The MOTIVA-PA systematic review protocol is registered in the International Prospective Register of Systematic Reviews (PROSPERO - https://www.crd.york.ac.uk/prospero/ ) under registration number CRD42021239689 17 and is funded by the Brazilian Ministry of Health (process number 4423831/2020-0). The Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA)18 will guide the systematic review report from this project.
The project is designed initially to carry out two extensive systematic searches in nine scientific databases (Medline - Pubmed: https://pubmed.ncbi.nlm.nih.gov/, Embase: https://www.embase.com, Scopus: https://www.scopus.com, Science Direct: https://www.sciencedirect.com, Web of Science: https://www.webofknowledge.com, Sport Discuss: https://www.ebsco.com/products/research-databases/sportdiscus, PsycINFO: https://psycnet.apa.org/home, Lilacs: https://lilacs.bvsalud.org, and Scielo: https://www.scielo.br/). The two different scrutinies will be carried out according to age groups (Systematic search 1: children and adolescents; Systematic search 2: adults and older people). Keywords were selected using the Medical Subject headings (MeSH) and relevant text to the topic. In addition, the references of the included studies will also be checked to identify studies relevant to the systematic review not discovered in the database search. Box 1 shows the search strategy for each systematic search and database.
Base
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Review
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Search Strategy
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Medline - Pubmed
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1
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(("child*"[Mesh] OR "adolescent*"[Mesh] OR "teen*" OR "youth") AND (“motivation*” [Mesh] OR “aspirations, psychological” [Mesh] OR “goal*” [Mesh] OR “handling, psychological”[Mesh] OR “barrier*” OR “facilitator*” OR “enabler*” OR “physical activity determinant*”) AND ("motor activit*"[Mesh] OR “physical activit*” OR "exercise*"[Mesh] OR "physical exertion"[Mesh] OR "sport*"[Mesh]) AND ("observation stud*" [Mesh] OR "prospective stud*"[Mesh] OR "cohort stud*"[Mesh] OR “retrospective stud*” [Mesh] OR "longitudinal stud*"[Mesh] OR "cross-sectional stud*"[Mesh]))
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2
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(("adult"[MeSH Terms] OR adult[Text Word] OR "aged"[MeSH Terms] OR aged[Text Word] OR elder [Text Word]) AND (“motivation*” [Mesh] OR “aspirations, psychological” [Mesh] OR “goal*” [Mesh] OR “handling, psychological”[Mesh] OR “barrier*” OR “facilitator*” OR “enabler*” OR “physical activity determinant*”) AND ("motor activit*"[Mesh] OR “physical activit*” OR "exercise*"[Mesh] OR "physical exertion"[Mesh] OR "sport*"[Mesh]) AND ("observation stud*" [Mesh] OR "prospective stud*"[Mesh] OR "cohort stud*"[Mesh] OR “retrospective stud*” [Mesh] OR "longitudinal stud*"[Mesh] OR "cross-sectional stud*"[Mesh]))
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Embase
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1
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('child'/exp OR 'child' OR 'children' OR 'adolescent'/exp OR 'adolescent' OR 'teenager') AND ('motivation'/exp OR 'aspirations (psychology)' OR 'aspirations, psychological' OR 'goals' OR 'handling (psychology)' OR 'handling, psychological' OR 'motivation' OR motives OR 'barrier'/exp OR 'perceived barrier'/exp OR 'barriers to physical activity' OR 'barriers to exercise' OR 'intrapersonal barriers' OR 'interpersonal barriers' OR 'environmental barriers' OR facilitators OR enablers OR 'physical activity determinants' OR 'factors influencing physical activity') AND ('motor activity'/exp OR 'motor activity' OR 'exercise'/exp OR 'biometric exercise' OR 'effort' OR 'exercise' OR 'exercise capacity' OR 'exercise performance' OR 'exercise training' OR 'exertion' OR 'fitness training' OR 'physical conditioning, human' OR 'physical effort' OR 'physical exercise' OR 'physical exertion' OR 'physical activity'/exp OR sports OR 'sports participation'/exp) AND ('observational study'/exp OR 'non experimental studies' OR 'non experimental study' OR 'nonexperimental studies' OR 'nonexperimental study' OR 'observation studies' OR 'observation study' OR 'observational studies' OR 'observational studies as topic' OR 'observational study' OR 'observational study as topic' OR 'cohort analysis'/exp OR 'cohort analysis' OR 'cohort studies' OR 'cohort study' OR 'retrospective study'/exp OR 'retrospective design' OR 'retrospective panel studies' OR 'retrospective panel study' OR 'retrospective studies' OR 'retrospective study' OR 'study, retrospective' OR 'prospective study'/exp OR 'prospective studies' OR 'prospective study' OR 'prospective method' OR 'longitudinal'/exp OR ‘cross-sectional study’ OR ‘cross-sectional study’/exp’) AND 'human'/de AND ('article'/it OR 'article in press'/it) AND ([adolescent]/lim OR [child]/lim)
