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Godoy-Izquierdo D, de Teresa C, Mendoza N. Exercise for peri- and postmenopausal women: Recommendations from synergistic alliances of women's medicine and health psychology for the promotion of an active lifestyle. Maturitas 2024; 185:107924. [PMID: 38599003 DOI: 10.1016/j.maturitas.2024.107924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 01/21/2024] [Accepted: 01/23/2024] [Indexed: 04/12/2024]
Abstract
Adopting healthy behaviors is a multifaceted and complex process that poses significant challenges for individuals. Despite awareness of the detrimental effects of certain behaviors on health, many individuals continue to engage in risky practices. Traditional medical advice and prescriptions, while well intentioned, often fall short in fostering lasting lifestyle changes. Although individuals may also have good intentions, solely relying on doctor's counsel does not ensure successful lifestyle adjustments. One primary reason for this limitation is the lack of specialized expertise in behavioral modification among gynecologists and healthcare providers. Health psychologists are specialized professionals capable of effectively guiding and assisting individuals in modifying health-related behaviors. Their expertise in behavior change strategies and psychological interventions proves invaluable in empowering individuals to embrace healthier lifestyles and contributes to people's well-being. This paper emphasizes the importance of collaborative efforts between medical professionals, such as gynecologists, and health psychologists to promote healthy behaviors among peri- and postmenopausal women and enhance women's health. By forging integrative alliances, they can develop comprehensive and tailored interventions. By bridging the gap between medical advice and behavior modification, this collaborative effort has the potential to ensure a more effective intervention process. This holistic approach not only addresses women's specific health needs but also fosters sustainable behavior change when promoting healthy behaviors among middle-aged women. The ultimate goal of such a synergy is to improve women's health outcomes and contribute to a healthier society overall.
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Affiliation(s)
- Débora Godoy-Izquierdo
- Health Psychology & Behavioral Medicine Research Group (CTS-267), University Research Institute of Women and Gender Studies, University of Granada, Rector López Argueta w/n, 18071 Granada, Spain; Department of Personality and Psychological Assessment & Treatment, Faculty of Psychology, University of Granada, C.U. Cartuja w/n, 18071 Granada, Spain.
| | - Carlos de Teresa
- Andalusian Center of Sports Medicine (CAMD), Ed. IMUDS, Parque Tecnológico Ciencias de la Salud, Avda. del Conocimiento w/n, 18007 Granada, Spain
| | - Nicolás Mendoza
- Department of Obstetrics & Gynecology, Faculty of Medicine, University of Granada, Avda. de la Investigación 11, 18071 Granada Spain.
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Berntzen BJ, Tolvanen A, Kujala UM, Silventoinen K, Vuoksimaa E, Kaprio J, Aaltonen S. Longitudinal leisure-time physical activity profiles throughout adulthood and related characteristics: a 36-year follow-up study of the older Finnish Twin Cohort. Int J Behav Nutr Phys Act 2024; 21:47. [PMID: 38671483 PMCID: PMC11046842 DOI: 10.1186/s12966-024-01600-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 04/19/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Personalized interventions aiming to increase physical activity in individuals are effective. However, from a public health perspective, it would be important to stimulate physical activity in larger groups of people who share the vulnerability to be physically inactive throughout adulthood. To find these high-risk groups, we identified 36-year leisure-time physical activity profiles from young adulthood to late midlife in females and males. Moreover, we uncovered which anthropometric-, demographic-, lifestyle-, and health-related characteristics were associated with these physical activity profiles. METHODS We included 2,778 females and 1,938 males from the population-based older Finnish Twin Cohort Study, who responded to health and behavior surveys at the mean ages of 24, 30, 40 and 60. Latent profile analysis was used to identify longitudinal leisure-time physical activity profiles. RESULTS We found five longitudinal leisure-time physical activity profiles for both females and males. Females' profiles were: 1) Low increasing moderate (29%), 2) Moderate stable (23%), 3) Very low increasing low (20%), 4) Low stable (20%) and 5) High increasing high (9%). Males' profiles were: 1) Low increasing moderate (29%), 2) Low stable very low (26%), 3) Moderate decreasing low (21%), 4) High fluctuating high (17%) and 5) Very low stable (8%). In both females and males, lower leisure-time physical activity profiles were associated with lower education, higher body mass index, smoking, poorer perceived health, higher sedentary time, high blood pressure, and a higher risk for type 2 diabetes. Furthermore, lower leisure-time physical activity was linked to a higher risk of depression in females. CONCLUSIONS We found several longitudinal leisure-time physical activity profiles with unique changes in both sexes. Fewer profiles in females than in males remained or became low physically active during the 36-year follow-up. We observed that lower education, higher body mass index, and more smoking already in young adulthood were associated with low leisure-time physical activity profiles. However, the fact that several longitudinal profiles demonstrated a change in their physical activity behavior over time implies the potential for public health interventions to improve leisure-time physical activity levels.
