Physical Activity Participation Research Articles

ABSTRACT Engaging those most disaffected from participation in sport and physical activity is an enduring challenge for policymakers and practitioners. The barriers to participation are most acute for individuals and groups that experience a complex and emergent set of social, cultural and economic issues within their local communities. In light of these challenges, in the UK over the past decade, there has been a proliferation of funding and strategic buy-in for place-based working. A place-based approach is now often advocated as the model for community-based provision, though the evaluation of place-based approaches delivered through community sport systems remains limited. This paper illustrates novel insights into how a process evaluation, when integrated with a place-based programme, can increase the chances of securing public health benefits that incorporate considerations of equity. To do this we reflect critically on the national evaluation of the Active Through Football (ATF) programme which began delivery in 2022. The paper presents a generic theory of change for place-based physical activity interventions based on our accumulated learning across 25 ATF place-based programmes. Our findings demonstrate how activities within a place-based approach contribute to a range of outcomes through the activation of key underlying programme mechanisms. This theory of change will be useful for those who wish to emulate ATF’s place-based approach, or evaluate key processes within place-based practice. This understanding of programme mechanisms is central to the continued accumulation of practical and theoretical knowledge to guide place-based sport practice and policy.

Factors that affect engagement with physical activity for patients who have received radiotherapy as part of their gynaecological cancer treatment - A rapid review.

Transgender, nonbinary, and gender-diverse (TNBGD) individuals experience significant inequities in health, access to health care, and participation in physical activity for a myriad of reasons, including gender dysphoria and the physical effects of gender-affirming practices like chest binding. Physical therapists have the requisite clinical skills to evaluate and treat these individuals, potentially enhancing overall health and wellness while reducing barriers to physical activity. Binding is a common practice for many TNBGD individuals, often performed to achieve improved congruence between an outward physical appearance and one's gender identity. Given the typical frequency and duration of binding, negative binding-related symptoms such as thoracic or rib pain, shortness of breath, and postural changes may occur. Physical therapists can be the provider of choice in minimizing the symptom burden and adverse effects of binding, but as a profession, we must improve inclusive care practices, deepen our understanding of the physiologic impacts of binding, and implement culturally responsive care plans tailored to the needs of TNBGD patients. Increased access to inclusive physical rehabilitation may improve lifelong health, promote physical activity, and mitigate health inequities in this population. Clinicians can purposefully advertise their preparedness and willingness to serve lesbian, gay, bisexual, transgender, queer, intersex, asexual, and two-spirit (LGBTQIA2S+) patients and work to understand and address disparities in health care access and quality. As a profession, we must continue to evolve to meet the needs of society, especially those who face systemic barriers and marginalization.

The transition to adulthood is a vulnerable period for the development of body image issues, which can increase the risk of behavioral disorders such as body dysmorphic and eating disorders. This study explored whether adherence to physical activity guidelines moderates the association between recreational screen time and body dissatisfaction in early adulthood. A sample of 1,475 young adults (mean age 18.81 years, 60.9% female) from 17 French-speaking public colleges in Quebec, Canada, completed self-report questionnaires in Fall 2021 and Winter 2022. Participants reported their daily recreational screen time, engagement in physical activity over the past 3 months, and sociodemographic characteristics. The analysis, based on multivariate linear regression, showed that higher screen time was associated with greater body dissatisfaction, but this relationship was weaker among participants who met the World Health Organization's physical activity guidelines. These findings suggest that adherence to physical activity guidelines may buffer the negative effects of recreational screen time on body dissatisfaction in young adults, highlighting the value of promoting physical activity in interventions aimed at reducing body dissatisfaction.

