A Mixed Methods Study Exploring Barriers and Enablers to Physical Activity Participation Among Women in Coastal Communities.

doi:10.21203/rs.3.rs-5368675/v1

Background: Physical inactivity is a critical global health issue that contributes to increased morbidity and mortality rates worldwide. Regular physical activity (PA) benefits both physical and mental health, with particular importance for women, who face increased risks for chronic conditions associated with inactivity. This study examines barriers to and enablers of PA participation among women in coastal communities in East England, a population particularly affected by socioeconomic, environmental, and logistical challenges to maintaining active lifestyles.

Methods: This study employed a mixed-methods convergent parallel design, integrating qualitative and quantitative data collected from 112 adult women recruited through local PA and weight loss programmes. Data collection utilised the International Physical Activity Questionnaire (IPAQ) and the Exercise Benefits and Barriers Scale (EBBS), alongside scenario-based and open-ended qualitative questions. The quantitative data were analysed via descriptive statistics and logistic regression in SPSS, whereas the thematic analysis of the qualitative data was conducted in NVivo.

Results: Quantitative findings indicate that healthcare professionals (40%) are the primary source of PA information, with health benefits (36%) being the main motivator. Key barriers include family responsibilities (45%), low self-confidence (31%), and limited access to facilities (27%). Logistic regression revealed that women with family caregiving roles and existing health conditions were less likely to engage in PA. Qualitative data further highlight psychological and environmental barriers, alongside motivators such as medical advice, social support, and personal goals, which significantly impact PA participation.

Conclusions: Women in coastal communities face unique socioenvironmental and psychological barriers to PA engagement. Effective interventions may need to incorporate multilevel, community-based approaches that address these specific challenges. This study highlights the potential for tailored interventions that leverage health advice, support networks, and culturally relevant programming to foster sustainable PA engagement among women in similar settings.

Sports Medicine and Kinesiology

Physical activity

barriers

enablers

coastal communities

women’s health

mixed-methods study

Physical inactivity remains a critical global health concern, significantly contributing to morbidity and mortality rates worldwide (37, 38). Regular physical activity (PA) is vital for both physical and mental well-being, with particular importance for women who face heightened risks for chronic conditions associated with inactivity (19, 35). Engaging in PA reduces the likelihood of obesity, cardiovascular disease, and type 2 diabetes while benefiting mental health by alleviating anxiety and depression (27, 37). For adults aged 18–65, engaging in 30 minutes of aerobic activity five days weekly to maintain overall health is recommended (30).

In the United Kingdom, coastal communities exhibit notably low PA levels, which are influenced by geographic, socioeconomic, and environmental challenges. Reports from the Northeast Coast Active Partnership (NECAP) reveal barriers such as limited recreational facilities, poverty, and environmental constraints that restrict PA access (25). These communities often experience resource limitations, weaker infrastructure, and higher poverty rates than inland areas do, which disproportionately affects women, who also contend with cultural and social barriers to PA (3, 25).

The Together an Active Future (TAAF) programme has underscored the importance of tailored, community-focused PA interventions, especially for deprived regions. By integrating cultural and logistical considerations, TAAF has demonstrated the effectiveness of partnerships with local stakeholders to address multilevel PA barriers. Community-led walking programmes, improved infrastructure, and accessible indoor spaces are among the recommended strategies to foster an active lifestyle in these areas (33). Despite such initiatives, PA participation among women remains low, particularly in rural and coastal regions, due to the unique challenges these settings pose (10).

