Review Article
Correlates of Physical Activity Among Disadvantaged Groups: A Systematic Review

https://doi.org/10.1016/j.amepre.2019.06.021Get rights and content

Context

Socioeconomically disadvantaged adults have lower engagement in leisure-time physical activity than those who are more affluent. Identification of correlates of physical activity can inform the design of effective interventions. The aim of this systematic review was to identify consistent correlates of unspecified physical activity and leisure-time physical activity among socioeconomically disadvantaged adults.

Evidence acquisition

PubMed and Scopus were searched up to May 2018, and titles/abstracts and full texts were screened against eligibility criteria. Methodologic quality was assessed, and correlates were synthesized from July to September 2018.

Evidence synthesis

Seventy-three studies were selected for synthesis; 48 examined unspecified physical activity and 31 examined leisure-time physical activity (6 examined both). Self-rated health, functional capacity, and physical activity self-efficacy were consistently, positively associated with unspecified physical activity. Mental health status and perceived benefits and enjoyment of physical activity were consistently, positively associated with leisure-time physical activity. Most studies were cross-sectional and used validated self-report measures of physical activity; few reported response rates >50%.

Conclusions

Few factors were consistently associated with either unspecified physical activity or leisure-time physical activity. Based on available evidence, strategies to increase physical activity should consider the needs of, and focus on, those with poor self-rated health and functional capacity and should use strategies to improve physical activity self-efficacy. Strategies to increase leisure-time physical activity should focus on simultaneously addressing leisure-time physical activity and mental health concerns and improving perceptions of physical activity benefits and enjoyment. It is recommended that future studies focus on leisure-time physical activity, focus on men, use longitudinal design, examine variables related to behavioral attributes and skills, and carefully consider and plan recruitment strategies.

Section snippets

CONTEXT

Regular physical activity (PA) has a range of health benefits.1 It is a protective factor for the prevention and treatment of leading chronic diseases, including heart disease, stroke, diabetes, and breast and colon cancer. PA is also associated with delay in the onset of dementia and improved mental health, quality of life, sleep, and well-being.2, 3, 4, 5, 6, 7 However, more than 40% of adults from developed countries do not meet recommended levels of PA.8 Consequently, physical inactivity

EVIDENCE ACQUISITION

PubMed and Scopus were searched up to May 2018 with no date limitation (Appendix Text 1, available online). Groups of thesaurus terms and free terms were searched for PA (physical* activ*, walk*, exercise, lifestyle, life style, health behavio*), correlates (correlate, determinant, mediator, moderator, predictor, relationships, associations, barriers, facilitators), and socioeconomic disadvantage (low SES, low* socio*, low* income, disadvantaged, deprived, underserved, low* educat*). Reference

EVIDENCE SYNTHESIS

In total, 1,558 titles and abstracts were screened; 1,435 were removed by title or abstract, and 123 full texts were reviewed, 73 of which were selected for synthesis (Figure 1).

Most eligible studies included analyses of PA (n=48), and 31 included analyses of LTPA. Six articles included analyses of both PA and LTPA. Study characteristics, quality assessment, and findings of these analyses are presented separately (noting that some articles appear in both).

Characteristics of PA studies are in

DISCUSSION

This review examined evidence relating to correlates of PA and LTPA among socioeconomically disadvantaged population groups. Overall, few factors were consistently associated with participation in either PA or LTPA. One explanation for the lack of consistent associations was that the included studies selected participants based on their low SES. Therefore, it was less likely that factors that are associated with engagement in PA when the general population is studied, such as level of education,

CONCLUSIONS

The aim of this review was to identify consistent correlates of participation in PA and LTPA among socioeconomic disadvantaged populations in developed countries. Overall, there were few consistent associations with either LTPA or PA. The available evidence suggests that future interventions and campaigns should focus on simultaneously addressing LTPA and mental health concerns, improve perceptions of benefits and enjoyment of PA, consider the needs of and focus on those with poor self-rated

ACKNOWLEDGMENTS

Author contributions: MC led the study; MC and EG conceptualized the study; GW, TAH, MC, MB, and AP screened for eligibility; GW, MB, MC, TAH, MP, and AP completed the data extraction. All authors were involved in the writing of the manuscript and read and approved the final manuscript.

