Hwang Suyoung, Yi Eun-Surk
Department of Exercise Rehabilitation & Welfare, Gachon University, Incheon 21936, Republic of Korea.
Healthcare (Basel). 2025 Jun 18;13(12):1469. doi: 10.3390/healthcare13121469.
Sustained exercise adherence among older adults is essential for healthy aging but remains challenging due to psychological, social, and economic barriers. This study aimed to investigate how perceived exercise barriers, financial burden, constraint negotiation mechanisms, and social support influence exercise adherence among adults aged 50 and older by integrating behavioral economics, constraint negotiation theory, and social cognitive theory. A cross-sectional survey was conducted with 1000 community-dwelling older adults in South Korea using a convenience sampling method. Participants were recruited from community centers, senior welfare facilities, and public health clinics in urban and suburban areas. Data collection was conducted between 11 January and 21 April 2024, using both online (Qualtrics) and offline (paper-based) surveys. Participants completed validated instruments measuring perceived exercise barriers, financial burden, constraint negotiation mechanisms (including financial management and social support mobilization), perceived social support, and behavioral exercise adherence. The final sample used for analysis included 974 individuals (mean age = 60.24 years, = 6.42). Structural Equation Modeling (SEM) was used to assess direct, mediating, and moderating effects. Additional exploratory analyses (ANOVA and -tests) examined subgroup differences. SEM results showed that perceived exercise barriers (β = -0.352, < 0.001) and financial burden (β = -0.278, < 0.001) were negatively associated with exercise adherence. Constraint negotiation mechanisms (β = 0.231, < 0.001) and perceived social support (β = 0.198, < 0.001) were positively associated. Mediation analyses revealed that constraint negotiation strategies partially mediated the relationships between perceived barriers and adherence (indirect β = 0.124) and between financial burden and adherence (indirect β = 0.112). Moderation analysis confirmed that social support buffered the negative effects of financial and psychological barriers. Exercise adherence in later life is shaped by the dynamic interplay of structural constraints, behavioral strategies, and social reinforcement. Interventions should combine financial support with socially embedded structures that promote behavioral planning and peer accountability to sustain long-term physical activity among older adults.
老年人持续坚持锻炼对于健康老龄化至关重要，但由于心理、社会和经济障碍，这仍然具有挑战性。本研究旨在通过整合行为经济学、约束协商理论和社会认知理论，探讨感知到的运动障碍、经济负担、约束协商机制和社会支持如何影响50岁及以上成年人的运动坚持情况。采用便利抽样方法，对韩国1000名社区居住的老年人进行了横断面调查。参与者从城市和郊区的社区中心、老年福利设施和公共卫生诊所招募。数据收集于2024年1月11日至4月21日进行，使用在线（Qualtrics）和离线（纸质）调查。参与者完成了经过验证的工具，测量感知到的运动障碍、经济负担、约束协商机制（包括财务管理和社会支持动员）、感知到的社会支持和行为运动坚持情况。用于分析的最终样本包括974人（平均年龄 = 60.24岁，标准差 = 6.42）。采用结构方程模型（SEM）评估直接、中介和调节效应。额外的探索性分析（方差分析和t检验）检验了亚组差异。SEM结果表明，感知到的运动障碍（β = -0.352，p < 0.001）和经济负担（β = -0.278，p < 0.001）与运动坚持呈负相关。约束协商机制（β = 0.231，p < 0.001）和感知到的社会支持（β = 0.198，p < 0.001）与运动坚持呈正相关。中介分析表明，约束协商策略部分中介了感知障碍与坚持之间的关系（间接效应β = 0.124）以及经济负担与坚持之间的关系（间接效应β = 0.112）。调节分析证实，社会支持缓冲了经济和心理障碍的负面影响。晚年的运动坚持受到结构约束、行为策略和社会强化之间动态相互作用的影响。干预措施应将经济支持与促进行为规划和同伴问责的社会嵌入结构相结合，以维持老年人的长期身体活动。
