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BMC Public Health

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Correlates associated with participation in physical activity among adults: a systematic review of reviews and update

BMC Public HealthBMC series – open, inclusive and trusted201717:356

https://doi.org/10.1186/s12889-017-4255-2

Received: 20 August 2016

Accepted: 11 April 2017

Published: 24 April 2017

Abstract

Background

Understanding which factors influence participation in physical activity is important to improve the public health. The aim of the present review of reviews was to summarize and present updated evidence on personal and environmental factors associated with physical activity.

Methods

MEDLINE and EMBASE were searched for reviews published up to 31 Jan. 2017 reporting on potential factors of physical activity in adults aged over 18 years. The quality of each review was appraised with the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) checklist. The corrected covered area (CCA) was calculated as a measure of overlap for the primary publications in each review.

Results

Twenty-five articles met the inclusion criteria which reviewed 90 personal and 27 environmental factors. The average quality of the studies was moderate, and the CCA ranged from 0 to 4.3%. For personal factors, self-efficacy was shown as the strongest factor for participation in physical activity (7 out of 9). Intention to exercise, outcome expectation, perceived behavioral control and perceived fitness were positively associated with physical activity in more than 3 reviews, while age and bad status of health or fitness were negatively associated with participation in physical activity in more than 3 reviews. For environmental factors, accessibility to facilities, presence of sidewalks, and aesthetics were positively associated with participation in physical activity.

Conclusions

The findings of this review of reviews suggest that some personal and environmental factors were related with participation in physical activity. However, an association of various factors with physical activity could not be established because of the lack of primary studies to build up the organized evidence. More studies with a prospective design should be conducted to understand the potential causes for physical activity.

Keywords

Physical activityEpidemiologic factorsReview of reviews

Background

Participation in regular physical activity contributes to health promotion, improving physical fitness, and prevention of non-communicable diseases [14]. The international health guideline for physical activity recommends that adults should be doing at least 150 min of moderate-intensity physical activity throughout the week or doing at least 75 min of vigorous-intensity physical activity regardless of the domains of physical activity such as leisure, transportation, occupational, and household chores [5]. However, the level of inactivity is reported to be high globally [6, 7]. Thus, motivating the public to participate in physical activity by finding which factors influence participation in physical activity is important to improve the public health and to mitigate the global burden of chronic diseases.

There are several theories that describe behavioral models of physical activity, and it is common to incorporate ideas from these theories into ecological models. According to an ecological model, factors which influence health behavior consisted of intra-personal, inter-personal, and environmental factors as well as policy [8]. Personal factors include demographic and biological factors, psychological, cognitive and emotional factors, behavioral factors, and social and cultural factors [9]. Environment factors include the facility, neighborhood, safety, home environment, location of region, and climate [10].

Although there has been one meta-analysis of associations between environmental factors and physical activity [11], most factors related to physical activity have been summarized by systematic reviews rather than by meta-analysis because of an insufficient number of primary studies on each factor and distinct analytical methods. In a study by Bauman, the authors conducted a review of reviews which is a capable method of summarizing previous evidence from systematic reviews, with or without synthesis [12, 13]. They reviewed variables as determinants of physical activity in children or adolescent among adults to investigate those factors throughout their life span; however, the variables studied in adults, but not in children or adolescents, were not reviewed [14].

The primary purpose of this study was to summarize and present updated evidence for personal and environmental factors potentially associated with participation in physical activity overall or by the domains of physical activity.

Methods

Search strategy and eligibility criteria

To identify systematic reviews, MEDLINE and EMBASE were searched for quantitative, peer-reviewed studies published up to 31 Jan. 2017 reporting on potential correlates, predictors or determinants of any type of physical activity in adults aged over 18 years (Fig. 1). Search terms indicative of physical activity were used in combination with correlates or determinants. For the adaption of search strategies, specific filters were used from the databases including study design, publication year, language, and age. In MEDLINE, medical subject headings (MeSH) such as ‘motor activity’ and ‘epidemiologic factors’ were also used in the search strategy.
Fig. 1

Flow chart of inclusion and exclusion criteria for previous reviews. 1Medical subject headings (MeSH) such as ‘Motor Activity’ and ‘Epidemiologic Factors’ were also used in the search strategy

After the removal of reviews that were duplicates in both literature databases or published in a non-English language or that targeted adolescents, the additional following reviews were excluded: 1) reviews of animal studies, 2) reviews of qualitative studies, 3) reviews of studies using other dependent variables rather than physical activity, 4) reviews that focused on participants with a specific status such as cancer, pregnancy, and alcohol use disorder, and 5) studies which did not provide either a list or significant level of previous primary studies because that information was used in the classification of the variables. Reference lists of the included reviews and primary studies in each review were checked to identify any unrevealed studies.

Rating the methodological quality

To assess the quality of each included review, the 11-item Assessment of Multiple Systematic Review (AMSTAR) checklist was used for the assessment [15]. The measure satisfies inter-observer agreement, reliability, construct validity and feasibility. The quality score ranges from 0 (lowest quality) to 11 (highest quality). In the current study, a review with a 0–2 AMSTAR score was considered as having a low quality, 3–6 as having a moderate quality and 7–11 as having a high quality. The checklist of the AMSTAR score is provided in Additional file 1: Table S1.

