Venna Alyssia, d'Udekem Yves, Figueiredo Sabrina
The School of Medicine and Health Sciences, The George Washington University, 111 Michigan Avenue NW, Washington, D.C, 20010, USA.
Children's National Hospital, Washington, D.C, USA.
BMC Public Health. 2025 Mar 28;25(1):1180. doi: 10.1186/s12889-025-22152-1.
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.
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.
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.
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.
PROSPERO: CRD42024516250.
体育活动对于改善先天性心脏病（CHD）患者的健康至关重要，但该群体的体育活动率显著低于普通人群。CHD患者体育活动率低的原因尚未得到充分记录。本综述旨在确定CHD儿童和青少年体育活动的障碍和促进因素。
对五个数据库进行了快速综述：PubMed、Scopus、CINAHL、PsycINFO和PEDRO，重点关注与CHD儿童或青少年体育活动相关的研究。使用COM-B模型对障碍和促进因素进行分类，并分为不可改变因素或个体、社会文化、社会经济或环境可改变因素。描述性分析和概念图用于进一步描述体育活动的障碍和促进因素。
纳入了49项研究。大多数文章是定量研究（76%），并评估了年龄和性别等不可改变的人口统计学影响因素。自我效能被认为是体育活动最常见的个体可改变促进因素。自我施加的限制和自我感知的障碍，如恐惧和焦虑、不足感以及缺乏乐趣，是体育活动的障碍。社会文化影响包括父母、教师和同伴的支持，尽管他们有时因焦虑和知识缺乏而阻碍活动。社会经济和环境障碍包括体育活动的成本和资源不足。
本综述确定了体育活动的障碍和促进因素，突出了性别和年龄等不可改变因素，以及焦虑、自我效能和父母参与等可改变因素。家庭和学校的环境因素也发挥了作用。本综述的结果使用COM-B模型进行组织，将障碍和促进因素分为能力、机会和动机，从而更深入地理解在为该人群制定干预措施时必须考虑的因素。未来的研究应探讨临床医生、患者和家庭对本文所确定因素的看法，并进行纵向研究以跟踪随时间对体育活动的影响。
PROSPERO：CRD42024516250。
