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Koa AJAF, Chou CC, Lindayani L, Wang CJ. Exploring barriers to physical activity participation among female nursing students adhering to specific social-cultural norms in Indonesia: A qualitative study. BELITUNG NURSING JOURNAL 2024; 10:438-447. [PMID: 39211463 PMCID: PMC11350347 DOI: 10.33546/bnj.3370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 05/11/2024] [Accepted: 07/09/2024] [Indexed: 09/04/2024] Open
Abstract
Background The prevalence of insufficient physical activity is common among nursing students and impacts their academic performance. Research on obstacles to physical activity (PA) among religious women, notably Muslims, is limited. Objectives This study aimed to explore barriers to PA among Indonesian Muslim female nursing students and gather suggestions for overcoming those barriers. Methods This study used a qualitative descriptive design. Two focus groups were conducted with 12 Muslim female nursing students in Makassar, Indonesia. Interviews were audio-recorded and transcribed verbatim. The data were collected from May and July 2019. Inductive thematic analysis was used to identify core themes and sub-themes. Results Thematic analysis identified barriers to PA across four main themes: intrapersonal, interpersonal, institutional, and social-cultural related to religious context. Each theme included two to three sub-themes, totaling nine categories of PA participation barriers. Intrapersonal barriers consisted of low motivation, emotional states, and a sedentary lifestyle. Interpersonal challenges included a lack of family or friend support and family obligations. Institutional barriers involved academic workload prioritization, school environment inaccessibility, and absence of athletic curriculum policy. Socio-cultural barriers posed by religious expectations included gender-related concerns and modest dressing. Drawing from their perspectives as Muslim female nursing students, study participants proposed six strategies to address these barriers. Proposed solutions include promoting PA through Apps, forming female team-up clubs, providing designated exercise spaces, and implementing mandatory athletic courses for nursing students at the institutional level. Additionally, offering female instructors and private exercise rooms could reduce the barriers from a socio-cultural perspective caused by religious expectations. Conclusions The study found that Muslim female nursing students with dual roles face increased barriers to PA participation, driven by intrapersonal and interpersonal levels, nursing learning load, and religious norms. Schools could build environments to meet the religious expectations within Indonesian society to promote PA for Muslim female nursing students. For example, the practical strategies include offering private rooms or female instructors when they physically exercise in school.
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Affiliation(s)
- Apryadno Jose Al Freadman Koa
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- School of Health Sciences Panakkukang Makassar, Makassar City, Indonesia
| | - Cheng-Chen Chou
- Institution of Community Health Care, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | | | - Chi-Jane Wang
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Alageel S, Alhujaili M, Altwaijri Y, Bilal L, Alsukait R. Barriers and facilitators to adopting healthier lifestyle among low-income women in Saudi Arabia: A qualitative study. Health Expect 2023; 26:1202-1212. [PMID: 36806821 PMCID: PMC10154786 DOI: 10.1111/hex.13735] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 01/31/2023] [Accepted: 02/08/2023] [Indexed: 02/21/2023] Open
Abstract
INTRODUCTION Low socioeconomic status (SES) is significantly associated with increased levels of obesity, unhealthy diet, and physical inactivity leading to a higher risk of chronic diseases. This study aimed to explore low SES women's barriers and facilitators to engaging in a healthy lifestyle and their accounts in developing future behaviour change interventions. METHODS Qualitative study using focus group interviews informed by the Capability Opportunity Motivation-Behavior (COM-B) framework. Interviews were conducted with a convenience sample, and data were analysed using thematic analysis. This study is conducted in partnership with Alnahda Society, a prominent nongovernmental organization in Riyadh, Saudi Arabia. RESULTS We conducted five focus groups with a total of 29 participants. We identified five overarching themes from the data related to participants' definition of a 'healthy life', the difficulties they face that hinder their engagement with a healthy lifestyle, the methods and reasons for changing health behaviour and participants' views of an ideal future behaviour change intervention. Women's definition of a healthy lifestyle did not only include a healthy diet and physical activity but also emphasized the importance of improving mental wellness. Following a healthy lifestyle, although desired, is not always a priority for women with low SES due to the high cost, lack of availability of healthy options and time constraints. Many women in our sample discussed the need to have a routine and discipline to follow and maintain a healthy lifestyle. Family members' support for behaviour change was discussed as a facilitator to maintaining a healthy lifestyle. Women highlighted several reasons that would motivate them to change their health behaviour, including having or preventing health conditions, improving mental health, and managing weight. Participants also discussed the characteristics of an ideal behaviour change intervention. DISCUSSION This study suggests that women with low SES are faced with several barriers to adopting a healthy lifestyle. Behaviour change intervention targeting this population needs to be tailored to address these barriers and facilitate behaviour change for people with limited resources. National policies to improve the availability and affordability of healthy options are also needed to reduce health disparities. PATIENT AND PUBLIC CONTRIBUTIONS Women of low SES who took part in the study were given a chance at the end of each focus group discussion to reflect on the questions and add any areas important to them that were not covered during the interview. Experts working with disadvantaged populations in a nonprofit organization (Alnahda society) contributed to the design of the topic guide.
