Understanding the barriers and facilitators that impact physical activity levels in children and adolescents with Congenital Heart Disease (CHD): a rapid review.

BACKGROUND

Physical activity is vital for improving health in patients with congenital heart disease (CHD), yet physical activity rates in this group are significantly lower than those in the general population. The reasons for these low rates among patients with CHD have not been thoroughly documented. This review aimed to identify barriers and facilitators of physical activity in children and adolescents with CHD.

METHODS

A rapid review was performed across five databases: PubMed, Scopus, CINAHL, PsycINFO, and PEDRO, focusing on studies related to physical activity in children or adolescents with CHD. Barriers and facilitators were categorized using the COM-B model and classified as non-modifiable or as individual, sociocultural, socioeconomic, or environmental modifiable factors. Descriptive analysis and concept maps were used to describe physical activity barriers and facilitators further.

RESULTS

Forty-nine studies were included. Most articles were quantitative (76%) and assessed non-modifiable demographic influences like age and gender. Self-efficacy was cited as the most common individual modifiable facilitator of physical activity. Self-imposed limitations and self-perceived barriers such as fears and anxiety, feelings of inadequacy, and lack of enjoyment were barriers to physical activity. Sociocultural influences included support from parents, teachers, and peers, though they sometimes hindered activity due to their anxiety and lack of knowledge. Socioeconomic and environmental barriers included costs and inadequate resources for physical activity.

CONCLUSION

This review identified barriers and facilitators to physical activity, highlighting non-modifiable factors like gender and age, as well as modifiable factors such as anxiety, self-efficacy, and parental involvement. Environmental factors at home and school also play a role. This review's findings were organized using the COM-B model, categorizing barriers and facilitators into capability, opportunity, and motivation, providing a deeper understanding of what must be considered when developing interventions for this population. Future research should explore the views of clinicians, patients, and families on the factors identified here and conduct longitudinal studies to track influences on physical activity over time.

TRIAL REGISTRATION

PROSPERO: CRD42024516250.