Addressing context to understand physical activity among Muslim university students: the role of gender, family, and culture

Correlates of Lifestyle Physical Activity Among Young Arab American Women

BACKGROUND

Young Arab American women are at risk for cardiovascular disease, but there is limited data on their physical activity (PA) engagement.

OBJECTIVES

The aim of this study was to examine the relationship between PA and its correlates in young Arab American women. The objectives of this study were to: (1) describe self-reported lifestyle PA behaviors of young Arab American women and (2) examine the relationship between their self-reported lifestyle PA, device-measured lifestyle PA (combined moderate/vigorous and steps), and potentially associated factors (demographics, physical measures, individual factors, and behavior cognition factors).

METHODS

This cross-sectional study was conducted with women 18 to 35 years of age and Arab American (n = 50) in the Midwest Region of the United States. Participants wore ActiGraph GT3X-BT monitors for 7 days; self-report measures included the International Physical Activity Questionnaire, demographics, acculturation, discrimination, religiosity, self-efficacy, and social support.

RESULTS

The mean age of participants was 25.5 years (SD: 5.5; range: 18-35). Per ActiGraph, the average daily steps were 5946 (SD: 2783); only 24% met the moderate-intensity PA guidelines. Self-efficacy was significantly associated with increased moderate-to-vigorous PA (B = 0.37; P = .012).

CONCLUSION

The average daily steps for the young Arab American women in this study were of low active classification. More than 75% of the women failed to meet the recommended weekly moderate/vigorous PA guidelines. Our study supports the importance of targeting and tailoring PA interventions on young Arab American women who have low self-efficacy for overcoming barriers to lifestyle PA.

Effect of social support on Muslim women's sporting activities: mediating effect of psychological adjustment

Objective

This study explores the relationship between social support and sporting activities of Muslim women and constructs a mediation model through role of psychological adjustment.

Methods

Using stratified cluster sampling, 301 Muslim women were measured in group psychology using the Social Support Scale and the Sports Activities and Psychological Adjustment Scale. The statistical software SPSS 24.0 and SPSS PROCESS 3.3 were used for statistical processing. The common-method variation test was carried out using the Harman single-factor control test. Finally, the Bootstrap sampling test method and process plug-in were used to test the significance of the intermediary effect.

Results

(1) Social support has a significant predictive effect on sports activities (β = 0.32, p < 0.001); (2) psychological adjustment (β = 0.552, p < 0.001) mediates the relationship between social support and sporting activities [social support → psychological adjustment → sporting activities (95% Cl, 0.093, 0.323)].

Conclusion

Social support positively influences sporting participation among Muslim women, and psychological adjustment mediates this relationship. Strengthening social support for Muslim women can enhance their psychological adjustment, thereby improving their participation in sporting activities and offering valuable theoretical and practical guidance.

Exploring barriers to physical activity participation among female nursing students adhering to specific social-cultural norms in Indonesia: A qualitative study

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.

Lifestyle Medicine in Focus: A Cross-Sectional Study Comparing Domestic and International Students

This study investigated lifestyle factors among Hungarian and international students, utilizing lifestyle medicine principles to enhance overall well-being. Conducted at the University of Debrecen through a cross-sectional survey, we examined selected lifestyle factors, more specifically sleep patterns, weight management, nutrition, physical activity, mental well-being, and alcohol use. Hungarian (N = 122) and international (N = 139) students were compared, revealing significant differences. Hungarian students slept less (p = 0.041), desired weight loss (p = 0.040), ate more fruits and vegetables (p = 0.014), exercised longer (p = 0.002), and reported higher purpose and social support (p = 0.009), with higher alcohol use (p < 0.001). These findings highlight distinct experiences and challenges faced by these student groups including variations in sleep, weight management, diet, exercise, and social support. Targeted interventions and tailored support are essential to address their specific needs. To promote the well-being of both Hungarian and international students, educational programs addressing various facets of a healthy lifestyle are crucial. This study offers valuable insights into lifestyle factors and health outcomes among Hungarian and international students and underscores the importance of addressing the unique needs of each group through tailored interventions.