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Affiliation(s)
- Bram J Berntzen
- Institute for Molecular Medicine Finland FIMM, University of Helsinki, P.O. Box 20, FI-00014, Helsinki, Finland
| | - Asko Tolvanen
- Methodology Centre for Human Sciences, University of Jyväskylä, P.O. Box 35, FI-40014, Jyväskylä, Finland
| | - Urho M Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35, FI-40014, Jyväskylä, Finland
| | - Karri Silventoinen
- Helsinki Institute for Demography and Population Health, University of Helsinki, P.O. Box 42, FI-00014, Helsinki, Finland
| | - Eero Vuoksimaa
- Institute for Molecular Medicine Finland FIMM, University of Helsinki, P.O. Box 20, FI-00014, Helsinki, Finland
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland FIMM, University of Helsinki, P.O. Box 20, FI-00014, Helsinki, Finland
| | - Sari Aaltonen
- Institute for Molecular Medicine Finland FIMM, University of Helsinki, P.O. Box 20, FI-00014, Helsinki, Finland.
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Pebole MM, Singleton CR, Hall KS, Petruzzello SJ, Reginald A, Smith BN, Whitworth JW, Gobin RL. Sex-specific associations between self-reported physical activity and PTSD among survivors of sexual violence. J Behav Med 2024; 47:220-231. [PMID: 37698803 DOI: 10.1007/s10865-023-00434-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 06/28/2023] [Indexed: 09/13/2023]
Abstract
This study examined sex-specific associations between sexual violence (SV) type and physical activity, and identified associations between PTSD symptoms and physical activity, all among cisgender men and women survivors of SV. Cross-sectional data from men (n = 197) and women (n = 356) survivors of SV were analyzed with stratified (men; women) hierarchical logistic regressions. Additionally, fully adjusted models for the total sample included interaction terms to further assess whether associations between SV type as well as PTSD symptoms (sum, clusters) and physical activity differed significantly by sex. Sexual assault was negatively associated with physical activity in the crude model among women (ORs: 0.58; p < 0.05). Harassment was positively associated with physical activity in the crude and adjusted models (ORs:1.92-2.16; ps<0.05) among women. Among men, there were no significant relationships. Regarding PTSD symptoms among women, crude and adjusted stratified models identified significant positive relationships with intrusion (ORs: 1.18-1.22; ps<0.05). Crude and adjusted models revealed significant positive relationships between avoidance and activity (ORs:1.38-1.41; ps<0.05) among men but not women. The interaction term for this difference in the association between avoidance and physical activity by sex was significant (OR: 0.65; 95%CI: 0.48-0.88; p < 0.01). Overall, findings provide evidence for sex-specific associations between SV and physical activity.
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Affiliation(s)
- Michelle M Pebole
- The Translational Research Center for TBI and Stress Disorders (TRACTS), Veterans Affairs Boston Healthcare System, 150 S Huntington Ave, Boston, MA, 02130, USA.
