Inclusion criteria
Types of participants
The quantitative and qualitative components of this review will consider studies that include community dwelling adults in developed countries aged 19 to 64 years without any medical conditions. As this review is concerned with barriers and motivators to physical activity within usual daily life, this review will not include adults within hospital environments including out-patients or any community programs led by a healthcare professional. Adults from developed countries as defined by the 2013 Human Development Index will be included in this review.14 Adults that are identified to be living in developing countries will not be included. Adults aged 19 to 64 will be included in this review as this age range has specific physical activity guidelines published.1,15 There are other specific guidelines available for those aged 18 and under and aged 65 years and over.
The textual component of this review will consider the same participants as the quantitative and qualitative components.
Types of intervention(s)/phenomena of interest
The quantitative component of the review will consider studies that identify barriers and motivators to physical activity for community dwelling adults. Studies on the effectiveness of individual or combined interventions will not be included as this review is concerned only with the identification of the barriers and motivators and not the effectiveness or efficacy of interventions themselves. Studies relating to the development and psychometric properties of questionnaires used to measure barriers and motivators to physical activity are not the focus of this systematic review. Studies which focus on psychological theory and models that explain barriers and motivators are not the focus of this systematic review. Such studies will therefore be excluded.
The qualitative component of this review will consider studies that investigate perceptions and experiences of barriers and motivators to physical activity in community dwelling adults.
The textual component of this review will consider publications that describe barriers and/or inhibitors and motivators and/or facilitators to physical activity in community dwelling adults.
Types of outcomes
This review will consider studies that include the following outcome measures:
Identified, detailed, or characterized barriers and motivators to physical activity participation in community dwelling adults. It is anticipated that survey instruments, questionnaires, interviews and focus groups will be the methods employed to identify such barriers and facilitators in the majority of the studies in this review.
Types of studies
The quantitative component of the review will consider analytical and descriptive epidemiological study designs, including prospective and retrospective cohort studies, case control studies, case series, individual case reports and descriptive cross sectional studies, for inclusion.
The qualitative component of the review will consider studies that focus on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research and feminist research.
In the absence of research studies, other text such as opinion papers and reports will be considered.
The textual component of the review will consider expert opinion, discussion papers, position papers and other text.
Search strategy
The search strategy aims to find both published and unpublished studies. A three step search strategy will be utilized in this review. An initial limited search of Medline and CINAHL will be undertaken followed by analysis of the text words contained in the title and abstract, and of the index terms used to describe articles. A second search using all identified keywords and index terms will then be undertaken across all databases. Thirdly, the reference list of all identified reports and articles will be searched for additional studies. Only studies published in English will be considered for inclusion in this review since translation services are not available to the review team. Due to the number of articles found during initial scoping, and to ensure findings have relevancy, the search will be limited to the past 10 years, from 2004 to 2014.
The databases to be searched include:
Medline (accessed via EBSCO HOST), CINAHL, AMED, EmBase, Science Direct, SPORTdiscus, PsycINFO, PsycARTICLES, Joanna Briggs Institute Library, and Web of Science.
The search for unpublished studies will include:
Google, Google Scholar, Conference proceedings, Centre for Reviews and Dissemination, Cochrane Reviews, and EThOS.
Initial keywords to be used will be: physical activity; motivators; facilitators; barriers; inhibitors
Assessment of methodological quality
Quantitative papers selected for retrieval will be assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardized critical appraisal instruments from the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) (Appendix I). Any disagreements that arise between the reviewers will be resolved through discussion, or with a third reviewer.
Qualitative papers selected for retrieval will be assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardized critical appraisal instruments from the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI) (Appendix I). Any disagreements that arise between the reviewers will be resolved through discussion, or with a third reviewer.
Textual papers selected for retrieval will be assessed by two independent reviewers for authenticity prior to inclusion in the review using standardized critical appraisal instruments from the Joanna Briggs Institute Narrative, Opinion and Text Assessment and Review Instrument (JBI-NOTARI) (Appendix I). Any disagreements that arise between the reviewers will be resolved through discussion, or with a third reviewer.
Data collection
Quantitative data will be independently extracted by two reviewers from papers included in the review using the standardized data extraction tool from JBI-MAStARI (Appendix II). The data extracted will include specific details about the interventions, populations, study methods and outcomes of significance to the review question and specific objectives.
Qualitative data will be independently extracted by two reviewers from papers included in the review using the standardized data extraction tool from JBI-QARI (Appendix II). The data extracted will include specific details about the interventions, populations, study methods and outcomes of significance to the review question and specific objectives.
Textual data will be extracted from papers included in the review using the standardized data extraction tool from JBI-NOTARI (Appendix II). The data extracted will include specific details about the interventions, populations, study methods and outcomes of significance to the review question and specific objectives.
In the event of missing data or to clarify unclear data, the authors will be contacted by the reviewers where relevant.
Data synthesis
Quantitative papers will, where possible be pooled in statistical meta-analysis using JBI-MAStARI. All results will be subject to double data entry. Effect sizes expressed as odds ratio (for categorical data) and weighted mean differences (for continuous data) and their 95% confidence intervals will be calculated for analysis. Heterogeneity will be assessed statistically using the standard Chi-square and also explored using subgroup analyses based on the different quantitative study designs included in this review. Where statistical pooling is not possible, the findings will be presented in narrative form including tables and figures to aid in data presentation where appropriate.
Qualitative research findings will, where possible be pooled using JBI-QARI. This will involve the aggregation or synthesis of findings to generate a set of statements that represent that aggregation, through assembling the findings (Level 1 findings) rated according to their quality, and categorizing these findings on the basis of similarity in meaning (Level 2 findings). These categories are then subjected to a meta-synthesis in order to produce a single comprehensive set of synthesized findings (Level 3 findings) that can be used as a basis for evidence-based practice. Where textual pooling is not possible the findings will be presented in narrative form.
Textual papers will, where possible be pooled using JBI-NOTARI. This will involve the aggregation or synthesis of conclusions to generate a set of statements that represent that aggregation, through assembling and categorizing these conclusions on the basis of similarity in meaning. These categories are then subjected to a meta-synthesis in order to produce a single comprehensive set of synthesized findings that can be used as a basis for evidence-based practice. Where textual pooling is not possible the conclusions will be presented in narrative form.
Conflicts of interest
The authors have no conflicts of interest to declare.
Acknowledgements
The authors would wish to thank Aberdeen City Health Improvement Fund and Aberdeen City Council for funding of this study.