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Barriers to home-based physical activity and predictors of activity levels among women with high sedentary habits: an explanatory mixed-methods study

BMC Research Notes volume 18, Article number: 217 (2025) Cite this article

Abstract

Objective

Understanding barriers to home-based physical activity is crucial for developing strategies to increase participation among women with high sedentary habits. This study aims to comprehensively scrutinize these barriers and predictor factors of physical activity levels, utilizing an explanatory mixed methods design. The quantitative phase involved 537 women, who completed a researcher-made questionnaire and the International Physical Activity Questionnaire (IPAQ) to assess physical activity levels, predictor factors, and barriers. The qualitative phase engaged 12 participants through in-depth interviews to gain a deeper understanding of barriers. Chi-square statistical tests, multinomial logistic regression, and content analysis were used.

Results

83.8% of women were in the inactive and low-activity category. The main barriers to physical activity included not prioritizing exercise, insufficient time, household responsibilities, and a deficit in motivation. Predictors included environmental barriers (P = 0.009, β = 0.701), social obstacles (P ≤ 0.001, β = 1.179), and lack of motivation (P ≤ 0.001, β = 1.836), all of which significantly impact the level of moderate to vigorous physical activity. The qualitative analysis classified barriers into three categories: personal, social, and environmental. Interventions such as community programs, awareness campaigns, and improved infrastructure are crucial. Health policymakers can take action with targeted strategies to remove barriers and promote women’s physical activity.

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Introduction

The Global Status Report on Physical Activity (PA) for 2022 revealed that the majority of people worldwide fail to meet the PA guidelines proposed by the World Health Organization (WHO) [1]. Compared with males, females are more prone to physical inactivity, as they tend to engage in sedentary behaviors [2]. The 2016 STEPS survey highlighted that 61.9% of Iranian women did not achieve adequate levels of physical exercise, emphasizing the significant inactivity among this group [3]. Globally, around 33.5% of adult women also fail to meet WHO’s recommended PA levels [4]. Sedentary behavior presents a noteworthy obstacle to public health, associating with a range of health risks including cardiovascular diseases, type 2 diabetes, cancer, high blood pressure, and stroke [5]. In actuality, physical inactivity is the fourth leading cause of global mortality, increasing the risk of death from any cause [6].

The relationship between religion and exercise among Muslim women is intricate [2]. Some studies suggest that veiled Muslim women engage in less PA than their Christian or atheist counterparts [6]. This may be attributed to social and cultural factors, such as insufficient family support, fears of harassment, and family exercise restrictions [7]. Other research has shown that those with a stronger religious identity are often more physically active, particularly if they are health-conscious [8].

Women face unique barriers to engaging in PA, globally and in Iran, including cultural, gender-related, and safety-related factors, that necessitate tailored interventions to encourage and support women’s consistent participation [4]. The socio-demographic factors like age, educational attainment, and ethnicity significantly influence women’s PA levels [9], and spousal characteristics such as education and financial status also play a crucial role [10]. Addressing these complex issues requires implementing targeted interventions that consider both individual and contextual variables to promote lasting participation in physical activities.

Home-based PA programs offer customized exercises that enhance strength, balance, and overall fitness, suitable for activities like walking, balance training, resistance training, or using digital devices [7]. These programs are particularly beneficial for the elderly and ill, aiming to maintain independence and delay disability [11]. Mixed-method studies have shown that such programs effectively improve PA levels among women, demonstrating their practicality, safety, and ability to promote adherence, positively impacting physical and mental health [2, 12,13,14].

Understanding participants’ perspectives, personalization, and adaptability are essential when designing these programs. The home environment’s physical, social, and cultural factors influence women’s PA [15,16,17]. Traditional gender roles can hinder PA at home [18], while the presence of sports equipment and family support can facilitate it [19]. Thus, the home environment plays a crucial role in shaping women’s PA behaviors [2].

Explanatory mixed methods provide a more comprehensive and nuanced understanding of the diverse components that influence home exercise programs. This integration allows researchers to examine the interplay between contextual factors and program facilitation, thereby providing deeper insight into factors such as motivation, barriers to PA, intervention outcomes, and usability [20].

Previous studies have mainly focused on barriers to PA in public spaces, overlooking the distinct challenges and supports within the home environment. Due to this gap and the significance of understanding the domestic setting in encouraging PA among religiously conservative populations, there is a noticeable lack of research on the specific hindrances to home-based PA in these communities [21, 22].