Data extraction

The following characteristics were extracted from the included reviews: report type (e.g., systematic review or meta-analysis), publication year, age of population, number of quantitative studies, outcomes, and proportion of longitudinal studies, and measurement method of physical activity and environmental factors. The domains of physical activity were collected as the outcome if the results of the primary studies included in each review were identifiable by the domains of physical activity.

Classification of variables

Variables from each review were classified according to the number of primary studies supporting the association or no association and the percentage of expected association among the total number of primary studies (Additional file 1: Table S2) [14]: not a correlate (NC) or not a determinant (ND), inconclusive (IC), a correlate (Cor) or determinant (Det). When more than 50% of the primary studies supporting an association or no association were derived from a longitudinal design, the variables were coded as a determinant rather than a correlate. If the factors were classified as a ‘correlate’ or a ‘determinant’, it was regarded as a definitely associated factor (DAF).

Corrected Covered Area (CCA)

Because some primary studies were included in more than one review, the summarized results from each review can be biased by those overlaps. To assess this bias, the degree of overlap between reviews was calculated with the Corrected Covered Area (CCA) method. The details of the CCA calculation have been described elsewhere [16]. Briefly, the CCA was calculated with the following equation showing how the primary studies in each review are duplicated:
$$ \mathrm{Corrected}\ \mathrm{Covered}\ \mathrm{Area}\kern0.5em \left(\mathrm{CCA}\right)=\frac{N- r}{rc- r} $$
where N is the sum of the number of primary studies in each review, r is the total number of primary studies, and c is the number of reviews. This measure has been validated in which the number of overlapped primary publications has a strong correlation with the CCA. A CCA score of less than 5% is regarded as a slight overlap, 5–9.9% as moderate overlap, 10–14.9% as high overlap and over 15% as a very high level of overlap [16]. The CCA was estimated for overall personal and environmental factors as well as for the factors classified as DAFs in more than 3 reviews. A study by Duncan et al. [11] was excluded in the CCA calculation because the list of included primary studies was not available.

Results

A total of 25 reviews with 980 primary studies met the inclusion criteria [911, 1738]. Among those reviews, there were 13 reviews with personal factors [9, 10, 17, 19, 22, 23, 26, 28, 3234, 36, 38] and 19 reviews with environmental factors [911, 1821, 24, 25, 2731, 33, 3538], respectively (Table 1). The number of primary studies for personal factors included in each review ranged from 11 to 91, and the number of primary studies for environmental factors ranged from 3 to 70. Four reviews included only primary studies conducted with a longitudinal design [28, 33, 36, 38]. Thus, the results derived from those reviews were regarded as a determinant rather than as a correlate. Reviews published before 1999 were not considered in the present study because a study by Trost et al. [9] had included and updated the results of those reviews [3942].
Table 1

Characteristics of previous reviews of personal and environmental factors on participation in physical activity

Author

Year

Population age

Publication period of studies

No. of quantitative studies

Outcomes

Proportion of longitudinal studies

No. of assessed factors

Ref

Reviews of personal factors

 Rhodes

1999

≥65

~1999

41

Leisure

14 (34%)

23

[17]

 Eyler

2002

≥18 women

1980–2000

81

Overall, leisure, household, transport

0

32

[10]

 Trost

2002

≥18

1998–2000

36

Overall

7 (18%)

48

[9]

 Plonczynski

2003

≥65 women

1994–2001

15

Overall

1 (6%)

16

[19]

 Rhodes

2006

≥18

1969–2006

33

Overall

16 (50%)

6

[23]

 Kaewthummanukul

2006

NA

1990–2002

11

Overall

0

22

[22]

 Allender

2008

NA

1977–2007

19

Overall

9 (47%)

5

[26]

 VanStralen

2009

≥40

1900–2008

54

Overall

54 (100%)

36

[28]

 Kirk

2011

18–64

1974–2010

62

Leisure

11 (18%)

6

[32]

 Koeneman

2011

≥55

1990–2010

34

Overall, leisure

34 (100%)

31

[33]

 Engberg

2012

17–70

1992–2012

34

Leisure

27 (79%)

5

[34]

 Rhodes

2015

18–64

2012–2014

78

Overall

75 (100%)

20

[36]

 Prince

2016

18–65 women

~2014

91

Overall

91 (100%)

29

[38]

Reviews of environmental factors

 Eyler

2002

≥18

1980–2000

15

Overall, leisure, household

0

13

[10]

 Trost

2002

≥18

1998–2000

8

Overall

0

14

[9]

 Humpel

2002

Adults

NR

19

Overall

1 (5%)

14

[18]

 Plonczynski

2003

≥65 women

1994–2001

5

Overall

0

6

[19]

 Cunningham

2004

Adults

1966–2002

27

Overall, leisure, walking,

0

13

[20]

 Owen

2004

Adults

~2004

18

Walking

2 (11%)

14

[21]

 Duncana

2005

NA

1989-2005

16

Overall

0 (0%)

6

[11]

 Tucker

2007

NA

1980–2006

6

Overall

0

2

[24]