Barriers to seeking tobacco cessation services: a qualitative assessment of university students' needs in Qatar

The prevalence of tobacco use in the Middle East is alarmingly high, especially among university students; most users initiate tobacco use during adolescence and young adulthood. Evidence-based cessation services can be beneficial when quitting tobacco use; however, these services are underutilized. This study aimed to explore the barriers preventing university students in Qatar from seeking tobacco cessation services. Semi-structured interviews were conducted with 20 Qatar University students who are current or former tobacco users (n = 18/2); most current cigarette smokers were also waterpipe users. The interviews were transcribed verbatim, coded, and analyzed using thematic analysis. The major barriers to seeking tobacco cessation services included misconceptions regarding nicotine addiction, negative perceptions of the cessation services' effectiveness, self-efficacy regarding the ability to quit without seeking cessation services, concerns and preferences regarding practitioners' characteristics at clinics, masculine culture that discourages men from seeking cessation help, social stigma around women who use tobacco in Arab culture, and a lack of time to visit cessation clinics. Our findings address gaps in the literature regarding the individual and sociocultural barriers to seeking tobacco cessation among youth in Qatar. A better understanding of these barriers can facilitate successful promotion of tobacco cessation services and enhance cessation-seeking behaviors.

Key influences on university students' physical activity: a systematic review using the Theoretical Domains Framework and the COM-B model of human behaviour

BACKGROUND

Physical activity is important for all aspects of health, yet most university students are not active enough to reap these benefits. Understanding the factors that influence physical activity in the context of behaviour change theory is valuable to inform the development of effective evidence-based interventions to increase university students' physical activity. The current systematic review a) identified barriers and facilitators to university students' physical activity, b) mapped these factors to the Theoretical Domains Framework (TDF) and COM-B model, and c) ranked the relative importance of TDF domains.

METHODS

Data synthesis included qualitative, quantitative, and mixed-methods research published between 01.01.2010-15.03.2023. Four databases (MEDLINE, PsycINFO, SPORTDiscus, and Scopus) were searched to identify publications on the barriers/facilitators to university students' physical activity. Data regarding study design and key findings (i.e., participant quotes, qualitative theme descriptions, and survey results) were extracted. Framework analysis was used to code barriers/facilitators to the TDF and COM-B model. Within each TDF domain, thematic analysis was used to group similar barriers/facilitators into descriptive theme labels. TDF domains were ranked by relative importance based on frequency, elaboration, and evidence of mixed barriers/facilitators.

RESULTS

Thirty-nine studies involving 17,771 participants met the inclusion criteria. Fifty-six barriers and facilitators mapping to twelve TDF domains and the COM-B model were identified as relevant to students' physical activity. Three TDF domains, environmental context and resources (e.g., time constraints), social influences (e.g., exercising with others), and goals (e.g., prioritisation of physical activity) were judged to be of greatest relative importance (identified in > 50% of studies). TDF domains of lower relative importance were intentions, reinforcement, emotion, beliefs about consequences, knowledge, physical skills, beliefs about capabilities, cognitive and interpersonal skills, social/professional role and identity, and behavioural regulation. No barriers/facilitators relating to the TDF domains of memory, attention and decision process, or optimism were identified.

CONCLUSIONS

The current findings provide a foundation to enhance the development of theory and evidence informed interventions to support university students' engagement in physical activity. Interventions that include a focus on the TDF domains 'environmental context and resources,' 'social influences,' and 'goals,' hold particular promise for promoting active student lifestyles.

TRIAL REGISTRATION

Prospero ID-CRD42021242170.

Physical Inactivity Prevalence in the Islamic World: An Updated Analysis of 47 Countries

BACKGROUND

Physical inactivity prevalence estimates for youth and adults have been published on a global scale and for various geographical and geopolitical permutations. Only one such study has presented estimates for adults in Muslim countries, and it is nearly 10 years old. I conducted an update of this study by incorporating newer data, refining methods, and including youth estimates.

METHODS

I identified 47 Muslim countries with physical inactivity data for youth, adults, or both. Data were extracted by country primarily from global estimates reported by Guthold et al in 2018 and 2020 and from World Health Organization surveillance data repositories. Weighted prevalence calculations for total prevalence and by sex, ethnicity (Arab vs non-Arab), and country income group accounted for country population, study sample size, and a country's proportion of Muslims. Z tests and chi-square tests, and follow-up odds ratios and percentage deviations, respectively, were used to determine differences by sex, ethnicity, and country income group.

RESULTS

Overall physical inactivity prevalence was 84.2% (youth) and 29.6% (adults). Gaps favoring males over females were observed for youth (5.6% lower prevalence) and adults (9.6% lower prevalence). Gaps favoring non-Arabs over Arabs were observed for youth (3.9% lower) and adults (3.8% lower). No pattern emerged for country income group for youth; however, prevalence for adults trended upward across income groups from low (22.7%) to high (62.0%).