This study aims to use an explanatory mixed-method design to explore the barriers to and predictors of home-based PA among women with high sedentary habits in a religiously conservative community.

Materials and methods

Study design

Considering the high prevalence of inactivity among women and the importance of understanding its barriers, this study employed a mixed-methods approach with an explanatory design. A cross-sectional study was conducted on an online platform to estimate the level of inactivity, identify barriers, and predict factors affecting home-based PA among women in Mashhad. In order to acquire more profound understanding, a qualitative research approach was implemented via comprehensive interviews. Methodological triangulation was accomplished by integrating both qualitative and quantitative data collection methods, whereas investigator triangulation was employed throughout the data analysis phase, with several researchers independently evaluating the qualitative data and engaging in discourse regarding their interpretations to achieve a collective agreement.

This multi-faceted approach allowed us to validate findings, reduce potential biases, and ensure a comprehensive understanding of the factors influencing PA among women in religiously conservative communities.

Participants

In the quantitative stage, 537 women from diverse social and economic backgrounds in Mashhad were included. The inclusion criteria for the study were Iranian women aged 30 to 50 years living in Mashhad, while the exclusion criteria included pregnancy, menopause, and lack of informed consent to participate. In the qualitative stage, 12 individuals were purposefully selected from among women living in Mashhad. The selection was based on the specific needs of the study and the progression of the interviews, and the process continued until information saturation was achieved.

Integration of quantitative and qualitative findings

Data integration occurred during the analysis phase, where insights from both quantitative and qualitative sources were compared and combined to form a comprehensive understanding of the target population’s needs and preferences. This integration confirmed findings and generated meta-inferences, leading to a clearer identification of factors affecting home-based PA among women.

Instrument

The quantitative tools included demographic questions (height and weight, marital status, couple’s age, occupation and education level, number of offspring, residential status, monthly household income, individuals who encourage PA, and car ownership), factors influencing women’s irregular PA, and the Iranian version of the International Physical Activity Questionnaire (IPAQ) [23]. The IPAQ consists of 27 items classified into four domains (work, leisure, commuting, and household chores) covering the preceding 7 days. The qualitative research segment involved guiding questions such as: do you engage in regular PA? What impediments do you face in doing PA?

For the barrier’s questionnaire, participants first answered two open-ended questions about obstacles to home-based PA, which informed the development of a 15-item questionnaire. The content validity of the questionnaire was assessed by five faculty members from Tabriz University of Medical Sciences and Mashhad, who are experts in PA, health promotion, and questionnaire design. Each item was evaluated based on relevance, clarity, simplicity, and necessity using a 4-point Likert scale (1 = not relevant, 2 = somewhat relevant, 3 = quite relevant, 4 = highly relevant). The Content Validity Index (CVI) was calculated by dividing the number of experts who rated an item as ‘quite relevant’ or ‘highly relevant’ (scores of 3 or 4) by the total number of experts, resulting in an overall CVI of 90%. The content validity ratio (CVR) of 60%. Reliability was confirmed with a Cronbach’s alpha coefficient of 72%.

Data collection and analysis

The quantitative study was completed online between August 15, 2023, and October 20, 2023, with two-stage cluster sampling. Clusters were defined as urban areas covered by five health centers in Mashhad city, representing distinct geographic and socio-demographic regions. In the first stage, one Urban Healthcare Center and one covered health base were randomly selected from each of the five health centers using simple random sampling. In the second stage, at least 100 individuals were systematically sampled from each selected health center and health base, based on the inclusion criteria and sample size requirements. In total, 537 eligible women completed the questionnaires. The qualitative study involved purposeful sampling until data saturation was reached through semi-structured interviews in October and November 2023. The interview times ranged from 45 to 60 min (52.5 ± 4.2 min). Also, in the qualitative phase of the data collection process, field notes were used to preserve valuable data. Participants were informed about consent, data anonymity, and confidentiality. Quantitative data analysis was performed with SPSS version 25 (IBM Corp., Armonk, N.Y., USA). Descriptive statistics, such as the mean, standard deviation, and frequency percentage, were calculated. Chi-square test was used to determine the relationship between demographic characteristics and PA barriers with PA level. Multinomial logistic regression examined factors predicting women’s home-based PA. To ensure statistical validity, certain variable levels were removed due to zero-frequency cells in the contingency table. Additionally, the confidence interval (CI) was set at 95%. Furthermore, qualitative analysis was conducted via MAXQDA software version 2020 (VERBI GmbH, Berlin, Germany).

