1. Background
The World Health Organization has set a target to reduce global physical inactivity by 10% by 2025; however, current trajectories indicate that this objective will not be achieved. This challenge is particularly acute in low-income countries and among women, for whom disparities in access to opportunities and cultural barriers are most pronounced (1). This widespread inactivity is directly associated with the rising global prevalence of obesity and elevated body mass index (BMI), both major risk factors for noncommunicable diseases (2). Therefore, promoting physical activity is a critical public health strategy for the primary and secondary prevention of conditions such as cardiovascular disease, type 2 diabetes, and certain cancers (3).
Beyond physical health benefits, physical activity can significantly affect depression, learning, cognitive speed, memory, and the prevention of neurological disorders such as stroke (4). Adults can maintain their health through regular physical activity. Recommended activity includes at least 30 minutes of moderate-intensity exercise (e.g., brisk walking or cycling at a steady pace) daily or, as a short-term alternative, approximately 20 minutes of high-intensity exercise (e.g., running or high-intensity interval training) at least 3 times per week (5).
A recent study in Kermanshah Province among 392 individuals aged 18 to 60 years found a statistically significant difference in physical activity levels between men and women. In addition, an inverse correlation was observed between physical activity and BMI. Various factors, including cultural norms, access to facilities, educational attainment, income level, and marital status, were identified as significant influences on physical activity patterns (6). This gender disparity is even more pronounced in certain regions, particularly rural areas, where cultural norms and limited access to dedicated sports facilities for women further restrict opportunities for physical activity.
Current evidence indicates that physical activity levels among rural women are shaped by a complex interplay of factors (7, 8). However, in rural Iran, these determinants have not been comprehensively examined. A substantial gap remains in the literature regarding a deep, contextual understanding of these barriers and facilitators. Moreover, rural women appear to have lower physical activity levels than their urban counterparts, largely due to poverty and a lack of facilities (9, 10). Investigating the determinants of physical activity among rural women is therefore a public health imperative. Their pivotal roles in rural households and agricultural productivity make their health and well-being fundamental to community sustainability and development.
2. Objectives
This study aimed to identify factors that facilitate or hinder physical activity among rural women in a village in Kangavar, Iran, to inform targeted interventions that may increase physical activity levels, improve health outcomes, and empower this population.
3. Methods
3.1. Study Area
The study was conducted in a village adjacent to the urban area of Kangavar in Kermanshah Province, western Iran. The village has a population of 911 people, including 446 females and 465 males.
3.2. Participants and Sampling Process
A total of 24 women, 12 men, and 3 local administrative managers participated in 4 focus groups conducted between August and September 2021. All participants were residents of the target village. Some local residents also held specific community roles, such as membership in the village council or service as Behvarz (community health workers). In addition, the study included 3 administrative officials: the District Governor, the Head of the Sports and Youth Department, and the Head of the local Health and Treatment Network.
Participants were selected using purposive sampling, and data collection continued until data saturation was achieved. The inclusion criteria were 1) age between 18 and 64 years, 2) willingness to participate, and 3) residence in the target village. The exclusion criterion was failure to meet any of the inclusion criteria. This age range was selected to capture a broad range of individual and social perspectives. All interviews were coordinated and conducted by the lead researcher (S.A.).
Before the interviews, participants provided verbal consent to participate and to have the interviews recorded. During the verbal consent process, each participant was asked to express willingness to participate. Before each interview, the study objectives and methods were explained, and participants were informed of their right to withdraw at any time. All interviews were conducted using a semistructured approach with a predefined interview guide containing open-ended questions and prompts to systematically explore key topics, including barriers, facilitators, and cultural perceptions. This format allowed flexibility to probe emerging ideas, follow participants’ narratives, and clarify responses in depth. All interviews were initially handwritten, then typed, and subsequently analyzed.
3.3. Data Analysis
Data collection and analysis were performed simultaneously. Because this was a qualitative study, no statistical software or quantitative tests were used. Data were analyzed manually using conventional content analysis in 3 stages: open, axial, and selective coding. During open coding, transcripts were read several times, and the main concepts were recorded as codes in the margins. Coding discrepancies were resolved by 3 independent individuals. Similar codes were then grouped into subcategories and main categories. To ensure rigor, 3 university professors in health education reviewed the questions for clarity and simplicity. In addition, the researcher recoded the transcripts after several days and compared the findings with the initial coding to confirm stability and reliability.