CONCLUSIONS

Gaps by sex and ethnicity have narrowed since the original report and prevalence values are somewhat higher than current global estimates.

Health and quality of life among women after participation in a CBPR-informed physical activity intervention: with a pandemic perspective

The lack of culturally and contextually oriented interventions promoting physical activity (PA) has led to increased physical inactivity among women living in disadvantaged neighbourhoods in Sweden. In this study one such intervention informed by community-based participatory research (CBPR) has been evaluated among 34 women from a disadvantaged neighbourhood before and during COVID-19. Health-related quality of life (HRQOL), behavioural and biomedical outcomes were assessed directly prior and post-intervention, followed by evaluations at 6-months and 18-months follow-up during COVID-19. The results revealed that HRQOL, particularly psychological, social, and environmental health significantly increased post-intervention compared to prior to intervention but reversed back at 6-months follow-up. Perceived health satisfaction and environmental health increased at 18-months follow-up during COVID-19. Participation in PA improved post-intervention and at 6-months follow-up. Everyday activities and fruit and vegetable intake continued to increase through all timepoints. Systolic blood pressure significantly decreased post-intervention and 6-months follow-up; blood flow rate increased significantly at all timepoints. Overall, the findings underscores the potential effectiveness of CBPR approaches in promoting and sustaining healthy lifestyles, even during acute situations such as the COVID-19. It may even serve as a future model for promoting health and addressing health disparities in similar groups.

A cross-sectional study on the perceived barriers to physical exercise among women in Iraqi Kurdistan Region

BACKGROUND

Limited research has investigated the barriers to physical exercise among women in Iraqi Kurdistan Region and other similar Muslim and Middle Eastern societies. This study aimed to determine the prevalence of perceived barriers to physical exercise among women and examine the associations of these barriers with the participants' sociodemographic characteristics.

METHODS

A cross-sectional study was carried out in Erbil, Iraqi Kurdistan Region, from December 2022 to January 2023. A self-administered online survey was designed using Google Forms. A convenience sample of 500 women and girls aged 18-65 years was selected for the study. A questionnaire was designed for data collection, including a list of 21 potential barriers to physical exercise developed based on literature review and experts' opinions. The barriers were divided into three categories: interpersonal (8 barriers), social environment (8 barriers), and built environment factors (5 barriers). The participants were asked to indicate for each potential barrier whether it was "not really a barrier, somewhat a barrier, or a very important barrier." The statistical package for social sciences was used to estimate the prevalence of different barriers and assess their association with sociodemographic characteristics using the Chi-square test.

RESULTS

The prevalence of physical inactivity among the study participants was 68.2%. The most prevalent interpersonal barriers to physical exercise included lack of time (47.4%), followed by fatigue (24%), and cost (22.4%). Regarding social environment factors, work (30.6%), harassment outside (22.2%), not having a friend or family member accompanying (19%), and not being allowed by family (15.4%) were the most prevalent barriers to physical exercise. Lack of footpaths, cycle lanes, or parks (34.4%), limited accessibility of gyms or other exercise facilities (25.8%), and environmental pollution (21%) were the most prevalent built environment factors as barriers to physical exercise.

CONCLUSION

Women in Iraqi Kurdistan Region experience many barriers to physical exercise. Women require family and social support and awareness about exercise benefits to overcome interpersonal and social environment barriers to physical exercise. Built environment factors are very important barriers and can be reduced by taking appropriate action and adopting necessary policies to provide the required infrastructure and facilities for physical exercise.

Understanding physical activity from a cultural-contextual lens

This paper aims to emphasize the need to acknowledge unique cultural and contextual meanings of physical activity to improve health outcomes in different communities. Leininger's Sunrise Model was used as the theoretical base to understand the complex cultural and contextual factors that influence physical activity. Beliefs and practices surrounding physical activity are influenced by a variety of cultural and contextual factors. Providing culturally relevant contexts to the meaning of physical activity allows opportunities for improving policies or programs that would engage individuals and communities in physical activity in culturally meaningful ways. Incorporating cultural and contextual factors is critical to promote physical activity, especially in minority and vulnerable communities.

The Impact of the Built Environment and Social Environment on Physical Activity: A Scoping Review

This scoping review aims to provide an overview of the current state of physical activity research, focusing on the interplay between built and social environments and their respective influences on physical activity. We comprehensively searched electronic databases to identify relevant studies published between 2000 and 2022. A total of 35 articles have been reviewed based on the research question. The review found that built and social environments influence physical activity, and consideration of people's perceptions of their surroundings can provide further insight. The literature was summarized, and recommendations were made for future research. Findings suggest that interventions targeting built and social environments can promote physical activity effectively. However, limitations in the literature exist, including a need for more standardization in research methods and consistency in measurement tools.