Background Moderate-to-vigorous physical activity (MVPA) and depression symptoms have a longstanding, inverse relationship. This short-term study examined the patterns of MVPA and prevalence of depression symptoms among adults seeking care from an employer-sponsored, multi-modal digital mental health platform. Methods Adults ( n = 755) with access to the platform enrolled in an online, observational study over 3 months. Baseline and longitudinal analyses were conducted on self-report MVPA and depression symptoms. Rates of activity and symptom improvement and maintenance were evaluated. Results Approximately 47% of participants were physically underactive at baseline, defined as <150 min of physical activity per week. Men participated in more physical activity than women ( p = 0.005), while women and individuals identifying as gender non-binary reported more depression symptoms than men ( p s < 0.05). Older adults reported fewer depression symptoms than younger adults ( r = −0.16, p < 0.001). Baseline MVPA baseline was negatively correlated with depression symptoms ( r = −0.19, p < 0.001). Depression scores significantly improved, with 66.9% of adults at risk of depression improving or recovering ( p < 0.001) and 94% of adults with low depression symptoms maintaining this status over time ( p = 0.004). Physical activity participation improved by 217% among individuals deemed underactive at baseline ( p < 0.001), while individuals who were active at baseline maintained high levels of physical activity ( p = 0.06). Conclusions Adults with access to a multi-modal digital mental health platform reported significant beneficial changes in depression symptoms and physical activity participation. Digital mental health tools may have the potential to elicit positive change in physical health domains, as well as mental health.

The decline in physical activity (PA) from childhood through adolescence is an escalating global concern with far-reaching implications for health and wellbeing. While prior research has examined general PA trends, critical gaps remain regarding the precise onset of decline, contributing factors, and the most effective intervention strategies. This systematic review synthesizes evidence on: (a) the age or developmental stage at which PA levels significantly decline, (b) key factors influencing this decline, and (c) interventions shown to be effective in slowing or preventing it. A comprehensive search was conducted across four electronic databases: Scopus, Web of Science, Google Scholar, and CORE guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework. From an initial pool of 14,621 records, 34 studies met the inclusion criteria. Findings reveal that PA levels begin to decline as early as age 7, with the most substantial drop occurring around age 9. Modifiable factors such as self-efficacy, motivation, screen time, and academic workload emerged as key contributors to this trend. Among intervention strategies, school-based, multicomponent, and theory-driven approaches, particularly those incorporating autonomy-supportive teaching, addressing both PA and sedentary behaviors, and engaging multiple stakeholders, demonstrated the strongest effectiveness. These results underscore the urgent need for early, multidimensional interventions to sustain PA engagement across developmental stages. Stakeholders including schools, policymakers, and researchers should prioritize integrated PA promotion strategies to reverse early inactivity trends. Future research should focus on the long-term sustainability of these interventions beyond the school context to ensure enduring behavioral change.

Background/Objectives: Heart transplantation substantially improves survival and quality of life in patients with advanced heart failure; however, many heart transplantation patients fail to recover normal physical activity levels. Persistent inactivity compromises secondary prevention and long-term outcomes. Kinesiophobia—an excessive and irrational fear of movement—may act as a central barrier limiting physical activity after heart transplantation. This study aimed to explore how kinesiophobia develops and interacts with physical and psychological factors that influence adherence to an active lifestyle after heart transplantation. Methods: A qualitative study was conducted in 24 adult heart transplantation patients (mean age 62.1 years; 83% male) at a tertiary hospital in Spain. Semi-structured interviews lasting 35–60 min were transcribed verbatim and analysed using reflexive thematic analysis. Methodological rigour was ensured through triangulation, reflexivity, and transparent documentation of analytic decisions. Results: Three interrelated themes were identified: (1) Kinesiophobia, characterised by fear of overexertion and avoidance of performing physical activity; (2) physical limitations, including fatigue, muscle weakness, treatment side effects, and intensified perceptions of vulnerability; and (3) psychological distress, encompassing anxiety, demotivation, and frustration, which intensified inactivity. These domains formed a self-perpetuating cycle that restricted participation in physical activity. Some participants reported simple adaptive strategies, such as pacing, walking and social support that enhanced their sense of safety and confidence. Conclusions: Kinesiophobia, physical limitations, and psychological distress interact to restrict physical activity in heart transplantation patients. Our findings suggest that rehabilitation should integrate psychological support, cognitive-behavioural strategies, and tailored education to reduce fear, enhance self-efficacy, and promote sustainable physical activity engagement.

