Barriers and facilitators for physical activity domains in Brazil: a systematic review

Christofoletti, Marina; Streit, Inês Amanda; Garcia, Leandro Martin Totaro; Mendonça, Gerfeson; Benedetti, Tânia Rosane Bertoldo; Papini, Camila Bosquiero; Borges, Lucélia Justino; Binotto, Maria Angélica; Silva-Júnior, Fernando Lopes e

doi:10.1590/1413-81232022279.04902022EN

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REVIEW • Ciênc. saúde coletiva 27 (09) • Sept 2022 • https://doi.org/10.1590/1413-81232022279.04902022EN copy

Barriers and facilitators for physical activity domains in Brazil: a systematic review

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Abstract

This study aimed to systematically review scientific evidence on the barriers and facilitators of physical activity (PA) among the Brazilian population, considering different domains (leisure, travel, work/study, and household). The search was conducted in the MEDLINE/PubMed, ISI Web of Science, SCOPUS, BIREME/LILACS, and APA PsycNET databases and was limited to papers published between 2010 and 2020. A manual search of the Brazilian Journal of Physical Activity & Health was also conducted. The selection process consisted of screening titles and abstracts, followed by the analysis of full texts. Each paper was assessed by two independent reviewers, and when discrepancies arose, a third reviewer was consulted. Leisure, environmental barriers and facilitators were the most investigated domains in the 78 included studies. There was consistency in the positive associations between six different intrapersonal and social facilitators for leisure PA and one environmental factor for travel. There have been a small number of investigations on the work/study and household domains, and future investigations on intrapersonal and social barriers and facilitators in the travel domain are important.

Key words:
Motor activity; Populations; Systematic review

Database/ journal	PECO Strategy Descriptors/terms^a	Boolean operators	Filters
BIREME/Lilacs Medline/PubMed SciELO Scopus APA PsycNET Web of Science BJPAH journal	POPULATION (P): (Brazil* [Title/Abstract]) AND (Humans [MeSH Terms])	AND and OR	Language (English, Portuguese or Spanish), Period (2010 to 2020)
	EXPOSure (E): (“motor activity” [MeSH Terms]) OR (exercise [MeSH Terms]) OR (“Physical Education” [Title/Abstract]) OR (“physical activity” [Title/Abstract]) OR (“recreational activity” [Title/ Abstract]) OR (sport* [Title/Abstract]) OR (sedentary [Title/Abstract]) OR (“physical inactivity” [Title/ Abstract]) OR (“active transport” [Title/Abstract]) OR (“active transportation” [Title/Abstract]) OR (“active commut” [Title/Abstract]) OR (“active travel” [Title/Abstract]) OR (bicycle [Title/Abstract]) OR (bicycling [MeSH Terms]) OR (bike [Title/Abstract]) OR (biking [Title/Abstract]) OR (walk [Title/Abstract] OR (walking [MeSH Terms]) OR (“leisure activities” [MeSH Terms]) OR (dancing [MeSH Terms]) OR (gardening [MeSH Terms]) OR (“activities of daily living” [MeSH Terms])
	COMPARISON (C): Not applicable
	OUTCOMES (O): (covariates [Title/Abstract]) OR (correlates [Title/Abstract]) OR (determinants [Title/ Abstract]) OR (mediators [Title/Abstract]) OR (moderators [Title/Abstract]) OR (predictors [Title/ Abstract]) OR (environment [MeSH Terms]) OR (contributors [Title/Abstract]) OR (facilitators [Title/ Abstract]) OR (barriers [Title/Abstract])