Research indicates that face-to-face interventions can effectively promote PA (21, 24). Nonetheless, social, physical, and cultural contexts profoundly shape PA behaviours, suggesting that multilevel, context-aware approaches may outperform single-strategy interventions (1, 7, 28). For example, ecological frameworks can help address various barriers by creating supportive, accessible environments and actively involving local communities, authorities, and stakeholders to sustain these initiatives (7, 28). Specifically, women in East England's coastal regions encounter unique PA challenges, including geographic isolation, unsafe facilities, and inadequate public transportation options (20, 29). These challenges are compounded by urban planning decisions that deprioritise rural areas, contributing to cycles of inactivity and related health issues (31, 26). Although research on PA barriers has been conducted, specific challenges faced by women in coastal communities remain underexplored, with most studies focused on urban or demographic-specific groups, thus overlooking the unique sociocultural and environmental factors in coastal areas (2, 34).

Predominantly quantitative research on PA barriers, while informative on participation rates, often overlooks the nuanced social and cultural influences impacting PA. Employing a mixed-methods approach that combines quantitative PA behavior data with qualitative insights into individual experiences could yield a more comprehensive understanding of these influences, particularly for women in coastal communities, whose PA participation reflects a complex interplay of socioeconomic, environmental, and cultural factors (15).

1.1 Research objective

This study seeks to investigate the specific barriers and enablers affecting PA participation among women in coastal communities of East England. Through a mixed-methods approach, this study aims to (1) assess PA information-seeking behaviours through quantitative methods and (2) explore in depth their perceptions of the barriers and enablers affecting PA engagement through qualitative research.

2.1 Research design

The study utilised a mixed methods convergent parallel design, following a pragmatist approach that integrated qualitative and quantitative methods (12). This design allowed for an in depth, simultaneous collection of data from online surveys and structured interviews, capturing a balanced view of divergent and convergent insights from both data types (13). This mixed-methods approach strengthened the exploration of participants' experiences and enabled researchers to quantify key trends and relationships, creating a comprehensive analysis framework for validation through larger-scale quantitative measures (17). This dual-phase approach maximised data reliability, as qualitative narratives offered a deeper understanding of participants’ perspectives, whereas quantitative data substantiated these themes on a larger scale. The integration of both methods ensured that the findings were both robust and contextually relevant, allowing the study to achieve greater validity and rigour in interpreting the unique challenges surrounding PAs in coastal settings (14,16).

2.2 Setting and recruitment

The study was conducted in a coastal county in East England, which is chosen for its diverse demographic composition, variations in recreational facility access, and distinct cultural characteristics that may influence health behaviours (36). A purposive sampling method was used to recruit 112 adult participants (over 18 years) enrolled in local PA and weight loss programmes. The participants were required to have proficiency in written and spoken English and to provide written informed consent. The study applied a maximum variation strategy to ensure diversity across age, gender, and rural or urban residence.

Recruitment utilised a multifaceted approach through local health centers, community organisations, and social media, complemented by informational sessions and recruitment flyers. This strategy enhanced the sample’s representativeness and helped establish trust within the community, encouraging participation, particularly among women who might otherwise be reluctant to engage in research (8, 36).

2.3 Data collection

The design for data collection in this study utilises both structured quantitative items and embedded qualitative prompts. This approach provides measurable data while also capturing participants’ experiences, attitudes, and motivations, which is particularly useful for understanding complex behaviours such as physical activity (13). The quantitative items included the self-administered adapted International Physical Activity Questionnaire (IPAQ), validated to measure PA levels across diverse populations (8) (see supplementary file), and the Exercise Benefits and Barriers Scale (EBBS), which assesses perceived PA barriers on a 4-point scale. Quantitative data from these scales allow for categorising and analysing responses in a standardised way, yielding reliable metrics for frequency, duration, and types of activities (22).

To capture deeper insights, scenario-based questions and open-ended reflective prompts are embedded after key quantitative items, inviting participants to elaborate on specific barriers, motivators, or experiences. For example, after reporting PA levels, participants might reflect on recent experiences that either motivated or discouraged them, allowing the researcher to contextualise quantitative scores with qualitative insights (13). This integration of qualitative prompts enables the collection of contextual data that are often missed in closed-ended surveys, as it allows respondents to interpret and express their experiences, adding depth and validity to the findings (32) (see supplementary file).

