Perception of barriers and facilitators for users to participate in physical activity programs

Abstract: In Brazil, physical activity is a priority area in health promotion in the Brazilian Unified National Health System (SUS). The study aims to describe users’ profiles and the barriers and facilitators in basic healthcare for participation in programs to promote physical activity. This was a statewide cross-sectional study in municipalities (counties) in Pernambuco State. Between 2 and 21 individuals were interviewed per municipality, using a previous tested instrument, validated in the following dimensions: sociodemographic; health status; participation; information on the program; reasons for participation; facilitators; barriers; and preference of activities. Descriptive and inferential analyses (chi-square) were performed. The sample consisted of 1,153 users, 35.9% of whom between 41-59 years of age; 90.1% lived in urban areas; 58.2% had participated in physical activities for at least a year. Weekly frequency of 3-4 days was 44.9%, and 71.1% practiced activities of an hour or more. The results showed that 40% of the barriers to participation in physical activity programs and 77.5% of the facilitators belonged to the intrapersonal domain. The most prevalent barrier was “current health condition” and the facilitator was the desire “to be healthier”. Women perceived more barriers than men. The conclusion is that barriers and facilitators from the intrapersonal domain, related to health, are the main factors involved in users’ engagement and retention in programs and interventions to promote physical activity, developed in basic healthcare services in the state of Pernambuco.

摘要：在巴西，身体活动是巴西统一国家卫生系统（SUS）健康促进领域的优先事项。本研究旨在描述伯南布哥州基层医疗中，参与身体活动促进项目的使用者概况，以及影响其参与的阻碍因素与促进因素。本研究为在伯南布哥州各市县开展的全州范围横断面研究，每个市县访谈2至21名受访者，采用经前期验证的调研工具，该工具的效度覆盖以下维度：社会人口学特征、健康状况、项目参与情况、项目相关信息、参与原因、促进因素、阻碍因素及活动偏好。研究采用描述性分析与推断性分析（卡方检验）处理数据。

本研究共纳入1153名使用者，其中35.9%的受访者年龄介于41至59岁；90.1%居住于城市地区；58.2%的受访者参与身体活动时长至少达1年。每周参与3至4次活动的受访者占比44.9%，71.1%的受访者每次活动时长≥1小时。

结果显示，40%的身体活动项目参与阻碍因素与77.5%的促进因素属于个体内部领域。最常见的阻碍因素为"当前健康状况"，最主要的促进因素为"获得更健康状态的意愿"。女性感知到的阻碍因素多于男性。

研究结论表明，与健康相关的个体内部领域阻碍与促进因素，是伯南布哥州基层医疗服务中开展的身体活动促进项目与干预措施中，影响使用者参与及留存的核心因素。