Barriers and facilitators	Leisure		Travel		Work/study
Barriers and facilitators	n = 179	%	n = 192	%	n = 18	%
Intrapersonal
Availability of personal equipment	7	3.91	6	3.13
Better skills	3	1.68	1	0.52
Pleasure and fun with physical activity	2	1.12	4	2.08
Higher motivation and having goals	5	2.79	6	3.13	1	5.56
Lack of time and presence of concurrent behaviors	5	2.79	7	3.65	8	44.44
Lower costs	1	0.56	2	1.04
More positive beliefs about capabilities	6	3.35	6	3.13	2	11.11
More positive beliefs about consequences	22	12.29	9	4.69	1	5.56
More/better knowledges	1	0.56	3	1.56
Negative emotions	9	5.03
Positive past experiences	2	1.12
Worse health condition	8	4.47	1	0.52
Social
Better/More positive general social support	2	1.12	1	0.52
Better/more positive social norms	7	3.91	2	1.04
Better/more positive support from family	8	4.47	6	3.13
Better/more positive support from friends	3	1.68	2	1.04
Better/more positive support from friends	12	6.70	14	7.29
Worse perceived safety	10	5.59	14	7.29
Environmental
Better land use mix			2	1.04
Better quality and condition of places	5	2.79	8	4.17
Better road safety	13	7.26	27	14.06
Better street connectivity			4	2.08
Better public transport provision	8	4.47	11	5.73
Existence of active travel infrastructure	10	5.59	18	9.38
Existence of facilities within places	5	2.79	8	41.7
Existence of. shorter distance to. and better access to places	22	12.29	14	7.29	6	33.33
Availability health promotion programs	2	1.12	1	0.52
Participation in supervised activities	1	0.56

Barriers and facilitators	Work/study							Leisure							Travel							Household
	Synthesis				Evidence			Synthesis				Evidence			Synthesis				Evidence			Synthesis				Evidence
	-	0	+	Total	n/N	%	R	-	0	+	Total	n/N	%	R	-	0	+	Total	n/N	%	R	-	o	+	Total	n/N	%	R
Intrapersonal	2	39	5	46	39/46	84.8	00	46	129	79	254	129/254	50.8	0?	4	54	16	74	54/74	73.0	00	0	0	0	0			I
Availability of personal equipment	0	0	0	0			I	0	2	10	12	10/12	83.3	++	0	0	4	4			I	0	0	0	0			I
Better skills	0	0	0	0			I	1	5	1	7	5/7	71.4	00	0	0	0	0			I	0	0	0	0			I
Pleasure and fun with physical activity	0	0	0	0			I	0	2	2	4			I	0	0	1	1			I	0	0	0	0			I
Higher motivation and having goals	0	0	0	0			I	1	1	5	7	5/7	71.4	++	0	0	0	0			I	0	0	0	0			I
Lack of time and presence of concurrent behaviors	0	3	0	3			I	12	32	19	63	32/63	50.8	0?	1	9	3	13	9/13	69.2	00	0	0	0	0			I
Lower costs	0	0	0	0			I	2	4	1	7	4/7	57.1	0?	0	0	0	0			I	0	0	0	0			I
More positive beliefs about capabilities	0	2	0	2			I	0	4	14	18	14/18	77.8	++	0	0	0	0			I	0	0	0	0			I
More positive beliefs about consequences	0	6	0	6	6/6	100.0	00	1	14	7	22	14/22	63.6	00	0	6	0	6	6/6	100.0	00	0	0	0	0			I
More/better knowledges	0	0	0	0			I	0	4	2	6	4/6	66.7	00	0	0	0	0			I	0	0	0	0			I
Negative emotions	2	24	5	31	24/31	77.4	00	8	33	7	48	33/48	68.8	00	3	29	5	37	29/37	78.4	00	0	0	0	0			I
Positive past experiences	0	2	0	2			I	0	3	4	7	4/7	57.1	+?	0	2	1	3			I	0	0	0	0			I
Worse health condition	0	2	0	2			I	21	25	7	53	25/53	47.2	0?	0	8	2	10	8/10	80.0	00	0	0	0	0			I
Social	3	16	15	34	16/34	47.1	0?	18	88	58	164	88/164	53.7	0?	9	38	5	52	38/52	73.1	00	2	15	3	20	15/20	75.0	00
Better/More positive general social support	0	0	0	0			I	0	9	5	14	9/14	64.3	00	0	3	0	3			I	0	0	0	0			I
Better/more positive social norms	0	5	7	12	7/12	58.3	+?	0	11	6	17	11/17	64.7	00	0	5	2	7	5/7	71.4	00	0	9	3	12	9/12	75.0	00
Better/more positive support from family	0	0	0	0			I	0	7	16	23	16/23	69.6	++	0	0	0	0			I	0	0	0	0			I
Better/more positive support from friends	0	6	4	10	6/10	60.0	00	2	5	11	18	11/18	61.1	++	0	0	1	1			I	0	0	0	0			I
Better/more positive support from friends	0	0	4	4			I	0	4	10	14	10/14	71.4	++	0	1	1	2			I	0	0	0	0			I
Higher physical activity of friends and family	0	0	0	0			I	0	1	8	9	8/9	88.9	++	0	0	0	0			I	0	0	0	0			I
Worse perceived safety	3	5	0	8	5/8	62.5	00	16	51	2	69	51/69	73.9	00	9	29	1	39	29/39	74.4	00	2	6	0	8	6/8	75.0	00