The inclusion of free-text responses allows participants to articulate their unique experiences, capturing nuances and social-cultural factors that may influence PA participation, which is particularly relevant for coastal communities where environmental and social contexts can vary significantly (15). Additionally, scenario-based questions help participants envision an ideal setting, which can yield useful insights for designing supportive environments and interventions (7).

2.4 Ethical considerations

Ethical approval for this study was granted by the University of Suffolk Research Ethics Committee, which adheres to the Declaration of Helsinki and the GDPR to protect participant rights, privacy, and welfare. The participants were initially approached electronically through various platforms, including emails and social media, to maximise accessibility. Accompanying the electronic questionnaire, detailed participant information sheets and consent forms were emailed to each participant. These documents outlined the study’s purpose, potential risks, and benefits, allowing participants to make informed decisions. The participants reviewed, signed, and returned consent forms electronically before beginning the questionnaire or interview. In line with the GDPR, all the data were anonymised, securely stored, and accessed only by authorised researchers. Aggregated results were reported to ensure privacy. Sensitive questionnaire sections, such as barriers to PA, included available support resources to address any potential discomfort. These measures ensured ethical integrity, transparency, and participant protection throughout the study.

2.5 Rigour

To ensure rigour in this study, several established strategies were employed to enhance credibility, validity, and transparency. Triangulation was achieved by integrating quantitative and qualitative findings, thus validating insights through multiple sources and enhancing the study’s overall validity (14). In addition, an audit trail documented every step of the research process, including methodological choices, coding decisions, and data analysis, providing transparency and allowing external reviewers to trace and evaluate findings independently (23). Consistent data collection tools across both the quantitative and qualitative phases further strengthened reliability, supporting the robustness of the mixed-methods approach (13). This combination of strategies ensured that the study maintained a high standard of rigour, yielding trustworthy and replicable findings.

3.1 Quantitative data analysis

The quantitative data were analysed via SPSS and R, which were chosen for their strengths in terms of user-friendliness and flexibility with complex datasets (16). Descriptive statistics were employed to summarise PA levels, barriers, and socioeconomic status (see Figs. 1a, 1b). Inferential tests, including logistic regression, explored associations between variables, such as the relationships between PA barriers and demographic characteristics (see Fig. 2). Visualisations in R use the bubble chart, presenting trends, making complex results more accessible for interpretation and linking them directly to research objectives (8). A subsequent regression analysis investigated the relationship between predictors of PA levels and barriers to PA and PA information-seeking behaviour, controlling for confounders identified in the initial model (see Table 2). The significance level was established at p < 0.05, ensuring that the results were statistically robust and reliable.

3.2 Qualitative data analysis

Qualitative data were analysed via NVivo, which offers powerful tools for thematic analysis, making it suitable for handling open-ended responses and scenario-based reflections (6). The responses were coded into themes reflecting barriers, motivators, and social-cultural influences on PA. NVivo’s text search and visual mapping capabilities facilitated thematic coherence, allowing for detailed exploration of context-specific factors, a method essential in uncovering nuanced challenges and motivations in coastal settings (15). Following transcription, coding commenced to identify data segments pertinent to the research objectives, applying codes that encapsulated each segment's essence. For example, participant expressions of feeling unsupported in PA efforts were coded as ‘lack of support.’ Related codes, such as ‘limited access to facilities’ and ‘transportation issues,’ were then grouped to form broader themes such as ‘barriers to participation’ (5, 19). Each theme underwent a process of definition and refinement to ensure accurate representation, continuing until thematic saturation was reached, indicating that no new themes emerged from later interviews (7, 23). Significant issues consistently noted in the latter interviews included ‘cultural barriers’ and ‘scheduling conflicts.’ Finally, themes were interpreted in light of literature and the study's aims, providing a richer understanding of the barriers and motivations specific to the study population (28, 30).

