Developing a Complex Understanding of Physical Activity in Cardiometabolic Disease from Low-to-Middle-Income Countries—A Qualitative Systematic Review with Meta-Synthesis

Heine, M; Badenhorst, M; van Zyl, C; de Melo Ghisi, GL; Babu, AS; Buckley, J; Serón, P; Turk-Adawi, K; Derman, W

Abstract

Physical activity behaviour is complex, particularly in low-resource settings, while existing behavioural models of physical activity behaviour are often linear and deterministic. The objective of this review was to (i) synthesise the wide scope of factors that affect physical activity and thereby (ii) underpin the complexity of physical activity in low-resource settings through a qualitative meta-synthesis of studies conducted among patients with cardiometabolic disease living in low-to-middle income countries (LMIC). A total of 41 studies were included from 1200 unique citations (up to 15 March 2021). Using a hybrid form of content analysis, unique factors (n = 208) that inform physical activity were identified, and, through qualitative meta-synthesis, these codes were aggregated into categories (n = 61) and synthesised findings (n = 26). An additional five findings were added through deliberation within the review team. Collectively, the 31 synthesised findings highlight the complexity of physical activity behaviour, and the connectedness between person, social context, healthcare system, and built and natural environment. Existing behavioural and ecological models are inadequate in fully understanding physical activity participation in patients with cardiometabolic disease living in LMIC. Future research, building on complexity science and systems thinking, is needed to identify key mechanisms of action applicable to the local context.

Citation

Heine, M., Badenhorst, M., van Zyl, C., de Melo Ghisi, G., Babu, A., Buckley, J., Serón, P., Turk-Adawi, K., & Derman, W. (2021). Developing a Complex Understanding of Physical Activity in Cardiometabolic Disease from Low-to-Middle-Income Countries—A Qualitative Systematic Review with Meta-Synthesis. International Journal of Environmental Research and Public Health, 11977 - 11977. https://doi.org/10.3390/ijerph182211977

• Acceptance Date: Nov 21, 2021
• Publication Date: Nov 15, 2021
• Journal: International Journal of Environmental Research and Public Health
• Electronic ISSN: 1660-4601
• Publisher: MDPI
• Pages: 11977 - 11977
• DOI: https://doi.org/10.3390/ijerph182211977
• Keywords: physical activity; diabetes; cardiovascular disease; metabolic syndrome; qualitative review; systems thinking
• Public URL: https://keele-repository.worktribe.com/output/421548
• Publisher URL: https://www.mdpi.com/1660-4601/18/22/11977