A theory-informed systematic review to understand physical activity among women in Gulf Cooperation Council countries

BACKGROUND

This systematic review was conducted to identify health beliefs and modifying factors influencing physical (in) activity among adult women in Gulf Cooperation Council (GCC) countries (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates).

METHODS

A comprehensive search of the Medline (Ovid), EMBASE, Cochrane Central, Web of Science, and Google Scholar databases was conducted to identify relevant articles published between 2009 and 2019. The quality of included studies was assessed using the Mixed Methods Appraisal Tool. Data collection and analysis based on the health belief model were performed to systematically examine the relationships of health beliefs and modifying factors to physical activity.

RESULTS

The sample comprised 15 studies (Saudi Arabia, n = 6; Oman, n = 5; Qatar, n = 2; Kuwait, n = 2). Reported physical activity prevalences were low (nearly 0% to 50%) and depended on the location, subpopulation, and measurement instrument. Evidence for relationships of modifying factors and health beliefs to physical activity was scarce and sometimes inconclusive. Among modifying factors, middle age and employment were associated positively with physical activity; marital status, educational level, income, and body mass index were not associated. Regarding health beliefs, the only conclusive evidence reported was that a lack of time was not associated significantly with physical activity in a population of men and women. Women reported a lack of social support and lack of skills significantly more frequently than men; these factors may explain the gender difference in physical activity prevalence. Differences in the reporting of fear of injury and lack of willpower were not significant.

CONCLUSIONS

Robust qualitative and quantitative research on the contributions of health beliefs and modifying factors to the low prevalence of physical activity among women in GCC countries is urgently needed. Current evidence indicates that unemployed women, women aged < 25 years, and elderly women are less likely to be physically active. Women in this population are more likely than men to believe that a lack social support and skills affects their physical activity. Many known factors and health beliefs appear to be unrelated to physical activity among adult women in GCC countries.

A Cross-Sectional Study Exploring the Physical Activity Levels of Afghans and Other South Asian Youth in the UK

Introduction: Participating in regular physical activity (PA) has numerous benefits, such as reducing obesity, chronic degenerative conditions, and depression. Despite many health-related benefits, physical inactivity is increasing in young people worldwide, especially in ethnic minority groups, such as British South Asians (BSAs). The aim of this study was to explore the PA levels of BSAs, specifically focusing on youth from Afghan, Pakistani, Bangladeshi, and Indian groups. Methods: A total of 191 (Afghans N = 44; Bangladeshi N = 39; Indian N = 56, Pakistani N = 52) youth from the West Midlands (UK) participated in this study (mean age 15.4 ± 0.5). The International Physical Activity Questionnaire—Short Form was used to measure PA levels. Data were modelled using a Bayesian approach to determine differences in PA levels. Results: The results indicated that 88.5% Afghans, 80% Bangladeshi, 78.6% Indians and 63% Pakistani reported engaging in <30 min of PA per day. Additionally, boys were more active than girls across all ethnic groups. Discussion: This study highlighted an alarmingly low proportion of young people from each BSA ethnic group meeting the PA guidelines. To the authors’ knowledge, this is the first study to explore and compare PA levels of the young British Afghan population, thus contributing novel findings to the area of BSA PA. Conclusion: Overall, the vast majority of BSA young people failed to meet the recommended PA guidelines of 60 min per day. Future research could utilise objective methods, such as Global Positioning System, pedometers and accelerometery to track and monitor PA levels, and could adopt an ecological approach to explore determinants of PA within each ethnic and gender group.

Group differences and associations among stress, emotional well-being, and physical activity in international and domestic university students

Objective: To examine the differences in experiences of stress, emotional well-being, and physical activity among international and domestic students. Participants: Domestic (n = 4,035) and international (n = 605) students at a large Canadian university. Methods: Responses to items on stress, emotional well-being (happiness and satisfaction with life), and moderate-to-vigorous physical activity (MVPA) and strength training were self-reported. Group differences were explored in a multivariate analysis of variance model, and student status was tested as a moderator of the associations between stress, emotional well-being (happiness and satisfaction with life), and MVPA. Results: International students reported significantly lower stress and emotional well-being compared to domestic students, and fewer days of MVPA. Student status moderated the association between stress and MVPA, with the association significant for domestic students. Conclusions: Given the findings, international students may have distinct attitudes and beliefs toward MVPA that could be targeted in tailored interventions.