3.3 Integrating quantitative and qualitative findings

NVivo’s matrix coding query feature enabled the integration of qualitative insights with quantitative findings and the alignment of thematic data (e.g., PA barriers) with quantitative metrics (e.g., EBBS scores). This mixed-methods integration allowed for a richer interpretation of PA behaviours and barriers, contextualising statistical trends with participant narratives, enhancing the study’s overall validity and providing robust, nuanced insights (17). This comprehensive approach, supported by tailored software, strengthens the study’s capacity to address complex research questions holistically, merging measurable outcomes with personal experiences in a structured manner (11, 36).

4.1 Quantitative

4.1.1 Sociodemographic characteristics

Demographic data, including age, ethnicity, BMI, marital status, employment, education, and residential area, were collected to profile the participants. Factors such as transportation and PA facility access provided insight into the influence of logistics on PA engagement, whereas income management and cultural affiliation highlighted support and barriers. The participant characteristics (Table 1) include a diverse sample: 100% female, nearly half under 40 (47%), 60% urban residents, and a mix of Black African (45%), South Asian (30%), and other ethnicities (25%). Over half were married, with 48% employed full-time and 68% affiliated with cultural or religious groups.

Table 1: Participant demographic characteristics (N = 112)

Characteristic	No. of Participants (%)
Sex
Female	112 (100%)
Geographical location
Urban	67 (60%)
Rural/Coastal	45 (40%)
Age
18-39	53 (47.3%)
40-59	44 (40.3%)
60-69	15 (13.4%)
Ethnicity
Black African	50 (45%)
South Asian	34 (30%)
Other Ethnicities	28 (25%)
Marital/Relationship Status
Married	58 (52%)
Single	39 (35%)
Divorced/Widowed	15 (13%)
Employment Status
Full-time	54 (48%)
Part-time	36 (32%)
Unemployed/Retired	22 (20%)
Education Level
High School	28 (25%)
Bachelor’s Degree	62 (55%)
Postgraduate Degree	22 (20%)
Access to Physical Activity Facilities
Adequate	78 (70%)
Limited	34 (30%)
Transportation Access
Private Vehicle	73 (65%)
Public Transportation	39 (35%)
Cultural/Religious Affiliation
Affiliated	76 (68%)
Nonaffiliated	36 (32%)
Chronic Health Condition
Yes	70 (62%)
No	42 (38%)
Weekly Physical Activity (≥150 mins)
Yes	65 (58%)
No	47 (42%)

4.1.2 Sources and motivations for PA information

As shown in Figure 1a, healthcare professionals (40%) were the most cited PA information source, followed by social media (25%) and friends/family (16%). Primary motivations for seeking PA information included health benefits (36%), appearance improvement (27%), and sports performance (22%) (see Figure 1b).

4.1.3 Barriers to PA participation

The participants reported multiple PA barriers, including family responsibilities (45%), work commitments (34%), and limited access to facilities (27%). Psychological barriers such as low self-confidence (31%) and fear of injury (22%) were notable, whereas financial costs, including gym memberships (24%) and activewear (17%), also impacted engagement (see Table 3).

4.1.4 Associations with PA behaviour

Logistic regression analysis identified key predictors of PA behaviour (see Table 2). Family responsibilities (B = -0.567, p = 0.045) and existing health conditions (B = -0.692, p = 0.012) negatively influenced PA-seeking behaviour. The participants in the PA programmes were more than twice as likely to seek PA information (odds ratio = 2.21, p = 0.001). Ethnicity was also significant: Black African participants were more likely to seek PA information than other groups were (B = 0.472, p = 0.030; Figure 3).