PROSPERO Registration: CRD42018097413.

No financial disclosures were reported by the authors of this paper.

REFERENCES (133)

  • DER Warburton et al.

    Health benefits of physical activity: a systematic review of current systematic reviews

    Curr Opin Cardiol

    (2017)
  • SJ Olney et al.

    A randomized controlled trial of supervised versus unsupervised exercise programs for ambulatory stroke survivors

    Stroke

    (2006)
  • MV Hernández-Hernández et al.

    Role of physical activity in the management and assessment of rheumatoid arthritis patients

    Reumatol Clin

    (2017)
  • LL Andersen et al.

    Effect of physical exercise interventions on musculoskeletal pain in all body regions among office workers: a one-year randomized controlled trial

    Man Ther

    (2010)
  • Y Hayashino et al.

    Effects of supervised exercise on lipid profiles and blood pressure control in people with type 2 diabetes mellitus: a meta-analysis of randomized controlled trials

    Diabetes Res Clin Pract

    (2012)
  • LQ Rogers et al.

    Effects of the BEAT Cancer physical activity behavior change intervention on physical activity, aerobic fitness, and quality of life in breast cancer survivors: a multicenter randomized controlled trial

    Breast Cancer Res Treat

    (2015)
  • KL Piercy et al.

    The physical activity guidelines for Americans

    JAMA

    (2018)
  • HW Kohl et al.

    The pandemic of physical inactivity: global action for public health

    Lancet

    (2012)
  • Global health risks: mortality and burden of disease attributable to selected major risks

    (2009)
  • SN Blair

    Physical inactivity: the biggest public health problem of the 21st century

    Br J Sports Med

    (2009)
  • R Stalsberg et al.

    Are differences in physical activity across socioeconomic groups associated with choice of physical activity variables to report?

    Int J Environ Res Public Health

    (2018)
  • C Gidlow et al.

    A systematic review of the relationship between socio-economic position and physical activity

    Health Educ J

    (2006)
  • MA Beenackers et al.

    Socioeconomic inequalities in occupational, leisure-time, and transport related physical activity among European adults: a systematic review

    Int J Behav Nutr Phys Act

    (2012)
  • JD Glover et al.

    The socioeconomic gradient and chronic illness and associated risk factors in Australia

    Aust N Z Health Policy

    (2004)
  • Australia's health 2014

    (2014)
  • K Ball et al.

    Addressing the social determinants of inequities in physical activity and sedentary behaviours

    Health Promot Int

    (2015)
  • AG Knuth et al.

    Temporal trends in physical activity: a systematic review

    J Phys Act Health

    (2009)
  • M Craike et al.

    Interventions to improve physical activity among socioeconomically disadvantaged groups: an umbrella review

    Int J Behav Nutr Phys Act

    (2018)
  • JF Sallis et al.

    Behavioral epidemiology: a systematic framework to classify phases of research on health promotion and disease prevention

    Ann Behav Med

    (2000)
  • V Cleland et al.

    Individual, social and environmental correlates of physical activity among women living in socioeconomically disadvantaged neighbourhoods

    Soc Sci Med

    (2010)
  • AE Bauman et al.

    Correlates of physical activity: why are some people physically active and others not?

    Lancet

    (2012)
  • J Choi et al.

    Correlates associated with participation in physical activity among adults: a systematic review of reviews and update

    BMC Public Health

    (2017)
  • JF Sallis et al.

    An ecological approach to creating active living communities

    Annu Rev Public Health

    (2006)
  • M Teychenne et al.