 Wendel-Vos

2007

≥18

1980–2004

47

Overall

3 (6%)

20

[25]

 Saelens

2008

Adults

2005–2006

29

Walking

0

8

[27]

 Van Stralen

2009

≥40

1900–2008

13

Overall

13 (100%)

12

[28]

 Panter

2010

18–65

1990–2009

43

Transport

0

4

[29]

 Koeneman

2011

≥55

1990–2010

3

Leisure, overall

3 (100%)

4

[33]

 McCormack

2011

≥18

1996–2010

31

Overall, leisure, walking/cycling, transport

2 (6%)

10

[30]

 Van Cauwenberg

2011

Mean > 65

2000–2010

31

Overall, leisure, walking/cycling, transport

3 (10%)

10

[31]

 Van Holle

2012

18–65

2000–2011

70

Overall, leisure, walking/cycling, transport

1 (0%)

11

[35]

 Rhodes

2015

18–64

2012–2014

12

Overall

12 (100%)

2

[36]

 Day

2016

NA

~2014

42

Overall, leisure, transport, occupation

0

12

[37]

 Prince

2016

18–65 women

~2014

9

Overall

9 (100%)

6

[38]

aMeta-analysis

The quality assessment scores are presented in Additional file 1: Table S1. The AMSTAR score for each review ranged from 2 to 8. Most of the reviews (21 out of 25) were rated as having a moderate quality. Information on study design (checklist 1), literature search strategy (checklist 3) and list of included studies (checklist 5) were provided in most studies. However, information on the status of the publication as an inclusion criterion (checklist 4), the combining methods (checklist 9), publication bias assessment (checklist 10) and conflict of interest of the included studies (checklist 11) were rarely provided.

Correlates of physical activity overall

A total of 117 factors were reported in the previous reviews. The definitions of each factor are shown in Additional file 1: Table S3 in alphabetical order.

Table 2 lists the relationships between personal factors and physical activity overall. There were 90 personal factors consisting of 24 demographic/biological factors, 40 psychological factors, 13 behavioral factors, and 13 social factors. Among the 90 personal factors, 53 factors were considered as DAFs in more than one of the reviews. For demographic and biological factors, age, gender, ethnicity, marital status, education, income, and employment were assessed in more than half of the reviews (7 out of 13). Among those, age was regarded as a negative DAF in 3 reviews. Bad health or fitness status was assessed in 5 reviews and classified as a negative DAF in 3 reviews. For psychological factors, cognitive and emotional factors, attitude, intention to exercise, outcome expectations, self-efficacy, and stress were assessed in more than half of the reviews. Intention to exercise, outcome expectations, perceived behavioral control, self-efficacy and perceived good fitness were assessed as positive DAFs in more than 3 reviews. Self-efficacy classified as a DAF in 7 reviews had the strongest association with participation in physical activity in this review of reviews. For behavioral factors, smoking was assessed in 7 reviews, which was not determined as a DAF in any of the reviews. For social and cultural factors, there were no variables evaluated in more than half of the reviews.
Table 2

Relationships between personal factors and physical activity

 

Rhodes (1999) [17]

Eyler (2002) [10]

Trost (2002)a [9]

Plonczynski (2003) [19]

Rhodes (2006) [23]

Kaewthummanukul (2006) [22]

Allender (2008) [26]

Van Stralen (2009) [28]

Kirk (2011) [32]

Koeneman (2011) [33]

Engberg (2012) [34]

Rhodes (2015) [36]

Prince (2016) [38]

No. of DAF/total No.b

Demographic and biological factors

 Age

Cor (−)

IC

Cor (−)

IC

-

Cor (−)

-

ND

-

ND

-

ND

-

3/8

 Gender, men

Cor (+)

-

Cor (+)

-

-

IC

-

ND

IC

IC

-

ND

-

2/7

 Ethnicity, white

-

Cor (+)

Cor (+)

IC

-

IC

-

ND

-

ND

-

IC

-

2/7

 Marital status, married

-

IC

IC

IC

-

IC

IC

ND

-

-

Det (−)

ND

ND

1/9

 Education, higher

IC

Cor (+)

Cor (+)

-

-

IC

-

ND

-

-

-

ND

IC

2/7

 Income, higher

IC

NC

Cor (+)

Cor (+)

-

IC

-

ND

-

-

-

IC

IC

2/8

 Occupation, blue color

-

IC

IC

-

-

Cor (−)

-

-

Cor (−)

-

-

-

-

2/4

 Employment

-

IC

-

-

-

-

Cor (−)

IC

-

IC

IC

ND

IC

1/7

 Total work hours

-

-

-

-

-

IC

-

-

Cor (−)

-

-

-

IC

1/3

 Overtime work hours

-

-

-

-

-

-

-

-

Cor (−)

-

-

-

-

1/1

 Fixed day time work

-

-

-

-

-

-

-

-

-

-

-

-

IC

0/1

 Shift work

-

-

-

-

-

-

-

-

-

-

-

-

IC

0/1

 Multiple job

-

-

-

-

-

-

-

-

-

-

-

-

IC

0/1

 Full time employment

-

-

-

-

-

-

-

-

IC

-

-

-

-

0/1

 Retirement

-

-

-

-

-

-

-

-

-

IC

Det (−)