Table 2: Logistic regression analysis of PA-seeking behaviour, barriers to PA, and PA level

Variable	B	p value	Odds ratio		95% CI
Model 1a
Time Constraints
Family/caregiver responsibilities	-0.567	0.045	0.56		0.32–0.99
Work commitments	-0.432	0.115	0.65		0.39–1.09
Environmental barriers
Lack of access to facilities	-0.389	0.153	0.68		0.38–1.21
Poor weather/outdoor conditions	-0.254	0.260	0.78		0.45–1.34
Social & cultural barriers
Lack of supportive social network	-0.490	0.081	0.62		0.36-1.07
Cultural/religious restrictions	-0.232	0.310	0.79		0.45-1.38
Psychological Barriers
Low self-confidence	-0.704	0.022	0.49		0.27-0.89
Fear of injury	-0.125	0.612	0.88		0.45-1.72
Physical Health Constraints
Existing health conditions	-0.692	0.012	0.50		0.29-0.84
Physical pain or discomfort	-0.374	0.089	0.69		0.45-1.06
Financial Barriers
Cost of gym membership/classes	-0.523	0.034	0.59		0.36-0.97
Cost of equipment/activewear	-0.314	0.210	0.73		0.43-1.22
Constant	1.342	0.002	3.84
Model b
Barriers to PA
Low		-0.214	0.220	0.81	0.57-1.16
High (Reference)
PA level
Low		-0.839	0.008	0.43	0.23-0.82
Moderate		-0.172	0.415	0.84	0.54-1.31
High (Reference)
Participating in PA programme
Yes		0.793	0.001	2.21	1.45-3.38
No (Reference)
Constant		0.728	0.035	2.08

4.5 Qualitative

The qualitative findings from this study highlight key factors influencing participation in physical activity programmes (see Figure 4). The participants identified various motivators, including health recommendations from medical professionals, personal weight loss goals, and social influences from friends and family. However, challenges such as time constraints, environmental factors, and psychological barriers have also emerged. The importance of support systems was evident, with family, peers, and professionals playing crucial roles in fostering engagement. The participants recognised the benefits of PA, including improvements in physical health, mental well-being, and a sense of community. They also provided recommendations for enhancing participation, such as flexible scheduling, increased access to facilities, integrated mental health support, cultural sensitivity, and the need for enjoyable exercise activities.

4.5.1 Motivators for participation
The study reveals a range of motivators that encouraged women to engage in PA programmes, revealing a complex interplay of personal, social, and health-related influences. Health-related advice emerged as a significant motivator for many participants, with medical professionals playing a pivotal role in promoting PA. A participant articulates this influence, stating, “…my doctor recommended I start exercising regularly because of my high blood pressure, and I took that seriously”. This statement emphasises the trust that women place in healthcare professionals and illustrates how medical guidance can catalyse behaviour change. The participants seemed to perceive exercise as a prescribed remedy, prompting proactive engagement in physical activities to manage their health conditions.

The aspiration for weight loss was frequently cited as a primary motivator. One of the participants shared, “I wanted to lose weight for my wedding, and this programme appeared to be the perfect opportunity”. These personal milestones serve as powerful incentives, driving individuals to commit to physical activity programmes.

Social influences were also critical motivators, with friends and family significantly impacting participants' decisions to join programmes as one of the participants shares: “my friend had great results from this programme, so I decided to give it a try”. This may indicate the powerful effects of social proof and informal endorsements that peers provide. The desire to share experiences with loved ones or join a community of likeminded individuals often led participants to engage in physical activities they might otherwise have avoided. This social aspect not only enhanced motivation but also fostered a sense of belonging and support among participants, further encouraging their commitment to PA.

4.5.2 Challenges and barriers

The participants faced numerous challenges and barriers that hindered their ability to maintain consistent physical activity, revealing insights into the complex realities of their lives. Time constraints were a pervasive barrier, with many participants struggling to balance their busy lives with exercise. “…Balancing work, family, and exercise is truly tough…”, one participant explained. This sentiment reflects the reality for many individuals juggling multiple responsibilities, suggesting that programs need to accommodate these busy lifestyles through flexible scheduling and time-efficient activities.

Adverse environmental conditions also pose challenges. The participants expressed frustration with limited access to facilities and unfavourable weather. “It’s hard to stay motivated when it’s raining all the time, and there aren’t many indoor options,” noted another participant. This highlights the need for programmes to consider environmental factors and perhaps offer alternatives or resources that enable consistent activity regardless of conditions.