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Affiliation(s)
- Samah Alageel
- Community Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Maysa Alhujaili
- Community Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Yasmin Altwaijri
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.,Alnahda Society, Riyadh, Saudi Arabia
| | - Lisa Bilal
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Reem Alsukait
- Community Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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Lightner J, Eighmy K, Valleroy E, Wray B, Grimes A. The Effectiveness of an After-school Sport Sampling Intervention on Urban Middle School Youth in the Midwest: Posttest-Only Study. JMIR Pediatr Parent 2023; 6:e42265. [PMID: 36696161 PMCID: PMC9909513 DOI: 10.2196/42265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/18/2022] [Accepted: 01/10/2023] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Effective and scalable interventions are needed to combat chronic low levels of youth physical activity. After-school sport sampling programs may be vital interventions for teaching sports and increasing physical literacy and physical activity, which result in healthy lifelong habits that are maintained into adulthood. OBJECTIVE The purpose of this study was to test the effectiveness of an after-school sport sampling intervention among underserved youth in the Midwest. METHODS Youth (n=81) in 3 middle schools within a large Midwest city participated in an 8-month, after-school physical activity intervention that aimed to increase moderate- and vigorous-intensity physical activity, improve physical literacy, and decrease BMI. Difference scores for this 2-group, posttest-only design were calculated. A series of 2-tailed t tests were conducted to assess between-group differences. RESULTS The intervention group had significantly better physical literacy (t115=7.57; P=.004) and engaged in more moderate- and vigorous-intensity physical activity minutes per week (t115=4.28; P=.04) and steps per day (t115=4.29; P=.03). CONCLUSIONS An after-school sport sampling program may be an effective solution for combating youth physical inactivity. Future research should assess the scalability of this intervention with larger populations and in different areas. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/37126.
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Affiliation(s)
- Joseph Lightner
- School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, MO, United States
| | - Katlyn Eighmy
- School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, MO, United States.,Department of Population Health, University of Kansas Medical Center, Kansas City, KS, United States
| | - Ella Valleroy
- School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, MO, United States.,Department of Population Health, University of Kansas Medical Center, Kansas City, KS, United States
| | - Bridget Wray
- School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, MO, United States
| | - Amanda Grimes
- School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, MO, United States
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Delfa-De-La-Morena JM, Bores-García D, Solera-Alfonso A, Romero-Parra N. Barriers to Physical Activity in Spanish Children and Adolescents: Sex and Educational Stage Differences. Front Psychol 2022; 13:910930. [PMID: 35726266 PMCID: PMC9206528 DOI: 10.3389/fpsyg.2022.910930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Abstract
According to worrisome childhood obesity and inadequate physical activity (PA) levels worldwide, especially exacerbated in adolescents girls, this work aimed to identify sex and educational stage differences in barriers to meet PA requirements and international guidelines in Spanish children and adolescents considering the entire educational pathway (primary, secondary, and college). The Short Form of the International PA Questionnaire and the Scale of Perceived Barriers were administered to primary, secondary, and college education students (13,491 boys and 13,238 girls, 9–19 yrs). Two-way ANOVA was performed to analyze barriers to PA according to sex and educational stage with physical status as covariate. Higher disliking and time barriers were reported by females (1.5 ± 1.2 and 3.2 ± 1.5 points) in comparison to males (1.2 ± 1.0 and 2.8 ± 1.4), while primary students showed lower disliking and time (1.2 ± 1.0 and 2.8 ± 1.5) and higher safety (3.1 ± 1.8) constraints in comparison to secondary (1.4 ± 1.1, 3.1 ± 1.4, and 2.8 ± 1.7) and college (1.5 ± 1.2, 3.2 ± 1.5, and 2.8 ± 1.6; p < 0.05 for all comparisons). College females showed higher disliking (1.7 ± 1.2) and time (3.5 ± 1.4) barriers than secondary females (1.5 ± 1.2 and 3.3 ± 1.4; p < 0.05). Sex and educational stage were determinant for time and dislike of PA barriers, which were rated higher by female students in comparison to their male counterparts and from primary education onwards. Altogether this, suggests promotion strategies should carefully consider girls and the step into secondary school.
