Understanding impediments and enablers to physical activity among African American adults: A systematic review of qualitative studies

University of Texas, Health Science Center at Houston, School of Public Health, Dallas Regional Campus, Dallas, TX, USA.
Health Education Research (Impact Factor: 1.66). 08/2011; 26(6):1010-24. DOI: 10.1093/her/cyr068
Source: PubMed


Physical inactivity is a leading cause of premature death, disability and numerous chronic diseases. Minority and underserved populations in the United States and worldwide have a higher prevalence of physical inactivity affecting their morbidity and mortality rates. In the United States, African Americans are less physically active and have a higher proportion of many chronic diseases in comparison to Caucasians. This disparity needs to be well understood in order to design and implement effective interventions aimed at increasing physical activity levels among African Americans. In the present study, we conduct a systematic review (through 2010) of the qualitative literature pertaining to impediments and enablers to physical activity participation among African Americans. This review focuses on qualitative research due to its advantages in understanding attitudes and perceptions related to health behavior within the context of participants' natural environment. Findings are stratified by gender and age, to explore unique impediments and enablers based on age and sex and results are discussed within the socio-ecological model to account for the multi-level nature of factors affecting physical activity. Findings should be taken into account by researchers, program planners and policymakers when tailoring physical activity interventions to African American communities in the United States.

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    • "2) Hair maintenance. One systematic review found that hair maintenance was perceived as a barrier to PA in African American women[24].Facilitator: Physically active female role models. One systematic review in adult women in general found[42]that they would feel more confident about adding PA to their lifestyles if they had female role models. "
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    ABSTRACT: Background: With an ageing population, there is an increasing societal impact of ill health in later life. People who adopt healthy behaviours are more likely to age successfully. To engage people in health promotion initiatives in mid-life, a good understanding is needed of why people do not undertake healthy behaviours or engage in unhealthy ones. Methods: Searches were conducted to identify systematic reviews and qualitative or longitudinal cohort studies that reported mid-life barriers and facilitators to health behaviour. Mid-life ranged from 40 to 64 years, but younger adults in disadvantaged or minority groups were also eligible to reflect potential earlier disease onset. Two reviewers independently conducted reference screening and study inclusion. Included studies were assessed for quality. Barriers and facilitators were identified and synthesised into broader themes to allow comparisons across behavioural risks. Findings: From 16,426 titles reviewed, 28 qualitative studies, 11 longitudinal cohort studies and 46 systematic reviews were included. Evidence was found relating to uptake and maintenance of physical activity, diet and eating behaviours, smoking, alcohol, eye care, and other health promoting behaviours and grouped into six themes: health and quality of life, sociocultural factors, the physical environment, access, psychological factors, evidence relating to health inequalities. Most of the available evidence was from developed countries. Barriers that recur across different health behaviours include lack of time (due to family, household and occupational responsibilities), access issues (to transport, facilities and resources), financial costs, entrenched attitudes and behaviours, restrictions in the physical environment, low socioeconomic status, lack of knowledge. Facilitators include a focus on enjoyment, health benefits including healthy ageing, social support, clear messages, and integration of behaviours into lifestyle. Specific issues relating to population and culture were identified relating to health inequalities. Conclusions: The barriers and facilitators identified can inform the design of tailored interventions for people in mid-life.
    Full-text · Article · Jan 2016 · PLoS ONE
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    • "Additionally, multiple enablers to physical activity were cited, such as a desire to be healthy, social support from family or friends, and environmental elements such as nearby recreational and exercise facilities. As in our study, Siddiqi et al in a systematic review found that lack of time and self-efficacy and unsafe neighborhoods were commonly cited barriers to activity among African American adults (22). "
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