Psychological barriers such as low self-esteem and fear of judgment were frequently mentioned. One participant remarked, “…I always feel like people are judging me when I exercise in public”. This sentiment underscores the importance of fostering supportive environments where individuals feel safe and accepted. This indicates a need for community-building initiatives within programs to alleviate these fears and encourage participation.

4.5.3 Support systems

The presence and quality of support systems emerged as critical to participants' success in engaging with physical activity. Family encouragement played a vital role for many participants. “…my husband is very supportive; he even joins me for some of the workouts”, shared a participant. This highlights how familial involvement can enhance motivation and accountability, making it easier for individuals to maintain their exercise routines. The emotional and practical support provided by family members can significantly impact an individual’s commitment to a fitness program

The participants noted that camaraderie with peers in the programme enhanced their experience. “…working out with friends makes it more fun and less of a chore,” said one participant. The social aspect of exercising in groups can create a sense of belonging and mutual encouragement, fostering a positive environment that promotes adherence to PA.

The participants expressed appreciation for the expertise of the program facilitators. “The trainers are very knowledgeable and always encourage us to push our limits,” a participant noted. This finding indicates that professional guidance not only provides essential knowledge but also instils confidence and motivation, helping participants achieve their fitness goals effectively.

4.5.4 Perceived Benefits

The participants reported various benefits stemming from their engagement in physical activity programs, reflecting improvements in multiple aspects of their lives. Many participants reported significant improvements in their physical health. “…I’ve lost weight, my blood pressure is down, and I feel more energetic”, one participant expressed. These tangible health benefits reinforce the value of engaging in regular physical activity, providing further motivation for continued participation.

Improved mental health outcomes were frequently noted. “…exercising regularly has truly helped with my anxiety and stress levels,” said another participant. This illustrates how physical activity serves as a coping mechanism for many people, highlighting the holistic benefits of exercise beyond physical health. The link between exercise and enhanced mood is well documented, and participants experienced these benefits first.

The feeling of belonging was a significant benefit reported by participants. “…I’ve made so many new friends through this programme; it feels like a second family…” one participant mentioned. This sense of community can enhance motivation and commitment, creating a supportive network that encourages individuals to persist in their physical activity efforts.

4.5.5 Recommendations for improvement

The participants offered various suggestions for enhancing the program to make it more effective and inclusive, highlighting areas for potential growth. Many participants recommended more flexible class times to accommodate diverse schedules. “It would be great if there were more evening classes for those of us who work late,” one participant suggested. This may emphasise the importance of accessibility and adaptability in program scheduling to meet the needs of a varied participant base.

Improving access to facilities was another prevalent theme. “…more indoor facilities would help, especially during bad weather,” another participant noted. Addressing environmental barriers through enhanced facility access can help mitigate challenges related to inconsistent weather and provide reliable spaces for exercise.

The need for integrated mental health support was emphasised by the participants. “Incorporating mental health workshops would be beneficial…” one participant suggested. This indicates a desire for holistic programming that recognises the interconnectedness of physical and mental well-being, suggesting that mental health resources could enhance overall programme effectiveness.

The participants highlighted the importance of culturally relevant programming. “It would be nice if the programmes included activities that are culturally relevant to our community…” mentioned one participant. Another added, “…understanding our cultural background can help tailor the interventions better.” This may suggest that incorporating culturally sensitive elements could increase engagement and effectiveness in reaching diverse populations.

Ensuring that exercise is enjoyable was seen as crucial for maintaining participation. “I stick with the programme because the activities are fun and engaging,” said one participant. “When exercise feels like play, it’s easier to stay committed,” added another. This reflects the need for programmes to prioritise enjoyment and engagement, creating positive experiences that encourage ongoing involvement in physical activity.