-

-

1/2

 Trajectory of employment, downward

-

-

-

-

-

-

-

-

-

-

-

-

IC

0/1

 Transition to university

-

-

-

-

-

-

-

-

-

-

Cor (−)

-

-

1/1

 Pregnancy

-

-

-

-

-

-

IC

-

-

-

Det (−)

-

-

1/2

 Health or fitness status, bad

Cor (−)

Cor (−)

-

-

-

IC

-

Det (−)

-

IC

-

-

-

3/5

 Chronic diseases, hypertension, CVD, cancer, and diabetes

-

IC

IC

-

-

-

IC

-

-

IC

-

-

-

0/4

 Injury history

-

IC

IC

-

-

-

-

-

-

-

-

-

-

0/2

 Childhood illness/disability

-

-

-

-

-

-

IC

-

-

-

-

-

-

0/1

 Functional limitation, disability

-

IC

-

-

-

-

-

IC

-

-

-

-

-

0/2

 Genetic factor

-

-

Cor (+)

-

-

-

-

-

-

-

-

-

-

1/1

Psychological, cognitive and emotional factors

 Attitude

Cor (+)

-

ND

-

-

IC

-

IC

-

IC

-

IC

IC

1/7

 Control over exercise

Cor (+)

-

IC

-

-

Cor (+)

-

-

-

-

-

-

-

2/3

 Intention to exercise

Cor (+)

-

Cor (+)

-

-

IC

-

Det (+)

-

IC

-

IC

Det (+)

4/7

 Outcome expectations (expect benefit)

Cor (+)

Cor (+)

Cor (+)

-

-

IC

-

IC

-

IC

-

IC

-

3/7

 Value of exercise outcomes

-

-

IC

-

-

-

-

-

-

-

-

-

-

0/1

 Physical outcome realization

-

-

-

-

-

-

-

Det (+)

-

IC

-

-

-

1/2

 Psychological outcome realization

-

-

-

-

-

-

-

Det (+)

-

-

-

-

-

1/1

 Health locus of control

IC

-

-

-

-

-

-

IC

-

IC

-

-

-

0/3

 Action planning

-

-

-

-

-

-

-

Det (+)

-

-

-

-

-

1/1

 Perceived behavioral control

Cor (+)

-

IC

-

-

Cor (+)

-

-

-

IC

-

IC

Det (+)

3/6

 Self-efficacy

Cor (+)

Cor (+)

Cor (+)

Cor (+)

-

Cor (+)

-

Det (+)

-

IC

-

IC

Det (+)

7/9

 Self-motivation

-

Cor (−)

Cor (+)

-

-

-

-

IC

-

IC

-

-

IC

2/5

 Self-schemata for exercise

-

-

Cor (+)

-

-

-

-

-

-

-

-

-

-

1/1

 Enjoyment of exercise

IC

IC

Cor (+)

IC

-

-

-

IC

-

-

-

-

-

1/5

 Stage of change

IC

-

Cor (+)

-

-

IC

-

Det (+)

-

IC

-

-

-

2/5

 Process of psychological change

-

-

Cor (+)

-

-

-

-

-

-

-

-

IC

-

1/2

 Knowledge of health and exercise

Cor (+)

Cor (+)

NC

-

-

-

-

IC

-

-

-

IC

IC

2/6

 Normative beliefs

-

-

NC

-

-

-

-

-

-

IC

-

-

ND

0/3

 Body image

-

-

-

-

-

-

-

-

-

IC

-

-

-

0/1

 Psychological health

IC

-

IC

Cor (+)

-

-

-

ND

-

-

-

-

-

1/4

 Stress

-

Cor (−)

IC

IC

-

IC

-

Det (−)

-

IC

-

-

ND

2/7

 High job strain

-

-

-

-

-

-

-

-

Cor (−)

-

-

-

-

1/1

 Barrier to exercise

Cor (−)

-

Cor (−)

-

-

IC

-

IC

-

IC

-

-

IC

2/6

 Perceived fitness, good

-

Cor (+)

Cor (+)

Cor (+)

-

-

-

-

-

-

-

-

Det (+)

4/4

 Quality of life, good

-

-

-

-

-

-

-

-

-

-

-

-

IC

0/1

 Lack of time

-

Cor (−)

Cor (−)

-

-

-

-

-

-

-

-

-

-

2/2

 Susceptibility to illness/seriousness of illness

-

-

NC

-

-

-

-

-

-

-

-

-

-

0/1

 Fear of symptoms

-

Cor (−)

-

Cor (−)

-

-

-

-

-

-

-

-

-

2/2

 Mood disturbance

-

-

Cor (−)

-

-

-

-

-

-

-

-

-

-

1/1

 Depression

-

-

-

-

-

-

-

IC

-

IC

-

-

IC

0/3

 Fatigue

-

Cor (−)

-

-

-

-

-

-

-

-

-

-

IC

1/2

 Anxiety

-

-

-

-

-

-

-

-

-

-

-

-

IC

0/1

 John Henryism

-

IC

-

-

-

-

-

-

-

-

-

-

-

0/1

 Personality variables

-

-

IC

-

-

-

-

-

-

-

-

-

-

0/1

 Extraversion

-

-

-

-

Cor (+)