Culture in Physical Activity: The Contribution of Basic Psychological Needs and Goal Orientation

Numerous variables affect motivation in physical activity (PA) with culture being an understudied variable. Self-determination theory's basic psychological needs (BPN) includes a combination of autonomy, competence, and relatedness in PA; however, cultural definitions pit autonomy and relatedness against each other. Thus, this study aims to investigate the moderating role of culture on relationships between BPN, goal orientations (ego, task) for PA, and PA behavior. A survey was implemented to 168 participants (109 females, 59 males; 92 Turks, 76 Americans) investigating students' self-construal type, their basic psychological needs in exercise (BPNES), PA levels (Godin Leisure-Time Exercise Questionnaire/GLTEQ), and goal orientation types (Task and Ego Orientation in Sport Questionnaire/TEOSQ). Turks (n = 92) and Americans (n = 76) demonstrated distinct cultural differences in terms of the study variables. American students were more autonomous, task-oriented, and physically active than Turkish students. Results from the multi-group path analysis showed that there was a moderating role of culture between predictors (i.e., BPN Autonomy, BPN Relatedness, BPN Competence, Ego Orientation, and Task Orientation) and Physical Activity. Such that, the paths from predictors (i.e., BPNT Autonomy, BPNT Relatedness, BPNT Competence, Ego Orientation, and Task Orientation) to PA was not significant in Turkish cultural context. Results suggest that culturally tailored approaches to PA interventions are critical in supporting motivation for physical activity and further research is needed to explore different culturally relevant motivational drivers for PA among adults.

Adherence and retention to the self-managed community-based Step Into Health program in Qatar (2012-2019)

Purpose

Investigate adherence and retention to the "Step Into Health (SIH)" initiative (www.stepintohealth.qa [website access only available from within the State of Qatar]), a Qatari self-managed community-based health program, from 2012 to 2019.

Methods

Participants (16,711; 16-80 years; 37% females, 34% Qatari) used a pedometer or smartphone application (app) to measure step count. Absolute adherence (ADH) and retention (RET) were calculated, with ADH (%) the ratio between number of days data and SIH enrollment length (RET). Linear Mixed Models identified differences in ADH between RET groups, main effects (i.e., sex, device, age, BMI, nationality) and interaction effects for ADH (RET entered as a covariate).

Results

Average ADH and RET to SIH (irrespective of sex, age, device and BMI) was 50% (±31%), and 16% (±20%), respectively, with ADH differing significantly between RET groups (F = 460.2, p < 0.001). RET (as a covariate) revealed a significant main effect for device (F = 12.00, p < 0.001) and age (F = 4.31, p = 0.001) on ADH observed. There was a significant association between RET and sex (p < 0.001), device (p < 0.001), and age groups 16-25 y (p < 0.001), and 26-35 y (p < 0.001). There were no significant main effects for sex or BMI on ADH, and no interaction effects (p ≥ 0.21) observed.

Conclusions

Follow-up data (e.g., interviews, focus groups, etc.) determining why differences in ADH and RET are observed appears prudent. To convert those that lapsed and/or abandoned SIH/PA into committed long-term PA adherers. This would be a first step to develop targeted public health promotions and initiatives to enhance health outcomes at a population level.

Obesity pillars roundtable: Obesity and individuals from the Mediterranean region and Middle East

Background

The rates of obesity in Mediterranean and Middle East regions are increasing. This may be related to worsening physical inactivity, and gravitation away from more healthful nutrition.

Methods

This roundtable discussion includes 4 obesity specialists with experience in the clinical management of obesity. Included in this discussion are citations regarding obesity and populations from the Mediterranean and Middle East regions.

Results

Among the most studied nutritional dietary pattern having evidence-based data supporting improved cardiometabolic health is the Mediterranean Diet. Prospective studies such as the PREvención con DIeta MEDiterránea (PREDIMED) study support the cardiometabolic benefits of dietary consumption of plant-based, higher fiber foods having a relatively high proportion of unsaturated fats. Cuisine from the Middle East has both similarities and some differences compared to the Mediterranean Diet. Interim analyses of the PREDIMED-Plus study suggest the Mediterranean Diet plus caloric restriction and physical activity intervention reduces body weight and improves cardiometabolic risk factors. As with any dietary intake, Mediterranean and Middle Eastern food choices and preparation affect their nutritional healthfulness.