This study aimed to explore the barriers to and enablers of PA among women, uncovering significant influences on PA engagement through both quantitative and qualitative methods. The findings provide critical insights into PA behaviours, motivations, and the complex sociocultural and environmental barriers these women face.

The quantitative data indicate that women primarily seek PA information from healthcare professionals, followed by social media and community resources. This aligns with previous research suggesting that healthcare professionals play a pivotal role in promoting PA, especially among populations managing chronic health conditions (19, 26). The emphasis on healthcare advice as a motivator supports the notion that medical recommendations can foster PA engagement, as observed by Warburton & Bredin (35), who highlighted the effectiveness of healthcare guidance in improving health-related behaviours among inactive populations. However, it is notable that social networks, a commonly cited influence in the PA literature (21), were less influential in this coastal setting, possibly because of geographic and social isolation commonly faced by coastal residents (3). This finding suggests a gap in accessible, community-driven support networks that could reinforce PA engagement, a consideration echoed by Martin et al. (24), who advocate for localised PA support networks to address contextual barriers.

The barriers identified through this study span multiple domains, including time constraints, environmental conditions, psychological factors, and financial limitations. Family and caregiver responsibilities were the most frequently cited time-related barriers, followed by work commitments, corroborating previous findings that women often bear significant caregiving burdens, limiting available time for PA (1). Environmental barriers such as poor weather conditions and a lack of access to suitable facilities also emerged as significant obstacles, which is consistent with findings of Sullivan et al. (31), who noted that environmental limitations are a key challenge in promoting PA among coastal populations. Women in these communities often face additional psychological barriers, such as low self-confidence and fear of injury, which prevent PA participation. This is consistent with Doherty et al. (15), who argue that psychological factors, often overlooked in quantitative studies, are central to understanding PA behaviours among underserved populations.

Qualitative insights provide a deeper understanding of these barriers, revealing that social and environmental isolation compounds feelings of self-consciousness and vulnerability. The participants highlighted a perceived lack of safe and welcoming spaces to exercise, supporting Ominyi et al. (26) in recognising the importance of safe, accessible environments. These findings highlight the need for multilevel interventions that account for the unique sociocultural contexts of coastal communities. Similarly, TAAF’s 2023 report suggests that interventions addressing local barriers, such as community-led programmes and accessible indoor activity spaces, may be more effective in increasing PA participation in underserved regions. This study adds to the literature by highlighting that coastal women may experience increased isolation and a lack of social support, which are factors that contribute to PA disengagement and require tailored, community-based solutions.

The study’s results also reveal significant enablers of PA engagement. Many women expressed a strong desire to improve their health, appearance, and general well-being, aligning with the findings of Rebar et al. (33), who suggested that health and aesthetic motivations can effectively promote PA. Additionally, women cited family and peer encouragement as positive influences, albeit less accessible due to geographic isolation. These findings support Bronfenbrenner’s ecological framework (27), indicating that support systems, when present, play a crucial role in promoting PA by providing emotional reinforcement and shared motivation. The importance of familial support aligns with Richmond & Foster’s (7) findings that familial encouragement is essential for sustained PA in underserved communities. In coastal areas, however, these support networks are less robust, highlighting a critical gap in social infrastructure that may inhibit PA participation.

While this study’s mixed-methods approach has provided valuable insights, it is essential to address limitations. The reliance on healthcare professionals as primary sources of PA information could indicate limited accessibility to broader community-driven information sources, such as fitness centres or public recreational spaces, which are more common in urban settings (2). Furthermore, despite extensive research on PA, studies specific to coastal women remain scarce. Previous research has often focused on urban or male-dominated samples, limiting the generalizability of existing findings to rural and coastal female populations (34). This study contributes to understanding the unique barriers coastal women face in accessing PAs and highlights the need for interventions that recognise these populations’ specific sociocultural and environmental contexts.

