASS-21) at baseline, then after 3, 6 (Mont Ventoux climb), 9, and 12 months. TxCYC and TxHIK participated in a 6-month intervention of individualized home-based cycling/hiking exercise and a series of supervised group training sessions. Barriers and facilitators to physical activity (Barriers and Motivators Questionnaire) were measured at 12 months. Regarding PROs, except for reducing TxHIK stress levels, MVT induced no substantial intervention effects. For both TxCYC and TxHIK, between-group comparisons at baseline showed that physical activity, HRQOL, mental health, depressive symptomatology and stress were similar to those of HCON. In contrast, compared to TxCYC, TxHIK, and HCON, physical activity, HRQOL and mental health were lower in TxCON. TxCON also reported greater barriers, lower facilitators, and different priority rankings concerning physical activity barriers and facilitators. Barely any of the PROs assessed in the present study responded to Transplantoux's MVT exercise intervention. TxCON reported distinct and unfavorable profiles regarding PROs and barriers and facilitators to physical activity. These findings can assist tailored physical activity intervention development. Clinical trial notation: The study was approved by the University Hospitals Leuven's Institutional Review Board (B322201523602).

Barriers and facilitators of domain-specific physical activity: a systematic review of reviews

BackgroundKnowing what facilitates and hinders physical activity behaviour across domains (leisure, travel, work or education, and household) is central for the development of actions for more active lifestyles. Thus, the aim of this systematic review of reviews was to summarize the evidence on barriers and facilitators of domain-specific physical activity.MethodsWe included systematic reviews with or without meta-analysis that investigated the association between modifiable barriers and facilitators and levels of domain-specific physical activity. Reviews published until September 2020 were retrieved from PubMed, ISI Web of Science, Scopus, Regional Library of Medicine (BIREME), and PsycNET, and from the reference list of selected articles. Each review was screened by two independent reviewers for eligibility. Data extracted from selected papers included methodological aspects (number of primary studies, study designs, and age groups); physical activity domains and barriers and facilitators investigated; and direction of association. For each pair of barrier/facilitator and domain-specific physical activity, we recorded the number of positive, negative, and null associations reported across reviews. Quality assessment of each systematic review was performed using the AMSTAR-2 tool.ResultsForty-four systematic reviews were selected. The evidence base was largest for leisure-time followed by travel-related physical activity. A very small number of reviews included physical activity in work, educational and domestic settings. Across all physical activity domains, factors related to the built environment were more abundant in the reviews than intra and interpersonal factors. Very consistent positive associations were observed between a range of intrapersonal factors and leisure-time physical activity, as well as moderately consistent evidence of positive association for general social support and support from family members. Evidence of moderate consistency was found for the positive association between transport-related physical activity and positive beliefs about consequences, walkability, and existence of facilities that support active travel. Evidence on barriers and facilitators for physical activity at work, educational, and domestic settings was limited in volume and consistency.ConclusionsEfforts and resources are required to diversify and strength the evidence base on barriers and facilitators of domain-specific physical activity, as it is still limited and biased towards the leisure domain and built environment factors.Trial registrationPROSPERO CRD42020209710.

Promoting Physical Activity Among Immigrant Asian Americans: Results from Four Community Health Worker Studies.

Racial/ethnic minorities have demonstrated lower rates of physical activity (PA) than non-Hispanic Whites. This study examined outcomes in PA measures after participation in a community health worker (CHW) intervention. We performed a secondary data analysis from four randomized controlled trials utilizing CHWs (n = 842) in New York City (Bangladeshi-diabetes management, Filipino-hypertension management, and Korean and Asian Indian-diabetes prevention). Outcomes included total weekly PA, PA self-efficacy, PA barriers, and PA social interaction. Each measure was examined at baseline and study endpoint. Generalized estimating equation models were fitted to assess the repeated measures over time, while accounting for study group and socio-demographic factors. Moderate PA, recommended PA, and self-efficacy increased significantly among treatment group participants. PA social interaction increased significantly among Filipinos and Asian Indians. In adjusted regression analysis, time x group interaction was significant for all PA outcomes except for PA barriers. Culturally-adapted lifestyle interventions may potentially improve PA-related outcomes in Asian immigrant communities. Trial registration at ClinicalTrials.gov includes: NCT03530579 (RICE Project), NCT02041598 (DREAM Project), and NCT03100812 (AsPIRE).

