The sudden and rapid outbreak of Severe Acute Respiratory Syndrome coronavirus-2 (SARS-CoV-2) led to the coronavirus disease 2019 (COVID-19) pandemic, which greatly affected the global healthcare system and economy .

As in many countries around the world, the UK government has also introduced various strategies, such as social distancing, closure of hospitality venues and gyms, and travel restrictions. In some areas, complete closures have been put in place and people residing in these areas have been asked to “stay at home”.

Study: Exploring barriers and facilitators to physical activity during the COVID-19 pandemic: a qualitative study. Image Credit: Drazen Zigic/Shutterstock.com

Background

Implementation of various non-pharmaceutical interventions (NPIs) restricted to physical activity (PA) outside homes. Previous studies based on quantitative analyzes have investigated the effect of pandemic restrictions on PA.

Although some studies have reported a reduction in PA during periods of confinement, others have reported differential results. For example, one study reported that, compared to older adults, a significant decrease in PA was observed in younger adults.

Several studies have also indicated that certain demographic groups, such as people with long-term health conditions (LTC), experienced prolonged restrictions compared to others. These groups, as well as those with mental health conditions (MHC), showed a decline in PA during the pandemic. Typically, parents of younger children have additional caregiving responsibilities, which has also resulted in reduced PA for these individuals during lockdowns.

The scientists indicated the paucity of papers related to qualitative studies on barriers and facilitators to PA during the pandemic. Some of the barriers to PA include cancellation of group activities, closure of exercise facilities, and lack of proper equipment for exercise.

The researchers described some of the facilitators of PA during the pandemic, including an individual’s urge to stay fit, to feel a positive mental state after PA, to exercise with another person, and have access to appropriate exercise equipment and technology.

Several studies conducted in France and the United States have reported that older people stopped taking exercise classes due to fear of contracting SARS-CoV-2 infection. Another barrier highlighted by a previous study was the lack of information about online PA resources. Other barriers to PA indicated by various studies were lack of routine, lack of motivation, and lack of club activities.

Previous studies have found that the key factors associated with achieving the target behavior are ability (knowledge and skills), opportunity (social and environmental factors), and motivation (cognitive processes guiding the behavior). Scientists have indicated the usefulness of the Ability, Opportunity, Motivation (COM-B) behavioral model for constructing barrier and facilitative factor maps. This type of map could be beneficial in predicting the need to develop interventions for future pandemics and health emergencies.

About the study

A new study published on the medRxiv* The preprint server discusses the results of a qualitative survey of barriers and facilitators to PA during the COVID-19 pandemic in different demographic groups.

The current study was a qualitative part of the 2020 UCL-COVID-19 (CSS) Social Study. Although the main objective of the CSS study was to determine the impact of COVID-19 restrictions on mental health and well-being, scientists have also extended their research to determine the impact of COVID-19 restrictions on PA.

In this study, the researchers conducted individual telephone/video interviews with younger people between the ages of 18 and 24, as well as people over the age of 70. The researchers acquired information about the mental health, long-term health conditions, and PA levels of the study participants. The authors also identified barriers and facilitators using reflective thematic analysis, while mapping themes using the COM-B model.

Study results

Most of the themes reflected the COM-B domains of physical opportunity and motivation. No themes were associated with PA capabilities. The results of this study are consistent with previous survey reports, which have observed that physical opportunity and reflective motivation are reliable predictors of behavior.

The importance of the outdoor environment was identified as a key theme, as lack of access to the garden was found to inhibit PA. Previous studies have reported that people in rural settings have environments more conducive to PA engagement, unlike those living in urban areas, where population density enhances the possibility of transmission of SARS-CoV- 2.

The researchers in the current study believe that these results will help in the development of future guidance in the event of a pandemic. For example, instead of restricting, individuals should be encouraged to use open spaces and gardens for PA activities. In addition, the adoption of initiatives to promote PA, such as video tips for exercising at home and outdoors following the advice in the event of a pandemic, will be very beneficial.

Notably, those residing in LTC were much more affected by the “protected” restrictions. Thus, in future pandemics, vulnerable groups should be advised to maintain their PA safely by exercising at home or using home exercise equipment.

conclusion

One of the strengths of this study is the large sample size, which allowed the researchers to analyze a wide range of viewpoints. Taken together, the observations reported in this study can be used to consider strategies for improving physical activity during future lockdowns and pandemics. To avoid further negative health effects after periods of confinement, future interventions should encourage physical activity and increase opportunities for reflection. Strategies that could be used include tailoring physical activity advice based on location and education about the benefits of physical activity.

*Important Notice

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be considered conclusive, guide clinical practice/health-related behaviors, or treated as established information.