5.1 Strengths and limitations

A major strength of this study is its mixed-methods approach, which provides a comprehensive view of the barriers to and enablers of physical activity (PA) among women in coastal communities. By combining quantitative data on PA behaviours with qualitative insights into personal experiences, this study captures both broad trends and nuanced factors, enhancing the depth of analysis (15). Additionally, the focus on a unique, underserved population highlights specific socioenvironmental challenges that may be overlooked in urban-centered research.

However, limitations include potential sample bias, as the study relies heavily on self-reported data, which may be influenced by social desirability or recall biases. The limited geographic scope may also constrain generalisability to other rural or coastal regions. Future research could expand to broader samples and include observational methods to validate self-reported behaviours.

5.1 Implications for future research

The findings of this study highlight critical directions for future research in understanding and supporting PA engagement among women in coastal communities. Given the significant socioenvironmental barriers identified, future studies should explore intervention designs that incorporate multilevel approaches, addressing not only individual motivations but also structural constraints such as facility access, safety, and social support. Expanding research to diverse coastal populations could improve the generalisability of findings, identifying commonalities and differences across regions.

Moreover, longitudinal studies could provide valuable insights into the long-term effectiveness of interventions in overcoming these barriers. Additionally, research could benefit from incorporating ecological frameworks to understand how social, cultural, and physical environments interact with individual behaviours in coastal contexts. Exploring partnerships with local stakeholders, including healthcare providers and community organisations, may reveal practical strategies for enhancing PA engagement that are sensitive to the unique needs of these communities.

This study explored the barriers and enablers influencing physical activity (PA) participation among women in coastal communities of East England. The findings indicate that multiple socioenvironmental factors, including limited access to facilities, adverse weather, and caregiving responsibilities, significantly constrain PA engagement. Psychological barriers, such as low self-confidence and fear of injury, further hinder participation, highlighting the complexity of PA behaviours in this population. Conversely, health recommendations, social support, and personal goals emerged as notable motivators, underscoring the potential for targeted interventions that leverage these enablers.

The mixed-methods approach enriched the analysis, allowing for a deeper understanding of PA behaviours within the unique sociocultural context of coastal communities. However, limitations include sample bias and geographic constraints, suggesting that future research should include diverse coastal populations and longitudinal approaches. Overall, the study highlights the need for multilevel, community-based interventions that address these specific barriers to promote sustained PA engagement among women in coastal regions.

Ethics approval

The study was conducted in accordance with the guidelines of the Declaration of Helsinki and was approved by the University of Suffolk’s Research Ethical Approval System (reference not applicable).

Consent to participate: Informed consent to participate was obtained from all participants prior to their enrolment in this study. Participant information sheets and consent forms were provided in advance via email. These documents were then reviewed and confirmed as appropriate.

Consent to Publish: Not applicable

Competing Interests: We declare no conflicts of interest.

Acknowledgements: We wish to thank all the women who participated in this study.

Author contributions: JO contributed to the conceptualisation and methodology of this study. JO conducted the investigation and validation of the results. JO was responsible for data curation and formal analysis. JO contributed to the drafting of the manuscript, whereas AC reviewed and edited the manuscript. All the authors have read and approved the final version of the manuscript.

Funding: None received

Data availability: The datasets utilised and/or analysed in this study are available from the corresponding author upon reasonable request. The data included in this document have not been previously published.

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Supplementary files are not available with this version

The authors declare no competing interests.

A Mixed Methods Study Exploring Barriers and Enablers to Physical Activity Participation Among Women in Coastal Communities.

Status:

Version 1

Abstract

Figures

1 Background

1.1 Research objective

2 Methods

3 Data analysis

3.1 Quantitative data analysis

3.2 Qualitative data analysis

3.3 Integrating quantitative and qualitative findings

4 Results

Table 1: Participant demographic characteristics (N = 112)

5 Discussion

5.1 Strengths and limitations

5.1 Implications for future research

6 Conclusions

Declarations

References

Supplementary file

Additional Declarations

Status:

Version 1