Facilitators and barriers to health enhancing physical activity in individuals with severe functional limitations after stroke: A qualitative study.

Patients with chronic conditions are less physically active than the general population despite knowledge of positive effects on physical and mental health. There is a variety of reasons preventing people with disabilities from achieving levels of physical activities resulting in health benefits. However, less is known about potential facilitators and barriers for physical activity (PA) in people with severe movement impairments. The aim of this study was to identify obstacles and facilitators of PA in individuals with severe disabilities. Using a qualitative approach to explore individuals' subjective perspectives in depth, five community-dwelling adults (age 52-72, 2 female, 3 male) living with chronic mobility impairments after stroke that restrict independent PA were interviewed. A semi structured topic guide based on the theoretical domains framework was utilized. The interview data was analyzed thematically, and the theoretical domains framework constructs were mapped onto the main and sub-categories. The six main categories of facilitators and barriers along the capability, opportunity, motivation-behavior (COM-B) framework were: (1) physical capabilities, (2) psychological capabilities, (3) motivation reflective, (4) motivation automatic, (5) opportunity physical, and (6) opportunity social. The physical capabilities to independently perform PA were variable between participants but were not necessarily perceived as a barrier. Participants were highly motivated to maintain and/or increase their abilities to master their everyday lives as independently as possible. It became clear that a lack of physical opportunities, such as having access to adequate training facilities can present a barrier. Social opportunities in the form of social support, social norms, or comparisons with others can act as both facilitators and barriers. While confirming known barriers and facilitators that impact the ability of individuals with functional limitations to be active, the findings highlight the need and opportunities for comprehensive service models based on interdisciplinary collaborations.

Perceived barriers and facilitators to physical activity in childhood cancer survivors and their parents: A large-scale interview study from the International PACCS Study.

Physical activity (PA) may reduce risks of late effects in childhood cancer survivors, yet many have low activity levels. Using the WHO's International Classification of Functioning, Disability, and Health for Children and Youths (ICF-CY) as a conceptual framework, we aimed to identify perceived barriers and facilitators to PA in young survivors and their parents. We conducted individual, semi-structured interviews with 63 survivors, aged 9-18years, ≥1-year off treatment, and 68 parents, recruited from three pediatric oncology departments in Norway and Denmark. Interviews were analyzed inductively using thematic analysis to identify barriers and facilitators to PA, which were mapped onto the ICF-CY model components; body function/structures, activities, participation, and environmental and personal factors. Two-thirds of the survivors described how treatment-related impairments of bodily functions (e.g., fatigue, physical weakness, reduced lung capacity) caused physical limitations, reducing opportunities to participate in PA, especially team sports and school physical education. This resulted in a perceived ability gap between survivors and peers, reducing motivation for PA. These PA barriers were moderated by environmental factors that facilitated or further hindered PA participation (family, peer, and school support). Similarily, personal factors also facilitated (acceptance, motivation, goal setting) or hindered (anxiety, low motivation, and lack of trust) PA participation. Treatment-related long-term or late effects represented significant barriers to PA as their functional consequences reduced survivors' capacities and capabilities to be active. Environmental and personal factors acting as facilitators or further barriers to PA were identified. Applying the ICF-CY framework in clinical practice could help to enable PA participation.

Lifestyle Changes During COVID-19 of University Staff in Indonesia: A Cross-Sectional Survey