Background Physical literacy (PL) is increasingly recognized as a foundational component of lifelong physical activity participation and healthy aging. However, research on PL in older adults remains scattered and lacks synthesis across domains. Objective To systematically map the current research landscape on physical literacy in older adults, including its definitions, core attributes, contributing factors, health-related outcomes, and intervention practices. Method Six databases (PubMed, Web of Science, Embase, CINAHL, SPORTDiscus, and PsycINFO) were searched from inception to May 2025. Additional grey literature was identified through Google Scholar and reference screening. Adopted Arksey and O′Malley’s five-stage methodological framework, two reviewers independently screened and extracted data focusing on definitions, attributes, antecedents, consequences, and interventions related to PL in older adults. Findings were synthesized using Braun and Clarke’s descriptive thematic analysis approach. Results Eighteen studies were included, which were published between 2019 and 2025, spanning medicine, psychology, and social sciences. The concept of PL among older adults did not have a consolidated definition but was identified through five defining attributes: Physical competence, Motivation and confidence, Knowledge and understanding, Affective and cognitive engagement and Environmental and social interaction. Influencing factors clustered into four categories: biomedical, psychosocial and behavioral habits, sociocultural environment, and education and early experiences. PL was positively associated with physical and mental health, willingness to engage in physical activity, successful aging, and public health outcomes. Intervention strategies included education-based programs, functional exercise training, dance, and exergaming. Conclusion Physical literacy is essential for supporting active aging. Standardized assessment tools and integrated interventions are needed to enhance PL among older adults. Future efforts should build upon the attributes of PL among older adults to develop or refine multidimensional assessment tools specifically designed for older adults, ensuring their cultural relevance and practical applicability.

Physical activity (PA) is essential for physical and mental health, yet sustaining long-term PA engagement remains a challenge. Booster strategies-follow-up contacts delivered after the end of interventions-have been proposed as a strategy to support PA maintenance, but their effectiveness remains unclear. The primary objective of this systematic review and meta-analysis was to classify the boosters used in PA interventions depending on their type and number. The secondary objective was to explore the efficacy of boosters in supporting participants' PA maintenance. A systematic search was conducted across seven databases, up to February 2025. Randomised controlled trials were included if they incorporated boosters and reported PA outcomes. Risk of bias was assessed using the RoB 2 tool. Meta-analysis examined changes in moderate-to-vigorous physical activity (MVPA) from baseline to the last available follow-up, and moderation analysis explored the effects of booster type, number of boosters administered, and follow-up duration on changes in MVPA. Studies not suitable for meta-analysis were synthesised narratively. Forty studies were included in the systematic review. The most common types of boosters used were phone calls and text messages, which were employed either alone or in combination with other types. 16 studies provided data for inclusion in the meta-analysis. There was conclusive evidence that including a booster in the intervention led to sustained increases in PA levels at follow-up. The estimated added effect of the booster over the intervention alone was a 6% increase. There was also conclusive evidence of increased MVPA for interventions with more boosters, and interventions that used remote and mixed-format delivery (vs in-person only) boosters. Finally, results showed conclusive evidence of increased MVPA for interventions that assessed MVPA using self-reported measures. Our findings suggest a trend indicating that boosters may support the maintenance of PA. Higher number of boosters and delivery through remote or mixed formats showed promising trends. Future research should also explore optimal booster numbers and formats to clarify their role in sustaining PA. PROSPERO (CRD42024510018); Protocol also available on Open Science Framework (OSF): https://osf.io/6abkw/?view_only=915375148520427db3dca76d2c32934d .

Climate change threatens human health, but its psychological effects on young people remains relatively understudied. Conversely, ample evidence demonstrates that Physical Activity (PA) positively impacts the psychological well-being in young people. Thus, this cross-sectional study investigated whether PA moderates the impact of a large flood experience on the relationship between eco-anxiety and well-being in young people. One thousand twenty-one (N = 1.021) adolescents aged 9 to 16 years old (Mage = 12.35 ± 1.38) completed measures for PA frequency, flood experience, eco-anxiety, and psychological well-being, six month after Daniel extreme flood event in Greece. Moderated moderation analysis was conducted to test the hypothesized model using PROCESS macro. We examined whether the relationship between eco-anxiety and well-being was moderated by flood experience alone, PA frequency alone, and/or flood experience and PA frequency combined. However the three-way interaction predicted only a very small of unique variance in well-being, ΔR2 = 0.007. Further examination of the three-way interaction showed that when PA frequency scores were lower than 2.71 days/week, flood experience potentiated the negative effect of eco-anxiety on well-being. In contrast, the moderating influence of flood experience on the relationship between eco-anxiety and well-being was buffered when PA frequency scores were higher than 6.25 days/week. Findings provide initial support that frequent PA participation (6-7 days /week) may improve the well-being of children and adolescents in times of crisis, potentially by reducing the effect of flood-related experience on the negative relationship between eco-anxiety and well-being.