-

-

-

-

-

-

-

-

1/1

 Openness to experience

-

-

-

-

NC

-

-

-

-

-

-

-

-

0/1

 Agreeableness

-

-

-

-

NC

-

-

-

-

-

-

-

-

0/1

 Neuroticism

-

-

-

-

Cor (−)

-

-

-

-

-

-

IC

-

1/2

 Conscientiousness

-

-

-

-

Cor (+)

-

-

-

-

-

-

-

-

1/1

 Psychoticism

-

-

-

-

NC

-

-

-

-

-

-

-

-

0/1

Behavioral factors

 Dietary habits

-

IC

Cor (+)

IC

-

IC

-

-

-

-

-

-

-

1/4

 Overweight/obesity

-

IC

Cor (−)

-

-

IC

-

ND

-

IC

-

-

-

1/5

 Alcohol

-

IC

IC

-

-

-

-

IC

-

-

-

ND

-

0/4

 Smoking

-

NC

IC

IC

-

IC

-

IC

-

IC

-

ND

-

0/7

 Activity during adulthood

IC

-

Cor (+)

-

-

-

-

Det (+)

-

IC

-

-

-

2/4

 Activity during childhood

IC

-

IC

-

-

-

-

-

-

IC

-

-

-

0/3

 Past exercise program

-

IC

Cor (+)

-

-

-

-

-

-

-

-

-

-

1/2

 Processes of behavioral change

-

-

Cor (+)

-

-

-

-

-

-

-

-

IC

-

1/2

 School sports

-

-

IC

-

-

-

-

-

-

-

-

-

-

0/1

 Type A behavior pattern

-

IC

IC

-

-

-

-

-

-

-

-

-

-

0/2

 Decisional balance sheet

-

-

IC

-

-

-

-

-

-

-

-

-

-

0/1

 Screening

-

IC

-

-

-

-

-

-

-

-

-

-

-

0/1

 Physical activity intensity

-

-

IC

-

-

-

-

IC

-

-

-

-

-

0/2

Social and cultural factors

 Social support for exercise

-

-

-

Cor (+)

-

-

-

IC

-

IC

-

IC

-

1/4

 Social support for exercise from friends/peers

Cor (+)

-

Cor (+)

IC

-

-

-

IC

-

IC

-

-

-

2/5

 Social support for exercise from spouse/family

IC

-

Cor (+)

IC

-

-

-

-

-

IC

-

-

-

1/4

 Social support from staff/instructor

-

-

-

-

-

-

-

IC

-

IC

-

-

-

0/2

 Physician influence

IC

Cor (+)

Cor (+)

IC

-

-

-

IC

-

IC

-

-

-

2/6

 Spousal physical activity habits

-

-

-

-

-

-

-

-

-

-

-

-

IC

0/1

 Work-family conflict

-

-

-

-

-

-

-

-

-

-

-

-

IC

0/1

 Social support

NC

Cor (+)

-

-

-

IC

-

IC

-

-

-

-

-

1/4

 Group cohesion

-

-

-

-

-

-

-

IC

-

IC

-

-

IC

0/3

 Social isolation

-

-

IC

-

-

-

-

-

-

-

-

IC

-

0/2

 Neighborhood deprivation

-

-

-

-

-

-

-

-

-

-

-

-

IC

0/1

 Caregiver to ill family member

-

-

-

-

-

-

-

-

-

-

-

-

IC

0/1

 Change in family structure: having child

-

Cor (−)

-

-

-

-

-

-

-

-

-

-

Det (−)

2/2

Abbreviations: NC not a correlate, ND not a determinant, Cor a correlate, Det a determinant, IC inconclusive, DAF definitely associated factor

aIncluding results of following reviews: “Dishman et al. [39]”, “Dishman et al. [40]”,"Dishman et al. [41]” “Sallis and Owen. 1999”

bNumber of reviews regarding the factor as definitely associated factor / total number of reviews assessing the factor

Table 3 lists the relationships between environmental factors and physical activity overall. There were 27 environment factors consisting of 4 facility factors, 8 neighborhood factors, 6 safety factors, 3 home environment factors, 3 location of region factors, and 3 climate factors. Among the 27 environmental factors, ten factors were considered as DAFs in more than one of the reviews. For facility factors, accessibility was assessed in more than half of the reviews (10 out of 19) and classified as a positive DAF in 5 reviews. For neighborhood factors, the presence of sidewalks and aesthetics were evaluated in 14 reviews and regarded as positive DAFs in more than three reviews. For safety factors, high crime rates in the region and heavy traffic were only determined as DAFs in less than three reviews although they were summarized in more than half of the reviews. There were no factors which were assessed in more than half of the reviews (10 out of 19) for home environment, location of region, and climate factors.
Table 3

Relationships between environmental factors and physical activity

 

Eyler (2002) [10]

Trost (2002) a[9]

Humpel (2002) [18]

Plonczynski (2003) [19]

Cunningham (2004) [20]

Owen (2004) [21]

Duncan (2005) [11]

Tucker (2007) [24]

Wendel-vos (2007) [25]

Saelens (2008) [27]