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2
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('adult'/exp OR 'adult' OR 'adults' OR 'grown-ups' OR 'grownup' OR 'grownups' OR 'aged'/exp OR 'aged' OR 'aged patient' OR 'aged people' OR 'aged person' OR 'aged subject' OR 'elderly' OR 'elderly people' OR 'elderly person' OR 'elderly subject' OR 'senior citizen') AND ('motivation'/exp OR 'aspirations (psychology)' OR 'aspirations, psychological' OR 'goals' OR 'handling (psychology)' OR 'handling, psychological' OR 'motivation' OR motives OR 'barrier'/exp OR 'perceived barrier'/exp OR 'barriers to physical activity' OR 'barriers to exercise' OR 'intrapersonal barriers' OR 'interpersonal barriers' OR 'environmental barriers' OR facilitators OR enablers OR 'physical activity determinants' OR 'factors influencing physical activity') AND ('motor activity'/exp OR 'motor activity' OR 'exercise'/exp OR 'biometric exercise' OR 'effort' OR 'exercise' OR 'exercise capacity' OR 'exercise performance' OR 'exercise training' OR 'exertion' OR 'fitness training' OR 'physical conditioning, human' OR 'physical effort' OR 'physical exercise' OR 'physical exertion' OR 'physical activity'/exp OR sports OR 'sports participation'/exp) AND ('observational study'/exp OR 'non experimental studies' OR 'non experimental study' OR 'nonexperimental studies' OR 'nonexperimental study' OR 'observation studies' OR 'observation study' OR 'observational studies' OR 'observational studies as topic' OR 'observational study' OR 'observational study as topic' OR 'cohort analysis'/exp OR 'cohort analysis' OR 'cohort studies' OR 'cohort study' OR 'retrospective study'/exp OR 'retrospective design' OR 'retrospective panel studies' OR 'retrospective panel study' OR 'retrospective studies' OR 'retrospective study' OR 'study, retrospective' OR 'prospective study'/exp OR 'prospective studies' OR 'prospective study' OR 'prospective method' OR 'longitudinal'/exp OR ‘cross-sectional study’ OR ‘cross-sectional study’/exp) AND ('human'/de AND ('article'/it OR 'article in press'/it) AND ([adult]/lim OR [aged]/lim)
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Scopus
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1
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(child OR adolescent OR teen ) AND ( motivation OR perceived AND barrier OR goals OR facilitators OR motives ) AND ( motor AND activity OR physical AND activity OR sports ) AND ( observational AND studies' OR cohort AND studies OR retrospective AND studies OR prospective AND studies OR longitudinal AND studies OR cross-sectional AND studies ) AND ( LIMIT-TO ( DOCTYPE , "ar" ) ) AND ( LIMIT-TO ( LANGUAGE , "English" ) OR LIMIT-TO ( LANGUAGE , "Spanish" ) OR LIMIT-TO ( LANGUAGE , "Portuguese" )) AND ( LIMIT-TO ( SRCTYPE , "j" ) )
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2
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(adults OR aged OR elderly) AND ( motivation OR perceived AND barrier OR goals OR facilitators OR motives ) AND ( motor AND activity OR physical AND activity OR sports ) AND ( observational AND studies' OR cohort AND studies OR retrospective AND studies OR prospective AND studies OR longitudinal AND studies OR cross-sectional AND studies ) AND ( LIMIT-TO ( DOCTYPE , "ar" ) ) AND ( LIMIT-TO ( LANGUAGE , "English" ) OR LIMIT-TO ( LANGUAGE , "Spanish" ) OR LIMIT-TO ( LANGUAGE , "Portuguese" ) ) AND ( LIMIT-TO ( SRCTYPE , "j" ) )
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Science Direct
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1
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Find articles with these terms:
(child OR adolescent OR teen) AND (‘observational studies’ OR ‘cohort studies’ OR ‘retrospective studies’ OR ‘prospective studies’ OR ‘longitudinal studies’ OR ‘cross-sectional studies’)
Title, abstract or author-specified Keywords:
(motivation OR ‘perceived barrier’ OR goals OR facilitators OR motives) AND (‘motor activity’ OR ‘physical activity’ OR sports)
Filters applied: Social Sciences; Psychology; Environmental Science
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2
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Find articles with these terms:
(adults OR aged OR elderly) AND (‘observational studies’ OR ‘cohort studies’ OR ‘retrospective studies’ OR ‘prospective studies’ OR ‘longitudinal studies’ OR ‘cross-sectional studies’)
Title, abstract or author-specified Keywords:
(motivation OR ‘perceived barrier’ OR goals OR facilitators OR motives) AND (‘motor activity’ OR ‘physical activity’ OR sports)
Filters applied: Social Sciences; Psychology; Environmental Science
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Web of Science
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1