Results

Quantitative study

In this study, data were collected from 537 participants. The mean age of the participants was 38.82 ± 6.1 years, the mean number of children was 1.46 ± 1.2, and their BMI was 26.4 ± 4.7. A total of 64.6% (n = 347) of the participants were inactive, 19.2% (n = 103) were in the low-activity category, 14.5% (n = 78) were in the moderate-activity category, and 1.7% (n = 9) were in the intense-activity category.

A significant association was found between women’s PA level and several factors, including marital status (P < 0.001), women’s education (P < 0.001), husbands’ occupation (P = 0.004), husbands’ education (P = 0.014), and the number of children (P < 0.001). Additionally, there was a statistically significant relationship between the presence of social support (P < 0.001), and car ownership (P = 0.01) with the level of PA (Table 1).

Table 1 Participants’ demographic characteristics and level of physical activity
Full size table

The barriers to PA for women, listed in order of priority, include not prioritizing exercise (59.6%), lack of time (37.1%), engagement in housework and daily activities (31.1%), and lack of motivation and interest (29.4%). Lack of interest and motivation (P < 0.001), lack of time (P = 0.033), and lack of awareness of the benefits of exercise (P = 0.005), which significantly impact women’s PA levels. Environmental barriers such as gym-related issues (P < 0.001) are also significantly associated with PA levels. Social barriers such as a lack of exercise companions (P < 0.001) influence women’s PA levels (Table 2).

Table 2 Association of Home-based physical activity barriers with women’s PA levels
Full size table

Predictors of physical inactivity include environmental barriers (e.g., gym-related issues; β= -0.701, P = 0.009), social barriers (e.g., lack of support and lack of exercise Companions; β= -1.179, P < 0.001), and lack of motivation (β= -1.836, P < 0.001), all of which significantly impact the likelihood of individuals being classified as inactive. Individuals who have experienced environmental barriers are 3.26 times more likely to be in the low-active group (OR2 = 3.257, 95% CI: [1.664, 6.369]). Additionally, social barriers increase the likelihood of individuals being in the inactive group by 3.25 times (OR2 = 3.247, 95% CI: [1.916, 5.525]). Furthermore, lack of motivation significantly affects PA, with individuals facing this issue being 6.41 times more likely to be in the low-active group (OR2 = 6.410, 95% CI: [3.322, 12.346]) (Table 3).

Table 3 Predictors of physical activity levels in women: multivariate logistic regression analysis
Full size table

Qualitative study

The qualitative phase of the study was conducted to explain the barriers associated with PA in 12 Mashhad females. The demographic characteristics of the participants are presented in Table 4. A total of thirty codes and subthemes emerged from the data analysis, which were classified into three main themes: personal, social, and environmental (Table 5).

Table 4 Participant demographic data
Full size table
Table 5 An overview of the key themes, subthemes and analysis process
Full size table

Discussion

This mixed-method study examined barriers and predictors of home-based PA among women in a religious community. A significant finding was that individual barriers, particularly lack of time and motivation, hindered women’s PA. Quantitative and qualitative data highlighted household priorities and time constraints as significant challenges. These results align with previous research that emphasizes the struggle women face in balancing family responsibilities with fitness, suggesting that home workouts can provide a flexible solution [24, 25].

Social barriers, such as the need for companionship and insufficient support from family members, were also significant. This highlights the role of social support and changing family dynamics in influencing women’s PA [15]. To boost motivation, home-based PA programs should include strategies like personal goal setting, progress tracking, and social features to create an enjoyable experience [26]. Family competitions and sports challenges can enhance togetherness while promoting PA [15].

Environmental barriers, including limited access to exercise spaces and insufficient sports equipment, were particularly noted by housewives due to their household duties [24]. Interventions should aim to establish dedicated workout areas at home, utilize everyday items as fitness tools, and create neighborhood-based women’s PA groups [2, 15].