Among the lecturers and staff at the university are experiencing stress disorders, especially during the COVID-19 pandemic. We aimed to determine the prevalence of cardiovascular risk factors, physical activity, and dietary adherence among lectures and staff associated with the national survey. A cross-sectional study with a web-based questionnaire presented anonymous demographic data, cardiovascular risk factors, physical activity, dietary intake, and healthy lifestyle barriers. A total of 1,862 lecturers and staff who met the following criteria for participation, having reached the age of majority at 25, were accepted into the study, gave informed consent online, and responded to a survey. BMI in the staff and lecturers group was overweight and obese, slightly lower for lecturers (25.9 kg/m2) compared to staff (27.4 kg/m2) with adjustments for age and gender. There was no significant difference (p>0.05) in the prevalence of obesity between staff and faculty regardless of age or gender. The short IPAQ questionnaire revealed that around 68.7% of lecturers did PA category 2 or 3 and 28.3% of lecturers did PA category 3. Muscle strengthening exercises were carried out in each group by 24.5% of lecturers and 21.4% of staff. Lecturers (74.2%) feel responsible for their health. Most of the participants expressed that their working hours prevented them from staying fit. Physical activity and low intake of vegetables and fruits due to lack of managerial support, fitness facilities, and long working hours are obstacles to a healthy lifestyle. Very few lecturers and staff can follow an active lifestyle every day of the week and tend to engage in physical activity for longer periods within days or regulate food intake during the COVID-19 pandemic.

Testing the feasibility and acceptability of an Acceptance and Commitment Therapy intervention to increase physical activity among individuals with depression: A protocol paper

BackgroundEngaging in regular physical activity (PA) is particularly important among individuals with depression, who are at heightened risk for a host of negative health outcomes. However, people with depression are 50% less likely to meet national guidelines for PA and face unique barriers to PA adherence, including lower distress tolerance and motivation for exercise. Acceptance and Commitment Therapy (ACT) may offer promise for increasing PA among adults with depressive symptoms due to its effects on distress tolerance and motivation. Therefore, we developed ACTivity, an ACT-based intervention designed to promote PA among low-active adults with elevated depressive symptoms. Prior to testing the efficacy of ACTivity in an RCT, an important first step is to conduct a preliminary trial to establish feasibility of study procedures for the ACTivity and comparison intervention programs, as well as to establish the credibility/acceptability of the intervention. The purpose of this paper is to describe the ACTivity intervention and the design of this feasibility trial. Method/designWe will conduct a feasibility RCT with two parallel groups and a 1:1 allocation ratio comparing ACTivity to a comparison intervention (relaxation training + PA promotion) among 60 low-active adults with elevated depressive symptoms. All study procedures will be conducted remotely. DiscussionResults of this feasibility study will inform a subsequent RCT designed to test the efficacy of ACTivity. If shown to be efficacious, ACTivity will provide a treatment that can be widely disseminated to increase PA among adults with depressive symptoms and thereby decrease their risk for chronic disease.

Perceived barriers to physical activity behaviour among patients with diabetes and hypertension in Kosovo: a qualitative study

BackgroundIn a cohort of primary health care users across Kosovo (KOSCO cohort), high rates and poor control of diabetes and hypertension were observed. These conditions can be prevented and better controlled by adapting to a healthy lifestyle. Physical activity is an important target, as inactivity and related obesity were very prevalent in the KOSCO cohort. This qualitative study aims to identify individual and structural barriers to physical activity perceived by patients with diabetes and/or hypertension so as to inform health care providers and policy-makers in Kosovo on strategies for promoting physical activity.MethodsInterviews were conducted from July to October 2020 with 26 public primary health care users from five municipalities of Kosovo (Mitrovica, Vushtrri, Fushe Kosova, Gjakova, and Malisheva). The qualitative study was nested into the KOSCO cohort. KOSCO was implemented in 2019 and recruited consecutive patients visiting the public primary health care centres in these municipalities. Participants of this qualitative sub-study were selected if they had a doctor’s diagnosis of diabetes and/or hypertension. The interview guide consisted of questions related to physical activity barriers these patients are facing, despite having received motivational counselling sessions in primary healthcare centres. Data were analysed using a framework methodology.ResultsThree main themes moderating physical activity behaviour were identified: 1) neighbourhood built environment, 2) health-related problems, and 3) social support. The barriers to physical activity related to the first theme were structural features of the neighbourhoods such as: crowded sidewalks, lack of green spaces, lack of proper lighting in public spaces, as well as dense traffic. In regards to the second theme, the main health reasons for study participants to delay physical activity were related to: physical discomfort as well as stress, worry, and lack of energy. An additional barrier to exercise was lack of social support specifically from friends.ConclusionThe study identifies structural and individual targets for integrated and inter-sectoral physical activity promotion efforts.