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(TS= ("physical activity motivation") OR TS= ("exercise motivation") OR TS= ("motives to practice sports") OR TS= ("reasons to practice sports") OR TS= ("motives to practice exercise") OR TS= ("motives to practice physical activity") OR TS= ("physical activity determinants") OR TS= ("barriers to physical activity") OR TS= ("barriers to exercise") OR TS= ("perceived barrier"*exercise) OR TS= ("perceived barrier"*"physical actity") OR TS= (facilitators*"physical actity") OR TS= (enablers*"physical actity") AND TS= ("physical activity correlates")) AND LANGUAGE: (English OR Portuguese OR Spanish) AND DOCUMENT TYPES: (Article)
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2
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(TS= ("physical activity motivation") OR TS= ("exercise motivation") OR TS= ("motives to practice sports") OR TS= ("reasons to practice sports") OR TS= ("motives to practice exercise") OR TS= ("motives to practice physical activity") OR TS= ("physical activity determinants") OR TS= ("barriers to physical activity") OR TS= ("barriers to exercise") OR TS= ("perceived barrier"*exercise) OR TS= ("perceived barrier"*"physical actity") OR TS= (facilitators*"physical actity") OR TS= (enablers*"physical actity") AND TS= ("physical activity correlates")) AND LANGUAGE: (English OR Portuguese OR Spanish) AND DOCUMENT TYPES: (Article)
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Sport Discuss
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1
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child OR children OR adolescent OR teenager OR youth (Full text)
AND
aspirations OR aspiration OR aspirating OR goals OR objectives OR hopes OR handling OR desires OR motivation OR motives OR motivators OR facilitators OR enablers OR barriers or obstacles OR challenges OR difficulties OR problems OR perceived barrier OR barriers to physical activity OR barriers to exercise OR intrapersonal barriers OR interpersonal barriers OR environmental barriers OR physical activity determinants (Subjects)
AND
motor activity OR exercise OR effort OR exercise capacity OR exertion OR fitness training OR physical effort OR physical exercise OR physical exertion OR physical activity OR sports OR sports participation (Subject)
AND
observational study OR non-experimental study OR observational research OR non-experimental research OR nonexperimental research OR nonexperimental study OR observation research OR observation study OR cohort study OR cohort research OR retrospective study OR retrospective research OR prospective study OR prospective methods OR longitudinal research OR longitudinal design OR longitudinal studies OR transversal study (Full text)
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2
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adults OR adult OR young adults OR adulthood OR aged OR elderly OR middle aged OR older person OR older people OR older adults OR eldery adults (Full text)
AND
aspirations OR aspiration OR aspirating OR goals OR objectives OR hopes OR handling OR desires OR motivation OR motives OR motivators OR facilitators OR enablers OR barriers or obstacles OR challenges OR difficulties OR problems OR perceived barrier OR barriers to physical activity OR barriers to exercise OR intrapersonal barriers OR interpersonal barriers OR environmental barriers OR physical activity determinants (Subject)
AND
motor activity OR exercise OR effort OR exercise capacity OR exertion OR fitness training OR physical effort OR physical exercise OR physical exertion OR physical activity OR sports OR sports participation (Subject)
AND
observational study OR non-experimental study OR observational research OR non-experimental research OR nonexperimental research OR nonexperimental study OR observation research OR observation study OR cohort study OR cohort research OR retrospective study OR retrospective research OR prospective study OR prospective methods OR longitudinal research OR longitudinal design OR longitudinal studies OR transversal study (Full text)
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PsycINFO
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1
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(Any Field: child OR Any Field: children OR Any Field: adolescent OR Any Field: teenager) AND Any Field: (motivation OR ‘aspirations, psychological’ OR goals OR ‘handling, psychological’ OR motives OR barrier OR ‘perceived barrier’ OR facilitators OR enablers OR ‘physical activity determinants’ OR ‘factors influencing physical activity’) AND Any Field: (‘motor activity’ OR ‘physical activity’ OR exercise OR effort OR ‘exercise capacity’ OR ‘exercise performance’ OR ‘exercise training’ OR exertion OR ‘fitness training’ OR ‘physical conditioning, human’ OR ‘physical effort’ OR ‘physical exertion’ OR sports OR ‘sports participation’) AND Any Field: (‘observational studies’ OR ‘cohort studies’ OR ‘retrospective studies’ OR ‘prospective studies’ OR ‘longitudinal studies’ OR ‘cross-sectional studies’) AND Population Group: Human NOT Age Group: Adulthood (18 yrs & older) AND Document Type: Journal Article