    Physical activity and likelihood of depression in adults: a review

    Prev Med

    (2008)
  • Global recommendations on physical activity for health

    (Published 2010)
  • List of developing countries as declared by the Minister for Foreign Affairs

    (Published 2018)
  • Armstrong T, Bauman A, Davies J. Physical activity patterns of Australian adults. Results of the 1999 National Physical...
  • DL Olstad et al.

    Can targeted policies reduce obesity and improve obesity-related behaviours in socioeconomically disadvantaged populations? A systematic review

    Obes Rev

    (2017)
  • J Sallis et al.

    A review of correlates of physical activity of children and adolescents

    Med Sci Sports Exerc

    (2000)
  • D Vancampfort et al.

    A review of physical activity correlates in patients with bipolar disorder

    J Affect Disord

    (2013)
  • SG Trost et al.

    Correlates of adults’ participation in physical activity: review and update

    Med Sci Sports Exerc

    (2002)
  • A Middelweerd et al.

    Do intrapersonal factors mediate the association of social support with physical activity in young women living in socioeconomically disadvantaged neighbourhoods? A longitudinal mediation analysis

    PLoS One

    (2017)
  • I Santos et al.

    Motivation and barriers for leisure-time physical activity in socioeconomically disadvantaged women

    PLoS One

    (2016)
  • M Teychenne et al.

    Is the link between movement and mental health a two-way street? Prospective associations between physical activity, sedentary behaviour and depressive symptoms among women living in socioeconomically disadvantaged neighbourhoods

    Prev Med

    (2017)
  • M Teychenne et al.

    Physical activity, sedentary behavior and depression among disadvantaged women

    Health Educ Res

    (2010)
  • AM MacFarlane et al.

    Sociodemographic and behavioural correlates of weight status among women with children living in socioeconomically disadvantaged neighbourhoods

    Int J Obes

    (2009)
  • D Vancampfort et al.

    A systematic review of correlates of physical activity in patients with schizophrenia

    Acta Psychiatr Scand

    (2012)
  • DO Clark

    Physical activity and its correlates among urban primary care patients aged 55 years or older

    J Gerontol B

    (1999)
  • S Dogra et al.

    Aging expectations are associated with physical activity and health among older adults of low socioeconomic status

    J Aging Phys Act

    (2015)
  • V Van Holle et al.

    Relationship between neighborhood walkability and older adults’ physical activity: results from the Belgian Environmental Physical Activity Study in Seniors (BEPAS Seniors)

    Int J Behav Nutr Phys Act

    (2014)
  • AM Chudyk et al.

    Neighborhood walkability, physical activity, and walking for transportation: a cross-sectional study of older adults living on low income

    BMC Geriatr

    (2017)
  • B Geboers et al.

    The association of health literacy with physical activity and nutritional behavior in older adults, and its social cognitive mediators

    J Health Commun

    (2014)
  • D Dlugonski et al.

    Motives and barriers for physical activity among low-income black single mothers

    Sex Roles

    (2017)
  • NL Fahrenwald et al.

    Physical activity behavior of American Indian mothers

    Orthop Nurs

    (2006)
  • Jilcott SB, Evenson KR, Laraia BA, Ammerman AS. AmmermanAssociation between physical activity and proximity to physical...
  • J Wilbur et al.

    Correlates of physical activity in urban midwestern Latinas

    Am J Prev Med

    (2003)
  • RE Lee et al.

    Contribution of neighbourhood socioeconomic status and physical activity resources to physical activity among women

    J Epidemiol Commun Health

    (2007)
  • ED Mansfield et al.

    Individual, social and environmental factors influencing physical activity levels and behaviours of multiethnic socio-economically disadvantaged urban mothers in Canada: a mixed methods approach

    Int J Behav Nutr Phys Act

    (2012)
  • T Osuji et al.

    Barriers to physical activity among women in the rural midwest

    Women Health

    (2006)
  • K Ball et al.

    Is healthy behavior contagious: associations of social norms with physical activity and healthy eating

    Int J Behav Nutr Phys Act

    (2010)
  • Cited by (0)

    View full text