Cultural and religious factors also emerged as significant barriers. Participants reported issues such as the incompatibility of sportswear with religious values and a lack of exercise necessities. Research suggests that appropriate Islamic sportswear can increase participation [27]. Additionally, raising awareness of exercise benefits through educational programs rooted in religious teachings and family support, especially from spouses, is crucial [28]. Creating safe, women-only exercise environments can address privacy concerns [29]. Promoting exercise as a positive activity through media and religious leaders can also shift social attitudes and enhance participation [30]. Attention should be given to the specific needs of married women, housewives, and mothers when designing flexible training programs that can be integrated into daily routines, utilizing mobile-based networks for accessibility.

Regarding predictors of PA, higher education levels and employment status were positively associated with PA among women, consistent with findings that education and income correlate with better access to health resources [2]. Conversely, married housewives with multiple children reported lower PA levels due to time constraints [11]. Flexible, effective home-based programs supported by mobile networks could help these women integrate PA into their routines.

The study found that women with private cars engaged in more PA, as car ownership facilitates access to exercise opportunities outside the home [31]. Family support, especially from spouses, was a key facilitator. Women whose husbands were employed and educated reported fewer barriers to PA, underscoring the importance of spousal support [2]. The relationship between a husband’s occupation and education and a wife’s PA is shaped by cultural norms and socioeconomic factors. Increasing husbands’ awareness of PA can enhance women’s activity levels through family engagement [2, 32].

Environmental predictors, such as access to safe exercise spaces, were significant. Women with private cars reported higher PA levels due to easier access to gyms and outdoor activities [30].

The findings indicate that social and environmental barriers, along with motivation, significantly impact women’s participation in moderate-to-vigorous PA. Environmental constraints, such as limited exercise spaces, and social barriers, like lack of support, hinder participation [33, 34]. Motivation, as a facilitating factor, aligns with psychological theories emphasizing intrinsic and extrinsic motivation in maintaining healthy behaviors [35].

Social, environmental, and individual factors significantly influence the long-term effects of PA interventions, particularly for women. Social factors such as companionship, family support, and community-based programs enhance motivation and adherence, while culturally tailored interventions address gender norms and cultural barriers [36]. Environmental factors, including access to safe exercise spaces, sufficient sports equipment, and safety measures, facilitate regular participation and improve adherence [37]. Individual factors like intrinsic motivation, self-efficacy, and the transition from extrinsic to intrinsic motivation are crucial for sustained engagement [38]. Collectively, these elements play a significant role in fostering enduring health advantages, which include a diminished likelihood of chronic illnesses, enhanced psychological well-being, and an improved overall quality of life [39].

Deep learning models have demonstrated the ability to analyze complex datasets, uncover hidden patterns, and accurately predict behavioral outcomes. For example, these models can analyze women’s PA data to identify key predictors, including environmental, social, and individual factors. They also enable the development of tailored interventions for specific groups of women, considering factors like age, socioeconomic status, and cultural background. By leveraging deep learning, future research can better understand PA barriers and design more effective, data-driven interventions to improve women’s health [40, 41].

According to a recent meta-analytic review [42], Social Cognitive Theory (SCT) provides a robust framework for understanding health behaviors, including PA. The theory’s emphasis on self-efficacy, social support, and environmental factors aligns well with our findings on barriers and predictors of home-based PA among women.

To address environmental barriers, it is recommended to promote home-based exercise programs that require minimal equipment. To overcome social barriers, fostering social support networks through community exercise groups and engaging family members can help. To increase women’s motivation, we can take action by raising awareness and attitudes among them and their families. By addressing key barriers such as lack of access, social support, and motivation, these initiatives can significantly improve PA levels and contribute to better health outcomes for women.

The interplay between barriers and predictors is crucial. For example, social support and motivation can alleviate time constraints and environmental challenges. Family activities and culturally appropriate sportswear can address social and cultural barriers. Higher education and employment can reduce individual and environmental barriers, highlighting the need to consider socioeconomic factors in promoting PA.

Interestingly, the barriers to PA in Mashhad do not significantly differ from those in other countries, despite its religious context. This similarity may stem from the establishment of suitable environments for women’s PA, such as women-only parks, and changing male attitudes toward women’s sports participation. Increased awareness has fostered a supportive environment that encourages women to pursue fitness with family backing.