- Department of Kinesiology and Community Health, University of Illinois at Urbana Champaign, 505 E Armory Ave, Champaign, IL, 61280, USA.
| | - Chelsea R Singleton
- Department of Social, Behavioral, and Population Sciences, Tulane School of Public Health & Tropical Medicine, 1440 Canal Street, New Orleans, LA, 70112, USA
| | - Katherine S Hall
- Geriatric Research, Education, and Clinical Center, Durham VA Healthcare System, 508 Fulton St, Durham, NC, 27705, USA
- Department of Medicine, Duke University, 2301 Erwin Road, Durham, NC, 27710, USA
| | - Steven J Petruzzello
- Department of Kinesiology and Community Health, University of Illinois at Urbana Champaign, 505 E Armory Ave, Champaign, IL, 61280, USA
| | - Alston Reginald
- Department of Kinesiology and Community Health, University of Illinois at Urbana Champaign, 505 E Armory Ave, Champaign, IL, 61280, USA
| | - Brian N Smith
- National Center for PTSD Women's Health Sciences Division, VA Boston Healthcare System, 150 S Huntington Ave, Boston, MA, 02130, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, 720 Harrison Avenue, Boston, MA, 02118, USA
| | - James W Whitworth
- National Center for PTSD Behavioral Science Division at VA Boston Healthcare System, 150 S Huntington Ave, Boston, MA, 02130, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, 720 Harrison Avenue, Boston, MA, 02118, USA
| | - Robyn L Gobin
- Department of Kinesiology and Community Health, University of Illinois at Urbana Champaign, 505 E Armory Ave, Champaign, IL, 61280, USA
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Li J. Gender inequity in physical activity and governmental health expenditure: evidence from big data. J Public Health (Oxf) 2023; 45:e808-e809. [PMID: 37329123 DOI: 10.1093/pubmed/fdad092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 05/30/2023] [Indexed: 06/18/2023] Open
Affiliation(s)
- Jiannan Li
- Institute of Advanced Studies in Humanities and Social Sciences, Beijing Normal University, Zhuhai, China
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Pebole MM, Singleton CR, Hall KS, Petruzzello SJ, Alston R, Gobin RL. Perceived Barriers and Benefits of Exercise Among Women Survivors of Sexual Violence by Physical Activity Level and Posttraumatic Stress Disorder Status. Violence Against Women 2023:10778012231182412. [PMID: 37350105 DOI: 10.1177/10778012231182412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
An online, cross-sectional survey of women survivors of sexual violence (SV; N = 355) gathered information on perceived barriers and benefits of exercise, along with exercise level and posttraumatic stress disorder (PTSD) symptoms. This study reports exercise perceptions and provides comparisons by exercise level and PTSD status. Differences by exercise level were found in life enhancement, physical performance, psychological outlook, and social interaction (ps < 0.05; rs = -0.04-0.25). Differences were found by PTSD status in physical performance, social interaction, and preventative health and exercise milieu, time expenditure, and family discouragement (ps < 0.05; rs = -0.39-0.21). Findings provide new information relevant for promoting exercise among women survivors of SV.
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Affiliation(s)
- Michelle M Pebole
- The Translational Research Center for TBI and Stress Disorders (TRACTS), Veterans Affairs Boston Healthcare System, Boston, MA, USA
- Department of Kinesiology and Community Health, University of Illinois at Urbana Champaign, Urbana, IL, USA
| | - Chelsea R Singleton
- Department of Social, Behavioral, and Population Sciences, Tulane School of Public Health & Tropical Medicine, New Orleans, LA, USA
| | - Katherine S Hall
- Department of Medicine, Duke University, Durham NC, USA
- Geriatric Research, Education, and Clinical Center, Durham VA Healthcare System, Durham, NC, USA
| | - Steven J Petruzzello
- Department of Kinesiology and Community Health, University of Illinois at Urbana Champaign, Urbana, IL, USA
| | - Reginald Alston
- Department of Kinesiology and Community Health, University of Illinois at Urbana Champaign, Urbana, IL, USA
| | - Robyn L Gobin
- Department of Kinesiology and Community Health, University of Illinois at Urbana Champaign, Urbana, IL, USA
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Bruder AM, Culvenor AG, King MG, Haberfield M, Roughead EA, Mastwyk J, Kemp JL, Ferraz Pazzinatto M, West TJ, Coburn SL, Cowan SM, Ezzat AM, To L, Chilman K, Couch JL, Whittaker JL, Crossley KM. Let's talk about sex (and gender) after ACL injury: a systematic review and meta-analysis of self-reported activity and knee-related outcomes. Br J Sports Med 2023; 57:602-610. [PMID: 36889918 DOI: 10.1136/bjsports-2022-106099] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2023] [Indexed: 03/10/2023]
Abstract