Van Stralen (2009) [28]

Panter (2010) [29]

Koeneman (2011) [33]

McCormack (2011) [30]

Van Cauwenberg (2011) [31]

Van Holle (2012) [35]

Rhode (2015) [36]

Day (2016) [37]

Prince (2016) [38]

No. of DAF/ total No.b

Facility

 Accessibility

-

IC

Cor (+)

-

IC

Cor (+)

Cor (+)

-

Cor (+)

IC

IC

-

IC

IC

IC

IC

ND

Cor (+)

IC

5/15

 Convenience of facilities

IC

-

IC

-

IC

Cor (+)

-

-

IC

-

-

-

-

-

-

-

-

-

ND

1/6

 Satisfaction with facilities

-

IC

IC

-

-

-

-

-

-

-

-

-

IC

-

-

-

-

-

-

0/3

 Cost of programs

-

IC

-

-

-

-

-

-

IC

-

-

-

-

-

-

-

-

-

-

0/2

Neighborhood

 Presence of sidewalks

IC

IC

Cor (+)

IC

IC

IC

Cor (+)

-

NC

IC

IC

IC

-

IC

IC

-

-

Cor (+)

-

3/14

 Aesthetics

IC

IC

Cor (+)

-

Cor (+)

Cor (+)

-

-

IC

IC

IC

IC

-

IC

NC

Cor (+)

ND

IC

-

4/14

 Transportation

-

-

-

-

IC

-

-

-

IC

-

-

-

-

IC

-

-

-

-

-

0/3

 Sprawl

-

-

IC

-

IC

IC

-

-

IC

-

-

-

-

IC

-

-

-

-

-

0/5

 Population density

-

-

-

-

-

-

-

-

-

IC

-

-

-

IC

IC

IC

-

IC

-

0/5

 Network connectivity

-

-

-

-

-

-

-

-

-

IC

IC

-

-

IC

IC

IC

-

IC

IC

0/7

 Land-use mix

-

-

-

-

-

-

-

-

IC

Cor (+)

IC

-

-

NC

IC

IC

-

Cor (+)

-

2/7

 Quality of environment

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

IC

-

-

-

0/1

Safety

 High crime rates in the region

IC

IC

IC

-

NC

IC

Cor (+)

-

IC

IC

IC

-

-

-

IC

IC

-

IC

IC

1/13

 Heavy traffic

IC

IC

IC

-

NC

IC

Cor (+)

-

IC

IC

IC

IC

-

IC

IC

IC

-

IC

-

1/14

 Frequently observe others exercising

IC

IC

-

-

-

-

-

-

IC

-

-

-

-

-

-

-

-

-

-

0/3

 Neighborhood safety

Cor (−)

IC

IC

IC

IC

-

-

-

-

-

IC

-

IC

-

IC

IC

-

-

-

1/9

 Adequate lighting

IC

IC

IC

-

IC

IC

IC

-

IC

-

IC

-

-

IC

-

-

-

-

-

0/9

 Unattended dogs

IC

IC

IC

-

IC

IC

IC

-

IC

-

IC

-

-

-

-

-

-

IC

-

0/9

Home environment

 Home equipment

-

IC

IC

-

-

IC

-

-

IC

-

IC

-

-

-

-

-

-

-

-

0/5

 Home age

-

-

-

IC

IC

IC

-

-

IC

-

-

-

-

-

-

-

-

-

-

0/4

 Stair in the home

-

-

-

IC

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

0/1

Location of region

 Hilly terrain

IC

IC

IC

-

IC

IC

-

-

IC

-

IC

-

-

-

-

IC

-

-

-

0/8

 Coastal location

-

-

-

-

-

IC

-

-

IC

-

-

IC

-

-

-

-

-

-

-

0/3

 Urban location

IC

IC

-

IC

-

-

-

-

IC

-

-

-

-

-

IC

IC

-

Cor (−)

IC

1/8

Climate

 Bad weather

IC

-

IC

IC

-

IC

-

IC

NC

-

-

-

IC

-

-

-

-

IC

-

0/8

 Pollution

-

-

-

-

-

-

-

-

IC

-

-

-

-

-

-

-

-

IC

-

0/2

 Season, summer

IC

-

-

-

-

-

-

Cor (+)

-

-

-

-

-

-

-

-

-

-

IC

1/3

Abbreviations: NC not a correlate, ND not a determinant, Cor a correlate, Det a determinant, IC inconclusive, DAF definitely associated factor

aIncluding results of following reviews: “Dishman et al. [39]”, “Dishman et al. [40]”,"Dishman et al. [41]” “Sallis and Owen. 1999”

bNumber of reviews regarding the factor as definitely associated factor / total number of reviews assessing the factor

Correlates of physical activity by the domains of the physical activity

The results by the domains of physical activity are summarized in Additional file 1: Tables S4 ~ S7. For personal factors, the factors for leisure-time physical activity were summarized (Additional file 1: Table S4). Of the 46 personal factors, twenty-two factors were considered as DAFs in one of the reviews. There were no personal factors considered more than twice as a DAF. For environmental factors, factors were summarized in leisure time physical activity, walking/cycling, and transportation, respectively (Additional file 1: Table S5 ~ S7). There were 6 factors regarded as DAFs in more than one of the reviews. Accessibility was considered as a DAF in all three domains. Population density and high crime rate in the region were considered as DAFs only in the leisure-time physical activity domain (Additional file 1: Table S5). Land-use mix and urban location were classified as DAFs in transportation (Additional file 1: Table S6) and walking/cycling (Additional file 1: Table S7). Aesthetics was considered once as a DAF only in the walking/cycling domain (Additional file 1: Table S7). The results for the occupation and household domain could be not summarized for both personal and environmental factors because there was only one or no reviews for those domains.