4. Results
Analysis of the interview content and codes identified five main categories of barriers: social, cultural, personal, family, and environmental (Table 1).
Table 1.
Summary of Main Barriers and Facilitators Influencing Rural Women's Participation in Physical Activity
| Categories | Barriers | Facilitators |
|---|---|---|
| Social | Lack of information/support, media and official neglect, fear of injury | Official and community support, public awareness |
| Cultural | Male-centered culture, harassment, fear of negative attitudes, appearance concerns | Men's awareness, cultural change, cyberspace use |
| Personal | Physical limitations, lack of time/interest/motivation, laziness | Self-confidence, scheduled exercise, motivation |
| Family | Opposition from family, poor economic status, childcare and housework | Husband and family encouragement/support |
| Environmental | No gyms/space, costly equipment, stray dogs, poor walkways | Equipment provision, walking paths, completing facilities |
5. Discussion
This study provides a clearer understanding of the main barriers to and facilitators of physical activity among rural women. The findings indicate that physical activity among rural women is insufficient and that multiple constraints affect their participation. These factors are discussed below in relation to the previous literature.
The findings indicate that many rural women are reluctant to participate in exercise activities because their families do not support them. Social support has an important effect on women's physical activity. According to Faghih et al. (11), social support is provided in 4 dimensions: emotional (empathy and love), instrumental (tangible help), informational (counseling), and evaluative (constructive feedback). Studies in different groups of women have shown that social factors can have a greater impact on physical activity than individual factors (12).
In the present study, some male participants stated that exercise is not necessary for women, whereas others believed that women exercising in the countryside could endanger the family's reputation. Alimohammadi et al. (13) reported similar findings in Iran, emphasizing the impact of cultural factors on women's participation in sports activities. Because of the nature of rural life, women's sports activities have not yet been socially accepted, and this issue requires changes in cultural patterns. Rural culture has not widely accepted women walking or exercising in gyms. Moreover, as Hejipoor et al. (14) noted, urbanization has changed the lifestyles of women in rural areas, which may negatively affect their physical activity.
In the present study, most participants acknowledged that the lack of accessible and suitable sports facilities for women is a major barrier. They identified problems such as a lack of appropriate walking paths and gyms and the presence of stray dogs. According to Wang et al. (15), proximity to sports facilities, the presence of parks, access to walking and cycling paths, and a sense of safety encourage physical activity among women. Conversely, Franzini et al. (16) found that even when facilities exist, unfavorable living conditions such as insecurity reduce their use. The availability of sports facilities plays a crucial role in encouraging rural women to improve their health and engage in social interaction (17, 18).
The present study found that lack of time, lack of motivation, laziness, physical disability, and fatigue were reasons for not participating in sports activities. An integrative review by Olsen (19) confirmed that insufficient knowledge of the benefits of physical activity and lack of motivation are important barriers among rural women.
Consistent with the present findings, Gorzelitz et al. (10) reported that low awareness of physical activity guidelines was a key barrier among rural women in the United States. Moreover, two recent studies from Iran, "The Correlation Between Junk Food Consumption and Health-Related Physical Fitness Factors in 10 - 12 Years Students of Kamyaran, Iran" (20) and "Evaluating the Impact of Total Resistance Exercise (TRX) System on Female Students and Their Static Balance" (21), emphasized the importance of physical fitness interventions in female populations, supporting the need for targeted programs in rural areas.
5.1. Limitations
Given the qualitative design of this study, the findings are not generalizable to other rural populations. Nevertheless, to the best of the authors' knowledge, no previous study in Iran has directly included rural women to explore the factors influencing their physical activity. Although some qualitative research has examined this issue from the perspective of rural sports stakeholders, the direct inclusion of rural women as participants is a key strength of the present study.
5.2. Conclusions
The past few decades have witnessed a steady decline in physical activity among large populations worldwide, and Iran has not been unaffected by this global trend. Young women and girls in the country face the critical challenge of physical inactivity, largely because of various barriers that hinder their access to sports facilities. The results of this study demonstrate that limitations in recreational and sports facilities for rural women, insufficient planning to upgrade existing infrastructure, a lack of qualified coaches, and cultural and familial barriers collectively have an adverse effect on physical activity. Consequently, physical education experts and regional policymakers should address this problem seriously and intensify efforts to overcome the existing barriers.