OBJECTIVE Investigate sex/gender differences in self-reported activity and knee-related outcomes after anterior cruciate ligament (ACL) injury. DESIGN Systematic review with meta-analysis. DATA SOURCES Seven databases were searched in December 2021. ELIGIBILITY CRITERIA Observational or interventional studies with self-reported activity (including return to sport) or knee-related outcomes after ACL injury. RESULTS We included 242 studies (n=123 687, 43% females/women/girls, mean age 26 years at surgery). One hundred and six studies contributed to 1 of 35 meta-analyses (n=59 552). After ACL injury/reconstruction, very low-certainty evidence suggests females/women/girls had inferior self-reported activity (ie, return to sport, Tegner Activity Score, Marx Activity Scale) compared with males/men/boys on most (88%, 7/8) meta-analyses. Females/women/girls had 23%-25% reduced odds of returning to sport within 1-year post-ACL injury/reconstruction (12 studies, OR 0.76 95% CI 0.63 to 0.92), 1-5 years (45 studies, OR 0.75 95% CI 0.69 to 0.82) and 5-10 years (9 studies, OR 0.77 95% CI 0.57 to 1.04). Age-stratified analysis (<19 years) suggests female athletes/girls had 32% reduced odds of returning to sport compared with male athletes/boys (OR 0.68, 95% CI 0.41 to 1.13, I2 0.0%). Very low-certainty evidence suggests females/women/girls experienced inferior knee-related outcomes (eg, function, quality of life) on many (70%, 19/27) meta-analyses: standardised mean difference ranging from -0.02 (Knee injury and Osteoarthritis Outcome Score, KOOS-activities of daily living, 9 studies, 95% CI -0.05 to 0.02) to -0.31 (KOOS-sport and recreation, 7 studies, 95% CI -0.36 to -0.26). CONCLUSIONS Very low-certainty evidence suggests inferior self-reported activity and knee-related outcomes for females/women/girls compared with males/men/boys after an ACL injury. Future studies should explore factors and design targeted interventions to improve outcomes for females/women/girls. PROSPERO REGISTRATION NUMBER CRD42021205998.
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Affiliation(s)
- Andrea M Bruder
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia .,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Adam G Culvenor
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Matthew G King
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Melissa Haberfield
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Eliza A Roughead
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - John Mastwyk
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Joanne L Kemp
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Marcella Ferraz Pazzinatto
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Thomas J West
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Sally L Coburn
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Sallie M Cowan
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.,Clifton Hill Physiotherapy, Melbourne, Victoria, Australia
| | - Allison M Ezzat
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.,Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Laura To
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.,Clifton Hill Physiotherapy, Melbourne, Victoria, Australia
| | - Karina Chilman
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Jamon L Couch
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.,Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Jackie L Whittaker
- Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada.,Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Kay M Crossley
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
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Ervin J, Taouk Y, Fleitas Alfonzo L, Peasgood T, King T. Longitudinal association between informal unpaid caregiving and mental health amongst working age adults in high-income OECD countries: A systematic review. EClinicalMedicine 2022; 53:101711. [PMID: 36353526 PMCID: PMC9637877 DOI: 10.1016/j.eclinm.2022.101711] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 10/04/2022] [Accepted: 10/05/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Informal unpaid caregivers provide most of the world's care needs, experiencing numerous health and wealth penalties as a result. As the COVID-19 pandemic has highlighted, informal care is highly gendered. Longitudinal evidence is needed to assess the causal effect of caregiving on mental health. This review addresses a gap by summarising and appraising the longitudinal evidence examining the association between unpaid caregiving and mental health among working age adults in high-income Organisation for Economic Co-operation and Development (OECD) countries and examining gender differences. METHODS Six databases were searched (Medline, PsycInfo, EMBASE, Scopus, Web of Science, Econlit) from Jan 1, 2000 to April 1, 2022. Population-based, peer-reviewed quantitative studies using any observational design were included. Population of interest was working age adults. Exposure was any unpaid caregiving, and studies must have had a non-caregiving comparator for inclusion. Mental health outcomes (depression, anxiety, psychological distress/wellbeing) were measurable by validated self-report tools or professional