Other issues for correlates of physical activity

When summarizing the review of studies conducted in older subjects, no differences were found when compared with the results for all adults. There were 13 personal factors which were classified as DAFs in at least one of two reviews that only focused on factors of older adults (> 65 years) (See the results of Rhode et al. [17] and Plonczynski et al. [19] in Table 2). There were no environmental factors considered as DAFs for older adults.

The results of objectively measured physical activity could be not summarized in this review of reviews because most of the reviews included less than four primary studies using objectively measured physical activity or did not provide information on the measurement of physical activity in the primary studies. In the results of objectively measured environmental factors, the following 5 factors were considered as DAFs in more than one of the reviews from among 17 factors: accessibility, population density, land-use mix, urban location, and high crime rate in the region (Additional file 1: Table S8).

Corrected Covered Area (CCA)

Additional file 1: Table S9 presents the CCA for each factor. The primary studies had a slight overlap across 13 (CCA: 2.0%) and 18 reviews (CCA: 1.6%) for personal and environmental factors, respectively. In addition, all the CCAs for the factors classified as DAFs in more than 3 reviews were less than 5%.

Discussion

This review of reviews summarized the results of 25 previous reviews that reported on the potential factors of participation in physical activity all of which showed mostly a moderate methodological quality. Several personal factors including age, health or fitness status, intention to exercise, outcome expectations, perceived behavioral control, self-efficacy, and perceived fitness and several environmental factors including accessibility, presence of sidewalks, and aesthetics were assessed as DAFs in more than three studies.

This study is the first updated review of reviews on factors for physical activity after the study by Bauman in 2012 [13]. Four reviews for personal factors [10, 34, 36, 38] and ten reviews for environmental factors [9, 10, 19, 24, 30, 33, 3538] were added in the present study after the previous review of reviews [13]. Most factors presented as correlates in the study by Bauman were considered as DAFs in the present study including personal history of physical activity during adulthood which was classified as a DAF in two reviews. Fifty-four factors were additionally summarized which were not evaluated in the review by Bauman. Among them, transition to university, pregnancy, past exercise program, processes of behavioral change, change in family structure, presence of sidewalks, and season were classified as DAFs at least once. A summary of previous reviews by the domains of physical activity and by measures of environmental factors was added.

For personal factors, self-efficacy was consistently evaluated as the clearest correlate in the present study consistent with the previous review of reviews [13]. According to Bandura’s Social Cognitive Theory, self-efficacy functions both directly and indirectly with outcome expectations and other constructs [43] and has a role as a mediating factor of social support in health behavior [44, 45].

For environmental factors, this study summarized the factors by the domains of physical activity, and the results of some factors such as accessibility were consistent overall and by the domains of physical activity. However, it can be concluded that it is too early to summarize the results of the review because there were a limited number of primary studies for each factor.

Although there were a number of factors whose effects on physical activity were assessed, we could not perform a meta-analysis because of the lack of primary studies for each factor, different analytical measures, and the presence of unclearly distinguished factors when compared with each other. For example, some psychological factors had similar definitions such as attitude and outcome expectation. There were many factors classified as a group such as employment-related factors including occupation type, employment status, total work hours, overtime work hour, fixed day time work, shift work, multiple job, and full time employment and social support-related factors including social support for exercise overall and from friends/peers, spouse/family, and staff/instructor and those factors were listed in their originally written form from each review to convey the most accurate meaning of each factor rather than conducting a meta-analysis.

Instead of a meta-analysis, the present study conducted a review of reviews. Although a review of reviews can only show the tendency or direction of an association rather than providing the magnitude or significance level of an association [46], the current evidence on participation in physical activity was comprehensively summarized. When using the review of reviews, there were some challenges. First, the quality of the review of reviews was greatly affected by the quality of the original reviews [47]. In this study, we confirmed that the quality of the original reviews were mostly moderate or higher by assessing the AMSTAR score. Second, if the primary studies were included in several reviews, they may produce bias related to overlapping effects [47]. By calculating the CCA, we showed that the primary studies included in each review were only slightly overlapped and proved that the results from each review were relatively independent.

The present study has limitations. First, a study by Duncan [11] was not included in the calculation of the CCA because it did not provide a list of the included primary studies. However, the effect of not including these primary studies is expected to be slight because there were only 16 primary studies in the study by Duncan. Second, the results of intervention and observational studies could not be separately summarized because the results were not presented separately for each design in most reviews. Further studies should summarize the effects of potential factors on physical activity by the design of the study. Third, policy-related variables were not considered in the present study because policies were rarely considered in previous reviews. Although the effects of policy-related factors were overlapped with the effects of environmental factors such as the presence of sidewalks, the effects of policies on participation in physical activity should be investigated in a future study. Fourth, the interaction effect between different types of factors such as age and presence of sidewalks could not be assessed because the previous reviews were only focused on the individual effect of each factor. Like the interaction effect, the moderating effect of individual factors such as gender and age could not be evaluated also because there were no reviews on this issue. Future research should be conducted to identify the interaction or moderating effect of each factor.