Environmental	0	9	5	14	9/14	64.3	00	23	282	173	478	282/478	59.0	0?	4	97	72	173	97/173	56.1	0?	0	0	0	0			I
Better general urban design and built environment	0	0	0	0			I	2	18	11	31	18/31	58.1	0?	0	13	12	25	13/25	52.0	0?	0	0	0	0			I
Better land use mix	0	0	0	0			I	2	45	9	56	45/56	80.4	00	0	4	10	14	10/14	71.4	++	0	0	0	0			I
Better quality and condition of places	0	3	0	3			I	3	39	37	79	39/79	49.4	0?	0	16	9	25	16/25	64.0	00	0	0	0	0			I
Better road safety	0	0	0	0			I	3	18	4	25	18/25	72.0	00	1	7	5	13	7/13	53.8	0?	0	0	0	0			I
Better street connectivity	0	0	0	0			I	0	5	0	5	5/5	100.0	00	0	6	5	11	6/5	54.5	0?	0	0	0	0			I
Better public transport provision	0	0	0	0			I	2	7	1	10	7/10	70.0	00	1	14	4	19	14/19	73.7	00	0	0	0	0			I
Better walkability	0	0	0	0			I	0	2	4	6	4/6	66.7	++	0	2	3	5	3/5	60.0	++	0	0	0	0			I
Existence of active travel infrastructure	0	0	0	0			I	1	19	15	35	19/35	54.3	0?	0	16	7	23	16/23	69.6	00	0	0	0	0			I
Existence of facilities within places	0	0	1	1			I	1	0	0	1			I	0	0	0	0			I	0	0	0	0			I
Existence of. shorter distance to. and better access to places	0	3	3	6	3/6	50.0	??	6	115	91	212	115/212	54.2	0?	2	18	17	37	18/37	48.6	0?	0	0	0	0			I
Availability health promotion programs	0	0	0	0			I	3	8	0	11	8/11	72.7	00	0	0	0	0			I	0	0	0	0			I
Better quality of physical activity programs	0	2	0	2			I	0	0	0	0			I	0	0	0	0			I	0	0	0	0			I
Participation in supervised activities	0	1	0	1			I	0	6	1	7	6/7	85.7	00	0	1	0	1			I	0	0	0	0			I
Better quality of instructors	0	0	1	1			I	0	0	0	0			I	0	0	0	0			I	0	0	0	0			I

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E-mail: cienciasaudecoletiva@fiocruz.br

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[1] Collaborations

All authors conceptualized the review, discussed the search strategy and extraction tools, worked on extracting the results, and contributed to the final manuscript. M Christofoletti, LMT Garcia, G Mendonça, MA Binotto, FL Silva-Júnior developed the search strategy, extraction tools, and the choice of methodological quality assessment of the studies. TRB Benedetti oversaw the project and LMT Garcia provided critical guidance throughout the process. G Mendonça and FL Silva-Júnior evaluated the methodological quality of the studies. M Christofoletti organized the synthesis of the results.