Barriers and facilitators to physical activity among ethnic Chinese children in school, home and community settings: a qualitative systematic review

Wang, Haiquan; Swain, Subhashisa; Luo, Jihao; Blake, Holly; Chattopadhyay, Kaushik

Abstract

Objective:
The review aimed to synthesize the barriers and facilitators from the available studies that dealt with physical activity among ethnic Chinese children and uncover any differences or similarities in these barriers and facilitators.

Introduction:
Physical activity promotes overall health, fitness, and well-being in children, yet prevalence of this has been low among ethnic Chinese children who reside in both Chinese and non-Chinese territories. Research has been conducted to explore the barriers and facilitators to physical activity among ethnic Chinese children. However, no qualitative systematic review has been conducted to synthesize these barriers and facilitators.

Inclusion criteria:
This review synthesized the barriers and facilitators to physical activity among ethnic Chinese children aged six to 17 years, or among people who had responsibility for them in school, home, and community settings or country (Chinese or non-Chinese territories). The review included studies that focused on their views, experiences, attitudes, understandings, perceptions, and perspectives. Studies were included if they focused on qualitative data including, but not limited to, designs such as phenomenology, ethnography, grounded theory and action research. In addition, the authors considered cross-sectional surveys to find any free-text relating to the review question.

Methods:
MEDLINE, Embase, CINAHL, PsycINFO, BNI, AMED, Web of Science, Scopus, CNKI, Wanfang and VIP databases were searched to identify published studies. The search for unpublished studies included EthOS, OpenGrey, ProQuest Dissertations and Theses, CNKI and Wanfang. Databases were searched from their inception dates till 10 December 2018 and no language restrictions were applied. The Joanna Briggs Institute (JBI) guidelines for qualitative systematic reviews were followed in conducting the review. The JBI process of meta-aggregation was used to identify categories and synthesize findings.

Results:
Out of 9460 records identified, 11 qualitative studies met the eligibility criteria and were included in the review. Regarding critical appraisal, using the JBI checklist for qualitative research (10 criteria), the scores ranged from a moderate score of six (n=2) to a high score of seven and above (n=9). Seven studies were from China, two from Australia, one each from the UK and US. The sample size ranged from 12 to 115 participants. A total of 56 findings were extracted and aggregated into 24 categories, based on the similarity of meaning. Fourteen categories described perceived barriers and 10 categories described perceived facilitators, while one category described both barriers and facilitators. From studies conducted in the Chinese territories, four synthesized findings (personal, socio-cultural, environmental, and policy- and program-related barriers and facilitators) were aggregated from 37 extracted findings and 16 aggregated categories. From studies conducted in the non-Chinese territories, only two synthesized findings (personal and socio-cultural barriers and facilitators) were derived from 19 extracted findings and eight aggregated categories.

Conclusions:
In terms of barriers and facilitators to physical activity, four broad themes emerged from the participants’ accounts, namely personal, socio-cultural, environmental, and policy- and program-related factors. Barriers and facilitators at the personal and socio-cultural level (e.g., parents and teachers) were most frequently cited, reflecting the importance of children's self-influence and the role of adults. Future interventions are needed to address the identified barriers and enhance the facilitators.

Citation

Wang, H., Swain, S., Luo, J., Blake, H., & Chattopadhyay, K. (2020). Barriers and facilitators to physical activity among ethnic Chinese children in school, home and community settings: a qualitative systematic review. JBI Evidence Synthesis, 18(12), 2445-2511. https://doi.org/10.11124/JBISRIR-D-19-00154

• Journal Article Type: Article
• Acceptance Date: Mar 3, 2020
• Online Publication Date: Aug 21, 2020
• Publication Date: Dec 1, 2020
• Deposit Date: Mar 17, 2020
• Publicly Available Date: Aug 22, 2021
• Journal: JBI Evidence Synthesis
• Electronic ISSN: 2689-8381
• Publisher: Wolters Kluwer
• Peer Reviewed: Peer Reviewed
• Volume: 18
• Issue: 12
• Pages: 2445-2511
• DOI: https://doi.org/10.11124/JBISRIR-D-19-00154
• Public URL: https://nottingham-repository.worktribe.com/output/4158448
• Publisher URL: https://journals.lww.com/jbisrir/Abstract/9000/Barriers_and_facilitators_to_physical_activity.99826.aspx