Table_2_Barriers and Facilitators of Physical Activity Participation in Adolescent Girls: A Systematic Review of Systematic Reviews.DOCX

Background: Persistent low physical activity (PA) levels among adolescent girls constitute a public health concern that calls for immediate and evidence-based policy action. This systematic review (SR) aimed to summarize evidence from SRs examining the barriers and facilitators of PA participation in adolescent girls. The objectives were to provide a synthesis of the available evidence and identify key areas for fostering gender-responsive action and policy implications.
Methods: A comprehensive search of relevant SR and meta-analyses were performed in PubMed and Cochrane Library, until February 2021. Studies were included if they were SRs or meta-analyses, included adolescent girls aged between 10 and 19 years, and described barriers or facilitators of PA. Two independent authors performed the screening of potentially eligible studies and both assessed the methodological quality of included studies using the AMSTAR 2 tool. The barriers and facilitators were synthesized at environmental, interpersonal, and individual levels.
Results: A total of eight SRs were included in the qualitative synthesis. The most frequent barriers identified were the lack of support from peers, family, and teachers, and the lack of time. The most reported facilitators were weight loss, and support from peers, family, and teachers. Key areas for action and policy implementation include an inclusive approach to curriculum development to address gender norms; adequate training of professionals so they have a range of skills to ensure inclusion of adolescent girls; environmental changes in and out of schools to stimulate participation, to allow adolescent girls to be active in a safe and attractive environment; multistakeholder support at local, regional, and national level in incorporating a gender-responsive approach toward PA participation.
Conclusion: The results highlight a variety of factors that influences the PA participation of adolescent girls. For the attainment of effective policies that increase PA levels in adolescent girls, it is essential to engage several stakeholders at different levels in incorporating a gender-responsive approach toward PA participation.
Systematic Review Registration: PROSPERO, identifier: CRD42020204023.

背景：青少年女性群体身体活动（Physical Activity, PA）水平持续偏低，已成为亟待采取基于证据的即时政策干预的公共卫生议题。本项系统综述（Systematic Review, SR）旨在汇总针对青少年女性身体活动参与障碍与促进因素的现有系统综述证据。本研究目标为整合现有相关证据，并明确可推动针对性别敏感的干预行动及政策制定的核心方向。
方法：本研究于2021年2月前，在PubMed与Cochrane Library数据库中全面检索相关系统综述及荟萃分析文献。纳入标准为：文献类型为系统综述或荟萃分析，研究对象为10~19岁青少年女性，且聚焦青少年女性身体活动参与的障碍或促进因素。由2名独立研究者分别对潜在符合纳入标准的文献进行筛选，并采用AMSTAR 2量表评估纳入文献的方法学质量。研究从环境层面、人际层面与个体层面整合分析了身体活动参与的障碍与促进因素。
结果：最终共有8篇系统综述被纳入定性整合分析。最常见的参与障碍包括同伴、家庭与教师支持缺失，以及可支配时间不足。被提及最多的促进因素包括减重获益，以及同伴、家庭与教师的支持。核心干预与政策实施方向包括：采用包容性课程开发模式以应对性别规范问题；对专业人员开展充分培训，使其掌握可保障青少年女性参与的相关技能；优化校内及校外环境以激发参与意愿，为青少年女性提供安全且适宜的活动场景；在地方、区域与国家层面推动多利益相关方协作，将性别敏感的身体活动参与策略纳入政策框架。
结论：本研究结果明确了多种影响青少年女性身体活动参与的相关因素。若要制定可有效提升青少年女性身体活动水平的政策，需推动不同层级的多利益相关方协作，将性别敏感的身体活动参与策略融入政策制定与实施全过程。
系统综述注册信息：PROSPERO数据库，注册号：CRD42020204023。