Introduction: Women treated for breast cancer (BC) often experience declines in exercise capacity and cardiac function which increases their heart failure risk. Physical activity (PA) participation during BC treatment may prevent these declines, but the long-term impacts of PA on exercise capacity and cardiac function in BC survivors are unknown. Research Question: This study evaluated PA participation prior to initiating BC treatment through 24-month follow-up and tested if women who reported being physically active had better exercise capacity and cardiac function relative to inactive women. Methods: Women with stage I-III BC (n=236) were enrolled in a multi-site prospective cohort study conducted through the Wake Forest NCORP Research Base (NCT02791581). Participants were categorized as active, moderately active, or inactive from self-reported PA surveys. Exercise capacity was determined by 6-minute walk distance (6MWD) and cardiac function [left ventricular ejection fraction (LVEF) and LV mean circumferential strain, LV strain] was measured by cardiac magnetic resonance imaging prior to BC treatment and then at 3-, 12- and 24-month follow-up. Analyses were adjusted for age, BMI, race, fatigue, comorbidities, and BC treatment. Results: Participants average (±SD) age was 56±11 years, 76% were White, and 52% were diagnosed with stage II BC. PA participation declined from baseline to 3-month follow-up but increased to baseline levels at 12- and 24-month follow-up. At baseline, active and inactive participants had similar exercise capacity (mean difference ± SE=17.4±10.4 m, p=0.21), LVEF (0.76±0.60, p=0.41), and LV strain (-0.71±0.87, p=0.69). 6MWD declined from baseline to 3-months among inactive participants only (-21.9±8.5 m, p=0.01). Active participants had higher exercise capacity relative to inactive participants at 3-months (42.5±11.3 m, p<0.001), 12-months (39.2±10.3 m, p<0.001), and 24-months (31.2±10.9 m, p=0.01) follow-up. LVEF and LV strain were similar between active and inactive participants throughout follow-up. Conclusions: Over 24 months, physically active women with BC maintained a higher submaximal exercise capacity compared to inactive individuals while cardiac function was similar between the groups. These data suggest that maintaining PA during BC treatment is important for preserving submaximal exercise capacity long-term, which reflects the ability to perform activities of daily living in BC survivors.

Background Graduate students face considerable health risks due to sedentary behavior and academic stress, often demonstrating a marked intention–behavior gap in physical activity (PA). This study developed a two-dimensional 9-box grid model based on total exercise volume (TEV) and aerobic capacity (AC) to compare the efficacy of weekly versus monthly feedback in improving AC and PA participation among graduate students. Methods A quasi-experimental trial was conducted over eight weeks. Thirty-two graduate students, stratified by baseline AC evaluated in a 12-minute run test, were randomized into two arms, weekly feedback ( n = 16) and monthly feedback ( n = 16). Feedback was delivered through a dynamic 9-box grid that integrated weekly TEV on the x -axis and periodic AC on the y-axis. The primary outcomes were changes in the 12-minute run performance and TEV. Secondary outcomes included scores from the Exercise Identity Scale (EIS) and the Self-Efficacy for Exercise Scale (SEE-C). Thirty graduate students ( n = 15 per group) completed the trial and were included in the final analysis. Results Significant group × time interactions were observed for 12-min run distance ( F = 4.29, p = 0.024, η 2 = 0.241) and score ( F = 6.49, p = 0.005, η 2 = 0.325). The weekly feedback group demonstrated sustained improvements across all intervals ( p < 0.001, Hedges’ g = 1.16–1.78), while the monthly group improved only post-intervention. Weekly feedback also resulted in significantly greater gains in self-efficacy ( p = 0.044, g = 0.77) and higher TEV scores at multiple timepoints ( p < 0.05). Both groups showed improved exercise identity ( p < 0.001), with no between-group difference. Center of gravity analysis indicated greater migration toward healthier grid zones in the weekly group (ΔG = −1.93 vs. −1.47). Conclusion The dynamic 9-box grid model effectively enhances aerobic capacity, promotes physical activity, and strengthens psychological outcomes through dual-axis evaluation and closed-loop feedback. Weekly feedback demonstrates superior efficacy in sustaining behavior modification and facilitating tier progression. This model provides a replicable, theory-informed strategy for health behavior management in graduate student populations.