Strengths and limitations

This study highlights the complex interplay of barriers and predictors of PA among women in religious communities. Key barriers include individual, social, environmental, and cultural factors, while predictors such as motivation and social support significantly influence PA levels. Future interventions should focus on reducing environmental barriers, enhancing motivation, addressing cultural concerns, and engaging families to create a supportive environment for women’s PA. While the study is limited to a specific geographic area and relies on self-reported data, it contributes valuable insights for enhancing PA among women in Mashhad, with potential applicability to other Iranian cities, especially where women face challenges like multiple roles, environmental limits, and limited social support. Also, reliance on self-report methods for assessing PA outcomes may have led to inaccuracies, as these methods are subject to personal bias and recall errors. Further research is needed to tailor home-based programs to meet women’s unique needs within urban lifestyles and access to fitness facilities.

Conclusion

This mixed-method study highlights the multifaceted nature of barriers to home-based PA among women with high sedentary habits, highlighting the influence of individual, social, and environmental factors. It identifies social and environmental elements as key predictors of women’s PA at home. The results indicate that factors like spousal education, women’s employment, quality of life, and stages of behavior change significantly affect women’s engagement in PA. These findings emphasize the importance of tailored interventions that address the specific challenges faced by women in religious and culturally conservative contexts. Policymakers and health planners can address environmental barriers by providing women access to safe and affordable exercise spaces, such as women-only gyms and community parks. Public health campaigns can increase awareness and attitudes in the community about the benefits of physical activity, as well as increase families’ motivation to be physically active by providing incentives and programs that encourage goal setting. Additionally, offering flexible exercise programs, time management workshops, and subsidized gym memberships can help women balance household responsibilities and prioritize physical activity. Integrating physical activity education into school curricula and advocating for workplace wellness programs can further support these efforts. Future research should investigate additional aspects, such as mental health, and employ objective measurement tools like wearable fitness trackers to further improve interventions and outcomes.

Data availability

“The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.”

Abbreviations

PA:

Physical Activity

WHO:

World Health Organization

IPAQ:

International Physical Activity Questionnaire short version

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Acknowledgements

This is a part of Malihe Noori-Sistani’s PhD thesis. We want to thank the Research Deputy of Tabriz University of Medical Sciences and Mashhad University of Medical Sciences and all those who contributed to the successful completion of this research protocol.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Tabriz University of Medical Sciences (IR.TBZMED.REC.1402.182).

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Authors and Affiliations

  1. Faculty of Health and Nutrition, Department of Health Education & Promotion, Tabriz University of Medical Sciences Tabriz, Tabriz, Iran

    Malihe Noori-Sistani, Hamid Allahverdipour & Zeinab Javadivala

  2. Faculty of Health, Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Science, Mashhad, Iran

    Mohammad Vahedian-Shahroodi

  3. Faculty of Physical Education and Sports Science, Department of Motor Behavior, Tabriz University, Tabriz, Iran

    Mahta Eskandarnejad

  4. Faculty of Education and Psychology, PhD student of exercise physiology, Mohaghegh Ardabili University, Ardabil, Iran

    Nahid Ashkriz

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  1. Malihe Noori-Sistani
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  3. Mohammad Vahedian-Shahroodi
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  4. Mahta Eskandarnejad
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  5. Nahid Ashkriz
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  6. Zeinab Javadivala
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Contributions

All authors (Malihe Noori-Sistani, Hamid Allahverdipour, Mohammad Vahedian-Shahroodi, Mahta Eskandarnejad, Nahid Ashkriz, Zeinab Javadivala) confirm that all stages of the research and manuscript writing were conducted collaboratively and that they support the results.

Corresponding author

Correspondence to Zeinab Javadivala.

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Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

This study was conducted following the ethical principles of the Declaration of Helsinki. The study protocol was approved by the Ethics Committee of Tabriz University of Medical Sciences (Approval Code: IR.TBZMED.REC.1402.182), and written informed consent was obtained from all participants before their inclusion in the study. They were be given full details about the aims, methods, potential risks and benefits of the research. They were assured that all data collected was kept confidential and anonymous to protect their privacy.

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Noori-Sistani, M., Allahverdipour, H., Vahedian-Shahroodi, M. et al. Barriers to home-based physical activity and predictors of activity levels among women with high sedentary habits: an explanatory mixed-methods study. BMC Res Notes 18, 217 (2025). https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s13104-025-07243-x

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  • DOI: https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s13104-025-07243-x

Keywords

BMC Research Notes

ISSN: 1756-0500

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