Review ArticleGlobal participation in sport and leisure-time physical activities: A systematic review and meta-analysis
Introduction
Attaining recommended amounts of physical activity for health benefits (physical, mental, emotional, social) is imperative for overall well-being for adults, adolescents, and children (Eime et al., 2013a, Janssen and Leblanc, 2010, Warburton et al., 2006, Taylor et al., 2004, Penedo and Dahn, 2005, Booth et al., 2012). Yet, large proportions of adults (31%) and adolescents (80%) are currently classified as insufficiently active (Hallal et al., 2012). Inactive individuals are prone to an increased risk of obesity, cancer, diabetes, and heart disease, as well as psychological and emotional distress (Hamer et al., 2009, Kohl et al., 2012, Lee et al., 2012).
Previous studies have typically focused on how much leisure-time physical activity people accumulate (Collings et al., 2014, Cooper et al., 2015, Nader et al., 2008), including a recent global review of physical activity rates and active transportation (Hallal et al., 2012). The authors of the review described physical inactivity as a global health pandemic and reported that large numbers of adults are not meeting physical activity guidelines (range: 17.0% in Southeast Asia to 43.3% in the Americas). Rates of active transportation were also low and at the highest end, no more than a third of individuals reported utilizing active transportation (Hallal et al., 2012). What remains less clear is an understanding of what types of physical activities individuals choose to perform in their leisure-time (separate from active transportation), at different life stages and across different regions of the world. This is a notable gap in the epidemiological literature, as different regions may perform different physical activities, and this may have implications for related health outcomes (Oja et al., 2015). Improving our understanding of the different types of leisure-time physical activities performed may provide insight into the disparities in global physical activity participation.
Physical activity choices may vary due to the age-related motivations for participation. For example, children often cite ‘fun’ and ‘enjoyment’ as the main reasons why they participate in physical activity (Humbert et al., 2006, Tannehill et al., 2013), while adolescents and adults are more likely to be motivated by the health and fitness benefits of physical activity (Allender et al., 2006, Costello et al., 2011). As motivation for physical activity changes over time, so too will the types of leisure-time physical activities selected by individuals. For example, during adolescence an individual might choose to participate in team sports (e.g., volleyball) to enhance their connectedness with friends, but as an adult, maintaining a healthy weight might become the primary motivation for staying active, thus time-efficient activities such as running might become the preferred option.
Leisure-time physical activity may be influenced by socio-demographic barriers including geographic location and socioeconomic status (Bauman et al., 2012, Humpel et al., 2002). For example, individuals who live in cold weather climates (e.g. Canada, Norway), as opposed to warmer climate areas (e.g. Mexico, Australia) are more likely to participate in snow sports, such as skiing and snowboarding. Additionally, safety concerns, environmental factors (i.e., aesthetics), and access to facilities (e.g. parks) may inhibit or facilitate participation in physical activity (Humpel et al., 2002, Ball, 2015, Eime et al., 2013b, Kurka et al., 2015). Socioeconomic factors (e.g., cost, quality and availability) may also influence physical activity choices, as costs incurred through memberships (e.g., health/fitness clubs), registrations fees, equipment, and transportation can limit activity options for economically disadvantaged individuals (Costello et al., 2011, Eime et al., 2013b, Boone-Heinonen et al., 2011).
A more complete picture of physical activity preferences across the globe and at various life stages, will arm policy makers and interventionists with useful information to aid physical activity promotion efforts. To date, no global synthesis of the specific physical activities individuals perform has yet been conducted. The purpose of this review is to determine the most commonly performed physical activities by children, adolescents, and adults globally.
Section snippets
Search strategy
This systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines (Liberati et al., 2009). The PRISMA checklist has been provided in the supplemental materials (Supplemental Table A.1). The literature search was conducted in two phases between November 17th, 2014 and April 31st, 2015. First, geohive.com, a database listing 207 independent nations (i.e., excluding territories/enclaves e.g., U.S. Virgin
Results
In total, 73,304 articles were identified by the search and 957 underwent full-text review. One-hundred and twenty-two articles met the inclusion criteria. However, following the exclusion of the least representative studies, where multiple studies for a single country and age category were provided, 64 articles were included in the final meta-analysis. Results reported show the top ten activities for each WHO region and corresponding age group.
Discussion
The purpose of this systematic review and meta-analysis was to determine the physical activities most commonly participated in by children, adolescents and adults globally. Sixty-four studies representing 47 countries across six regions were included. Global participation rates reflected a consistent pattern of participation in lifelong physical activities (e.g., swimming, running, walking) and soccer among adults. Alternatively, there was considerable variability in adolescent and child
Conclusions
This is the first review and meta-analysis that has synthesized on a global scale specific sport and leisure-time physical activities. It is important to note that this review is a first step in understanding global participation rates, with room for improvement in strengthening the methodologies used to collect this data. Nevertheless, for a global review, it is important to include data as it currently stands, especially from developing countries with less opportunity to be able to conduct
Contributors
Author RMH was responsible for conception and design of the work, data acquisition and analysis, interpretation of results, drafting the manuscript, and final approval of manuscript. Authors JJS, PJM, LMB, PCH, and DRL were responsible for the conception and design of the work, interpretation of results, critical revisions of the manuscript and final approval. Author KC was responsible for data analysis, interpretation of results, critical revisions, and final approval. All authors agree to be
Competing interests
None.
Funding
Funding for this review was provided by the Priority Research Centre for Physical Activity and Nutrition at the University of Newcastle for the purposes of data analysis and interpretation.
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