ABSTRACTIssue AddressedDespite substantial investment in government‐funded physical activity initiatives, there is limited evidence on how external stakeholders are engaged in their development and implementation. Gathering stakeholder feedback is often challenging, particularly without established mechanisms for ongoing evaluation. Therefore, this study aimed to explore how external stakeholders interacted with a government‐funded population‐based physical activity portfolio of initiatives in South Australia and examine key factors influencing its implementation, including challenges and opportunities to optimise future implementation.MethodsIn‐depth, semi‐structured interviews (n = 18) were conducted with stakeholders working at relevant agencies in South Australia. Interviews were audio‐recorded, transcribed verbatim, and analysed thematically to identify key themes related to stakeholder interaction and implementation insights.ResultFour key themes were identified related to: (1) awareness and engagement, (2) benefits and challenges to participation, (3) benefits and challenges to organisational partnerships, and (4) opportunities to enhance implementation. Funding, networking, and communication significantly influenced the promotion and engagement of the initiatives. Expanding funding and improving decision‐making were identified as opportunities to improve the implementation of future initiatives, with stakeholders emphasising transparency and the importance of monitoring and evaluation.ConclusionThis study highlights the crucial role of external stakeholders and the need for more funding and effective communication to enhance engagement in state government physical activity initiatives.So What?These findings provide policymakers with insights into stakeholder relationships and emphasise the importance of strengthening collaborative approaches to enhance stakeholder contributions to government‐led physical activity initiatives.

Physical activity (PA) is a key strategy in preventing and treating metabolic syndrome (MetS). The purpose is to investigate the associations of leisure-time PA (LTPA) trajectories across adulthood and current PA with MetS at age 61. Participants were 159 Finnish adults (52% women). LTPA frequency was assessed at ages 27, 42, 50, and 61 with a single question. Current PA at age 61 included self-reported vigorous, muscle-strengthening, commuting, and occupational PA. Cardiometabolic risk factors at age 61 included waist circumference, blood pressure, high-density lipoprotein (HDL) cholesterol, triglycerides, and glucose. MetS was defined based on the ATP III criteria. LTPA trajectories were conducted using k means for longitudinal data. Of the three LTPA trajectories found, consistently inactive (N=34) and increasingly active (N=58) had a higher risk of MetS compared to consistently active (N=67) (odds ratio [95% confidence interval]: 3.93 [1.55, 10.01] and 2.39 [1.14, 4.99], respectively). Only the difference between consistently inactive and consistently active remained statistically significant when the current PA indicators were included in the model. Considering the individual components of MetS, those who were consistently inactive and increasingly active had higher waist circumference, lower HDL, and higher triglyceride levels compared to consistently active. These differences did not remain statistically significant when current PA was included. Although consistently inactive and increasingly active individuals had higher cardiometabolic risk at age 61 compared to those who were consistently active across adulthood, current PA participation at the beginning of late adulthood attenuated these risks. These findings emphasize the importance of promoting and sustaining PA throughout life to reduce the burden of MetS in the aging population.