Conclusion

The panelists of this roundtable discussion describe their practical diagnostic processes and treatment plans for patients with obesity from the Mediterranean Region and Middle East.

A Systematic Review of Physical Activity Intervention Programs in ASEAN Countries: Efficacy and Future Directions

A systematic review was conducted on the efficacy of interventions to improve physical activity. PubMed, Scopus and Web of Science were scanned for eligible studies published from 1978 to August 2021, resulting in a total of 52 relevant studies for review. The Downs and Black checklist was used as a quality assessment ool for a risk of bias assessment. The 52 studies were then broadly categorised into three major approach types: informational, behavioural and/or social, as well as direct. Within each major approach, studies were further sub-categorised into more specific intervention types before being assessed for their efficacy and applicability. Overall, the intervention types that seemed to be the most efficacious in increasing physical activity levels were those that involved home-based information provision, community-wide campaigns, incentivised change, individually adapted health behaviour programs, family-based social support interventions and the provision of self-monitoring tools. However, the results must be interpreted holistically, as many of the successful interventions included more than one approach type and success is likely contingent on effectively addressing several concurrent facets. The systematic review is registered on PROSPERO. Registration number: 282752.

Gender Differences in the Associations Between Physical Activity, Smartphone Use, and Weight Stigma

Background

Physical activity (PA) is important for health. However, there is little evidence on how weight stigma, time spent on sedentary activities (including smartphone, social media, online learning), time spent on outdoor activity, and nomophobia associate with PA among Chinese individuals with consideration of gender. The present study examined the aforementioned associations in the COVID-19 pandemic era.

Methods

University students (N = 3,135; 1,798 females, 1,337 males) with a mean age of 19.65 years (SD = 2.38) years completed an online survey from November to December, 2021. The online survey assessed weight stigma (using the Perceived Weight Stigma Scale and Weight Bias Internalization Scale), PA (using the International Physical Activity Questionnaire Short Form), time spent on different activities (using self-designed items for time on smartphone, outdoor activity, social media, and online learning), and nomophobia (using the Nomophobia Questionnaire). Parallel mediation models were constructed (dependent variable: PA; mediators: perceived weight stigma, weight-related self-stigma, time spent on smartphone, time spent on outdoor activity, time spent on social media, and time spent online learning; independent variable: nomophobia) and evaluated using Hayes' Process Macro Model 4 (IBM SPSS 20.0).

Results

Weight-related self-stigma (β = −0.06; p = 0.03), time spent on outdoor activity (β = 0.21; p < 0.001), time spent on social media (β = 0.07; p = 0.02), time spent on online learning (β = 0.06; p = 0.03), and nomophobia (β = −0.07; p = 0.01) were all significant factors explaining the PA among female participants. Perceived weight stigma (β = −0.07; p = 0.01), time spent on outdoor activity (β = 0.27; p < 0.001), and time spent on online learning (β = 0.10; p = 0.002) were all significant factors explaining PA among male participants.

Conclusion

Chinese healthcare providers should design programs on weight stigma reduction and outdoor activity improvement to enhance PA among university students.

Barriers to high school and university students' physical activity: A systematic review

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.

Enabling Better Physical Activity and Screen Time Behaviours for Adolescents from Middle Eastern Backgrounds: Semi-Structured Interviews with Parents

The unrelenting obesity pandemic in Middle Eastern (ME) adolescents living in Australia warrants culturally responsive and locally engineered interventions. Given the influence of parents on the lifestyle behaviours of adolescents, this qualitative study aimed to capture the opinions of ME parents on the barriers and enablers to sufficient physical activity and limiting screen time behaviours in adolescents. Semi-structured interviews were conducted with 26 ME parents (female) aged 35–59 years old, most of whom resided in lower socioeconomic areas (n = 19). A reflexive thematic analysis using the Theoretical Domains Framework and the Capability, Opportunity, Motivation-Behaviour model was performed for coding. Parents voiced confidence in their knowledge of the importance of physical activity and limiting screen time but were less optimistic in their ability to enable change in behaviours, especially for older adolescents without outside support. Despite adolescents having the necessary skills to engage in a wide array of sports, the parents admitted deep fears regarding the safety of the social environment and restricted their children’s independent mobility. Gender differences were noted, with parents reporting older girls expressing disinterest in sports and having limited physical opportunities to participate in sports at school. It may be that a community-based participatory framework is needed to improve physical activity opportunities and to address specific physical, social, and cultural barriers.