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Affiliation(s)
- José Manuel Delfa-De-La-Morena
- Department of Physiotherapy, Occupational Therapy, Physical Medicine and Rehabilitation, Rey Juan Carlos University, Móstoles, Spain
| | - Daniel Bores-García
- Department of Physiotherapy, Occupational Therapy, Physical Medicine and Rehabilitation, Rey Juan Carlos University, Móstoles, Spain.,Research Group of Humanities and Qualitative Research in Health Science, Rey Juan Carlos University, Madrid, Spain
| | - Adrián Solera-Alfonso
- Department of Physiotherapy, Occupational Therapy, Physical Medicine and Rehabilitation, Rey Juan Carlos University, Móstoles, Spain
| | - Nuria Romero-Parra
- Department of Physiotherapy, Occupational Therapy, Physical Medicine and Rehabilitation, Rey Juan Carlos University, Móstoles, Spain.,LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sports Science, Universidad Politécnica de Madrid, Madrid, Spain
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Ferreira Silva RM, Mendonça CR, Azevedo VD, Raoof Memon A, Noll PRES, Noll M. Barriers to high school and university students' physical activity: A systematic review. PLoS One 2022; 17:e0265913. [PMID: 35377905 PMCID: PMC8979430 DOI: 10.1371/journal.pone.0265913] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 03/10/2022] [Indexed: 11/19/2022] Open
Abstract
Physical inactivity commonly occurs throughout one's life, particularly during adolescence and young adulthood. Multiple factors can negatively influence participation in physical activity, but there has been no review examining the barriers to physical activity among high school and university students. Therefore, the aim of this systematic review was to summarize evidence of barriers to the practice of physical activity among high school and university students. The literature search was conducted without time limits using five databases, including CINAHL, Cochrane Library, Embase, PubMed, and Scopus. In total, 59 studies (37 with high school students [n = 22,908] and 22 with university students [n = 15,411]) were included. The main barriers identified in high school and university students were lack of time, lack of motivation, and lack of accessible places. These findings may be useful in designing and implementing evidence-informed interventions and programs for physical activity promotion in students.