diagnosis. Screening, data extraction and quality assessment (ROBINS-E) were conducted by two reviewers. The study was prospectively registered with PROSPERO (CRD42022312401). FINDINGS Of the 4536 records screened; 13 eligible studies (133,426 participants) were included. Overall quality of evidence was moderate. Significant between-study heterogeneity precluded meta-analysis, so albatross and effect-direction plots complement the narrative synthesis. Results indicate a negative association between informal unpaid care and mental health in adults of working age. Importantly, all included studies were longitudinal in design. Where studies were stratified by gender, caregiving had a consistently negative impact on the mental health of women. Few studies examined men but revealed a negative effect where an association was found. INTERPRETATION Our review highlights the need to mitigate the mental health risks of caregiving in working age adults. Whilst men need to be included in further scholarship, reducing the disproportionate caregiving load on women is a crucial requirement for policy development. FUNDING Melbourne School of Population and Global Health, Targeted Research Support Grant.
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Affiliation(s)
- Jennifer Ervin
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
- Corresponding author. Centre for Health Equity, Melbourne School Population and Global Health, The University of Melbourne, Level 4, 207, Bouverie Street, Victoria 3010, Australia.
| | - Yamna Taouk
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Ludmila Fleitas Alfonzo
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Tessa Peasgood
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Tania King
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
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McKeon G, Mastrogiovanni C, Teychenne M, Rosenbaum S. Barriers and Facilitators to Participating in an Exercise Referral Scheme among Women Living in a Low Socioeconomic Area in Australia: A Qualitative Investigation Using the COM-B and Theoretical Domains Framework. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12312. [PMID: 36231623 PMCID: PMC9565931 DOI: 10.3390/ijerph191912312] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/26/2022] [Accepted: 09/26/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Despite the health benefits of regular physical activity, women experiencing socioeconomic disadvantage are at high risk of inactivity. Reasons are multifactorial but likely include broad structural and contextual factors, e.g., lack of access to physical activity programs, as well as individual and interpersonal factors, e.g., lack of motivation and childcaring responsibilities. Few studies among women of low socioeconomic position (SEP) have explored these factors in-depth, yet an understanding of these factors can help inform the development and improve the uptake of exercise referral schemes. The Theoretical Domains Framework (TDF) and COM-B model (capability, opportunity, motivation and behaviour) were employed to understand behaviours for intervention development. Therefore, using these behaviour change models, this study aimed to explore the barriers and facilitators influencing the use of an exercise referral scheme among women living in a socioeconomically disadvantaged area. METHODS Semi-structured interviews were conducted with women who had registered with a free exercise referral scheme (Live Life Get Active) and living in a low socioeconomic neighbourhood in Sydney, Australia. Reflexive thematic analysis and framework analysis were used to allow naturally identified themes to be determined and then allocated to theoretically driven domains. RESULTS Nine women were interviewed (aged 30-69 years). Eighteen themes were identified and mapped directly on to the six COM-B constructs. The most reported barriers to using the physical activity referral scheme related to the opportunity construct of the COM-B model, specifically childcare responsibilities, work commitments and environmental barriers. Key facilitators were enjoyment (motivation), no cost (opportunity), instructor led (opportunity) and social support (opportunity). CONCLUSION Future exercise referral schemes targeting women living in low-SEP neighbourhoods should ensure programs are designed and delivered to overcome barriers aligned with the constructs of the COM-B model, particularly opportunity-related constructors.
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Affiliation(s)
- Grace McKeon
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW 2052, Australia
- School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia
| | - Chiara Mastrogiovanni
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW 2052, Australia
| | - Megan Teychenne
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3217, Australia
| | - Simon Rosenbaum
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW 2052, Australia
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