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2
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(Any Field: adults OR Any Field: aged OR Any Field: elderly) AND Any Field: (motivation OR ‘aspirations, psychological’ OR goals OR ‘handling, psychological’ OR motives OR barrier OR ‘perceived barrier’ OR facilitators OR enablers OR ‘physical activity determinants’ OR ‘factors influencing physical activity’) AND Any Field: (‘motor activity’ OR ‘physical activity’ OR exercise OR effort OR ‘exercise capacity’ OR ‘exercise performance’ OR ‘exercise training’ OR exertion OR ‘fitness training’ OR ‘physical conditioning, human’ OR ‘physical effort’ OR ‘physical exertion’ OR sports OR ‘sports participation’) AND Any Field: (‘observational studies’ OR ‘cohort studies’ OR ‘retrospective studies’ OR ‘prospective studies’ OR ‘longitudinal studies’ OR ‘cross-sectional studies’) AND Population Group: Human AND Age Group: Adulthood (18 yrs & older) AND Document Type: Journal Article
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Lilacs
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1
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((child) or (children) or (adolescent) or (teen) or (teenager) or (youth))
AND
((motivation) or (aspirations, psychological) or (goals) or (handling, psychological) or (motives) or (barriers) or (perceived barrier) or (barriers to physical activity) or (barriers to exercise) or (intrapersonal barriers) or (interpersonal barriers) or (environmental barriers) or (facilitators) or (enablers) or (physical activity determinants) or (factors influencing physical activity))
AND
((motor activity) or (physical activity) or (exercise) or (effort) or (exercise capacity) or (exercise performance) or (exercise training) or (exertion) or (fitness training) or (physical conditioning, human) or (physical effort) or (physical exertion) or (physical exercise) or (sports) or (sports participation))
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2
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((adult) or (adults) or (grown-ups) or (grownup) or (grownups) or (aged) or (elderly) or (senior citizen))
AND
((motivation) or (aspirations, psychological) or (goals) or (handling, psychological) or (motives) or (barriers) or (perceived barrier) or (barriers to physical activity) or (barriers to exercise) or (intrapersonal barriers) or (interpersonal barriers) or (environmental barriers) or (facilitators) or (enablers) or (physical activity determinants) or (factors influencing physical activity))
AND
((motor activity) or (physical activity) or (exercise) or (effort) or (exercise capacity) or (exercise performance) or (exercise training) or (exertion) or (fitness training) or (physical conditioning, human) or (physical effort) or (physical exertion) or (physical exercise) or (sports) or (sports participation))
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Scielo
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1
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( ((child) or (children) or (adolescent) or (teen) or (teenager) or (youth))) AND (((motivation) or (aspirations, psychological) or (goals) or (handling, psychological) or (motives) or (barriers) or (perceived barrier) or (barriers to physical activity) or (barriers to exercise) or (intrapersonal barriers) or (interpersonal barriers) or (environmental barriers) or (facilitators) or (enablers) or (physical activity determinants) or (factors influencing physical activity))) AND (((motor activity) or (physical activity) or (exercise) or (effort) or (exercise capacity) or (exercise performance) or (exercise training) or (exertion) or (fitness training) or (physical conditioning, human) or (physical effort) or (physical exertion) or (physical exercise) or (sports) or (sports participation)))
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2
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(((adult) or (adults) or (grown-ups) or (grownup) or (grownups) or (aged) or (elderly) or (senior citizen))) AND (((motivation) or (aspirations, psychological) or (goals) or (handling, psychological) or (motives) or (barriers) or (perceived barrier) or (barriers to physical activity) or (barriers to exercise) or (intrapersonal barriers) or (interpersonal barriers) or (environmental barriers) or (facilitators) or (enablers) or (physical activity determinants) or (factors influencing physical activity))) AND (((motor activity) or (physical activity) or (exercise) or (effort) or (exercise capacity) or (exercise performance) or (exercise training) or (exertion) or (fitness training) or (physical conditioning, human) or (physical effort) or (physical exertion) or (physical exercise) or (sports) or (sports participation)))
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Review 1: Children and Adolescents; Review 2: Adults and older people.