The reduction of physical activity among children continues to be a major concern globally, including in Indonesia. The purpose of this study is to analyze physical literacy in upper-grade elementary students (V and VI) from SD Negeri Cepoko and SD Negeri Sadeng 01, Semarang City, employing a descriptive quantitative survey method. The study employed a total sampling method, involving 89 participants. Physical literacy was assessed across three domains: physical competence (measured through TIAMSA, PACER, and Sit-Up tests), motivation and self-confidence, as well as knowledge and understanding. The results revealed that most students were classified as progressing, with only a quarter reaching the achieving category. At SD Negeri Cepoko, all students were categorized as progressing, whereas in SD Negeri Sadeng 01, a number of students particularly male students in grade V and female students in grade VI reached the achieving level. These results highlight disparities in physical literacy outcomes between schools and student groups. Hence, improvements in PJOK learning strategies, teacher development, and supportive learning environments are required to encourage sustainable participation in physical activity.

Introduction Pre-service primary teachers, especially primary Physical Education (PE) teachers, must acquire core teaching skills and effective classroom management strategies. The acquisition of motivating teaching styles in PE lessons has positive consequences for both teachers and students. Grounded in Self-Determination Theory and the Circumplex Model, the present study presents the first intervention program designed to foster motivating teaching styles (i.e., autonomy support and structure) and prevent (de)motivating teaching styles (i.e., control and chaos) among preservice primary PE teachers. Methods The training program also strives to improve preservice primary PE teachers’ competence and motivation, which might increase motivation for PE and physical activity engagement in the students later under their charge. A quasi-experimental design was employed that took a mixedmethods approach. A total of 370 participants from the [anonymized peer review process] will participate in the study. Participants were divided into control and experimental groups. The intervention program is structured into two main phases (i.e., general and specific phases) and will last a total of 35 h. Theoretical and practical face-to-face sessions will be conducted by university PE specialist professors. Following the training program, participants will complete school placements to apply what they have learned. Findings and discussion Pre-service primary PE teachers will learn to effectively use motivational strategies and teaching skills, whilst also adopting motivating teaching styles during practical sessions. Motivation, (de)motivating teaching styles, and perceptions of efficacy and competence will be assessed via questionnaires and focus groups. Findings represent an important first step towards improving motivational training programs for pre-service primary PE teachers and improving the quality of university teaching.

BackgroundBlack people in the United States have the highest rates of heart failure, and the worst outcomes of any racial/ethnic group which has been linked to both sociostructural (e.g. racism, poverty, food deserts) and behavioral factors. Physical activity is vital in managing heart failure, yet little is known about the perceptions of the Black community with heart failure. The purpose of this study was to understand and interpret physical activity engagement and the factors that may influence it in Black individuals with heart failure.MethodsThis study used a thematic analysis approach. One-on-one semi-structured interviews of eight Black individuals with heart failure addressed physical activity habits, health beliefs, health literacy, medical mistrust, depression, self-efficacy, health disparities, social support, barriers and facilitators. Line-by-line coding was conducted, and themes were developed.ResultsThe four key themes identified were 1. I don’t understand what heart failure is; 2. I was told that physical activity would not hurt; 3. I struggled when treated by providers from different cultures; 4. Having heart failure means I don’t have long to live. All eight participants acknowledged that physical activity was important but reported being underactive. Most could not describe what heart failure was and thus could not explain the importance of physical activity in managing heart failure. Physical activity instruction was not emphasized by healthcare providers, which likely contributed to an undervaluation of physical activity and to underactivity. Cultural differences between patients and clinicians had potential to result in non-adherence to recommendations.ConclusionsHealthcare providers should strive for adequate patient literacy about heart failure, and educate on the importance of physical activity, ensuring the appropriate level of instruction is provided so that Black individuals with heart failure are informed to best address their health.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12889-025-24945-w.

Factors associated with attempts to stop smoking in people with psychotic disorders.

Participating in physical activity and meeting physical activity guidelines are far more challenging for persons with disabilities than for the general population. This American College of Sports Medicine expert consensus statement provides an evidence-based summary of (i) the impact of physiological factors, physical activity guidelines, and barriers on physical activity participation and prescription for individuals with disabilities; (ii) three consensus statements derived from research evidence; and (iii) five practical recommendations for prescribing and designing physical activity programs tailored to adults with disabilities, based on an integration of research evidence with expert consensus.

Physical activity in young people with epilepsy: development of an informational software application.