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Affiliation(s)
| | | | | | - Aamir Raoof Memon
- Institute of Physiotherapy and Rehabilitation Sciences, Peoples University of Medical and Health Sciences for Women, Nawabshah (Shaheed Benazirabad), Pakistan
| | | | - Matias Noll
- Federal Institute Goiano, Ceres, Goiás, Brazil
- Federal University of Goiás, Goiânia, Goiás, Brazil
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Grimes A, Lightner JS, Pina K, Donis de Miranda ES, Meissen-Sebelius E, Shook RP, Hurley E. Designing an adolescent physical activity and nutrition intervention before and after COVID-19: A formative research study. JMIR Form Res 2021; 6:e33322. [PMID: 34932499 PMCID: PMC8785954 DOI: 10.2196/33322] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 11/15/2021] [Accepted: 12/13/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND With rates of childhood obesity continually increasing, effective physical activity (PA) and nutrition interventions are needed. Formative research is used to tailor interventions to different cultural and geographic contexts and can also be vital in adapting intervention strategies in the face of significant disruptive circumstances (like COVID-19). OBJECTIVE We conducted formative research via in-person and online focus groups among middle schoolers and parents to better understand barriers and facilitators to PA and fruit and vegetable (FV) consumption and inform the design of a large intervention for a low-income, urban setting in the U.S. Midwest. METHODS We conducted two phases of qualitative focus groups with parents (n=20) and 6-9 grade middle schoolers (n=22). Phase 1 was conducted prior to the COVID-19 pandemic in late 2019, and phase 2 was conducted during the COVID-19 pandemic in the summer of 2020. Focus groups were transcribed and thematically coded using Dedoose software. RESULTS Main facilitators to PA prior to the pandemic included the opportunity to have fun, peer influence, competition (for some), and incentives, while main barriers to PA were time constraints and social discomfort. Main facilitators to eating FV included parental influence, preparation technique, and convenience, while barriers included dislike of vegetables, time constraints, and preparation or freshness. During the pandemic, facilitators to PA remained the same, while additional barriers to PA such as lack of motivation and limited time spent outside of the home were reported during the pandemic. For FV consumption, both facilitators and barriers remained the same for both time periods. Additionally, for some participants, the pandemic offered an opportunity to offer more FV to middle schoolers throughout the day. CONCLUSIONS Some themes identified were common to those reported in previous studies, such as peer influence on PA and parental influence on FV consumption. Novel themes, such as lack of motivation to be active and limited time outside the home, helped improve intervention adaptation, specifically during the COVID-19 pandemic. The continuity of formative research after a major, unexpected change in intervention context can be essential in targeting areas of an intervention that can be retained and those that need to be adjusted. CLINICALTRIAL
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Affiliation(s)
- Amanda Grimes
- School of Nursing and Health Studies, University of Missouri-Kansas City, 2464 Charlotte St., Kansas City, US
| | - Joseph S Lightner
- School of Nursing and Health Studies, University of Missouri-Kansas City, 2464 Charlotte St., Kansas City, US
| | - Kimberly Pina
- Division of Health Services and Outcomes Research, Children's Mercy Kansas City, Kansas City, US
| | | | - Emily Meissen-Sebelius
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, Kansas City, Kansas City, US
| | - Robin P Shook
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, Kansas City, Kansas City, US.,Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, US
| | - Emily Hurley
- Division of Health Services and Outcomes Research, Children's Mercy Kansas City, Kansas City, US.,Department of Population Health, University of Kansas Medical Center, Kansas City, US.,Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, US
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Enabling Better Nutrition and Physical Activity for Adolescents from Middle Eastern Backgrounds: Focus Groups. Nutrients 2021; 13:nu13093007. [PMID: 34578885 PMCID: PMC8466108 DOI: 10.3390/nu13093007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/22/2021] [Accepted: 08/27/2021] [Indexed: 01/27/2023] Open
Abstract
The obesity epidemic in adolescents from Middle Eastern (ME) backgrounds necessitates co-designed and culturally-responsive interventions. This study's objective was to gather the opinions, attitudes, capabilities, opportunities and motivations of ME adolescents residing in Australia on healthy eating and physical activity (PA) behaviours to inform a future prevention program. Five focus groups were conducted, with 32 ME participants, aged 13-18 years, recruited via purposive and snowball sampling. More participants were female (n = 19) and from lower socioeconomic areas (n = 25). A reflexive thematic analysis was performed using the Capability, Opportunity, Motivation-Behaviour (COM-B) model as the coding framework. Limited nutritional knowledge and cooking skills accompanied by a desire to make dietary changes were reported. Local and school facilities provided adolescents with PA opportunities, but participants declared safety concerns and limited opportunities for females and older grade students. Social support from family and friends were enablers for both healthy eating and PA. Cravings and desire for cultural foods influenced food choices. Individual and/or group approaches using social media and face-to-face format were recommended for future programs. To enable PA and dietary behaviour changes, interventions should be specifically tailored for ME adolescents to improve their nutrition literacy and skills, along with providing safe environments for sport in conjunction with social support.
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