Figure 1. Search strategy.
Source: Authors
Studies will be included in the systematic reviews if they meet the following inclusion criteria:
- A sample including children and adolescents (aged 6 to 17 years) for the Systematic search 1, and adults and older people (over 18 years old) for the Systematic search 2;
- Studies verifying motivational factors/constructs (e.g., motivations, psychological needs support, needs satisfaction) to engaging and maintaining PA practice;
- Studies verifying the barriers to engaging and maintaining PA practice;
- Studies verifying the facilitators to engaging and maintaining PA practice;
- Cross-sectional or longitudinal observational studies;
Narrative or systematic reviews, qualitative studies, case or case-series studies, experimental studies, and studies written in languages other than Portuguese, Spanish, and English will be excluded.
Each systematic search will result in several studies according to a specific context (Figure 1). Systematic search 1 will provide evidence to discuss the motivational determinants, perceived barriers, and facilitators of physical activity in children and adolescents during leisure time, active transportation, physical education classes, sports practice, and for children and adolescents in several health settings. Systematic search 2 will discuss the motivational determinants, perceived barriers, and facilitators of physical activity in adults and older people during leisure time, participation in specific PA programs, active transportation, and people in several health settings.
After the systematic searches, all the outputs will be imported to the Rayyan software to manage references, duplicate removal, and screening process 19. Overall, four reviewers (two for each systematic search) will screen for titles, abstracts, full-text, data extraction, and risk of bias. The study coordinator will solve disagreements between the reviewers.
The data extraction will follow a standardized protocol. The following information will be extracted from the included studies:
• Descriptive information: Place of the study (city, state, and country); the number of participants; demographic information (age, sex, race/ethnicity, socioeconomic status, urban or rural residence;
• Presence of special adjacent health conditions;
• Exercise or sports practice;
• Engagement in physical activity programs from the city, state, or federal endorsement;
• Instruments used to assess motivation, barriers, and facilitators for the practice of physical activity;
• Instruments used to measure physical activity;
• Types of motivation;
• Types of barriers;
• Types of facilitators;
• PA prevalence in specific domains;
• The motivational factors indicated by the participants;
• Barriers perceived by the participants;
• Facilitators appointed by the participants;
• Statistical indicators of association of motivational aspects, perceived barriers, and facilitators with the engagement and maintenance of physical activity.
The study's quality assessment will be carried out using two tools, depending on the studies' observational design (cross-sectional or longitudinal). The Appraisal tool for Cross-Sectional Studies (AXIS) will be used 20 to evaluate cross-sectional studies. The AXIS tool was designed to evaluate the quality of reporting, design, and risk of biases. It includes 20 items divided into five sections (Introduction, Methods, Results, Discussion, and Others) 20.
The Newcastle-Ottawa scale for cohort studies 21 will assess the quality of the studies with a longitudinal design. The tool includes 8 items divided into three sections (Selection, Comparability, and Outcome). The quality of each study will be classified according to the following cut-off points: Good quality: 3 or 4 points in selection domain AND 1 or 2 points in comparability domain AND 2 or 3 points in outcome/exposure domain; Fair quality: 2 points in selection domain AND 1 or 2 points in comparability domain AND 2 or 3 points in outcome/exposure domain; Poor quality: 0 or 1 point in selection domain OR 0 point in comparability domain OR 0 or 1 point in outcome/exposure domain 21.
A machine learning model to predict motivational factors, barriers, and facilitators to engagement in PA will be implemented in a simulated study according to the following steps: 1) Built an extract database from systematic review screened and selected studies. 2) Specify and rank the main outcomes (e.g., motivators: health or weight loss) for each group/study screened. 3) Specify the characteristics of the predictors, the distributions, and the relationships of outcomes. 4) Generate a random sample from predictors and outcomes using a bootstrapping procedure. 5) The simulated database will be divided into two samples: 1-training; 2-test. After pre-processing, the training sample will test at least 20 different machine learning algorithms using the "caret" package 22 in R software. The algorithms will be classified according to their predictive ability, and the top 5 will be adopted for the model validation procedure with the test sample data. 6) Repeat steps 3 to 5 >100 times to guarantee the effects of random variation 23.