Conclusion

In conclusion, the present study summarized the associations of potential factors with physical activity which could provide directions for improving participation in physical activity. More studies with a longitudinal design are needed to validate the associations of many factors. If more correlates are established with an accurate method, those factors can be used to form public policies and programs that will encourage the public to participate in physical activity and ultimately improve the public health.

Abbreviations

AMSTAR: 

assessing the methodological quality of systematic reviews

CCA: 

corrected covered area

Cor: 

correlate

DAF: 

definitely associated factor

Det: 

determinant

IC: 

inconclusive

MeSH: 

medical subject heading

NC: 

not correlate

ND: 

not determinant

Declarations

Acknowledgement

This study was supported by a grant from Seoul National University Hospital (2016) and Korea Centers for Disease Control and Prevention (2004-E71004-00, 2005-E71011-00, 2005-E71009-00, 2006-E71001-00, 2006-E71004-00, 2006-E71010-00, 2006-E71003-00, 2007-E71004-00, 2007-E71006-00, 2008-E71006-00, 2008-E71008-00, 2009-E71009-00, 2010-E71006-00, 2011-E71006-00, 2012-E71001-00, and 2013-E71009-00).

Funding

This study was supported by a grant from Seoul National University Hospital (2016) and Korea Centers for Disease Control and Prevention (2004-E71004–00, 2005-E71011–00, 2005-E71009–00, 2006-E71001–00, 2006-E71004–00, 2006-E71010–00, 2006-E71003–00, 2007-E71004–00, 2007-E71006–00, 2008-E71006–00, 2008-E71008–00, 2009-E71009–00, 2010-E71006–00, 2011-E71006–00, 2012-E71001–00, and 2013-E71009–00).

Authors’ contributions

JC conducted the literature searches, the selection of reviews, the data extraction, the quality rating and the data analysis, and drafted the manuscript. ML, JKL and DK were involved in the study as advisors and were also involved in commenting on the manuscript. JYC conducted the literature searches, the selection of reviews, the data extraction, the quality rating and the data analysis, and drafted the manuscript. All authors read and approved the final draft.

Competing interests

The authors declare that they have no competing interests.

Consent for publication

Not Applicable.

Ethics approval and consent to participate

Not Applicable.

Publisher’s Note

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Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Authors’ Affiliations

(1)
Department of Biomedical Sciences, Seoul National University Graduate School
(2)
College of Physical Education and Sport Science, Kookmin University
(3)
JW Lee Center for Global Medicine, Seoul National University College of Medicine
(4)
Department of Family Medicine, Seoul National University College of Medicine
(5)
Institute of Environmental Medicine, Seoul National University Medical Research Center
(6)
Department of Preventive Medicine, Seoul National University College of Medicine
(7)
Cancer Research Institute, Seoul National University

References

  1. Berlin JA, Colditz GA. A meta-analysis of physical activity in the prevention of coronary heart disease. Am J Epidemiol. 1990;132(4):612–28.View ArticlePubMedGoogle Scholar
  2. Thune I, Brenn T, Lund E, Gaard M. Physical activity and the risk of breast cancer. N Engl J Med. 1997;336(18):1269–75.View ArticlePubMedGoogle Scholar
  3. Michaud DS, Giovannucci E, Willett WC, Colditz GA, Stampfer MJ, Fuchs CS. Physical activity, obesity, height, and the risk of pancreatic cancer. JAMA. 2001;286(8):921–9.View ArticlePubMedGoogle Scholar
  4. Warburton DE, Nicol CW, Bredin SS. Health benefits of physical activity: the evidence. CMAJ. 2006, 174(6):801–809.Google Scholar
  5. Organization WH: Global recommendations on physical activity for health. 2010.Google Scholar
  6. Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet (London, England). 2012, 380(9838):219–229.Google Scholar
  7. Hallal PC, Andersen LB, Bull FC, Guthold R, Haskell W, Ekelund U. Global physical activity levels: surveillance progress, pitfalls, and prospects. Lancet (London, England). 2012, 380(9838):247–257.Google Scholar
  8. Sallis JF, Owen N. Ecological models of health behavior. Health Behav: Theory Res practice. 2015;5:43–64.Google Scholar
  9. Trost SG, Owen N, Bauman AE, Sallis JF, Brown W. Correlates of adults' participation in physical activity: review and update. Med Sci Sports Exerc. 2002;34(12):1996–2001.View ArticlePubMedGoogle Scholar
  10. Eyler AE, Wilcox S, Matson-Koffman D, Evenson KR, Sanderson B, Thompson J, Wilbur J, Rohm-Young D. Correlates of physical activity among women from diverse racial/ethnic groups. J Women's Health Gender-Based Med. 2002;11(3):239–53.View ArticleGoogle Scholar
  11. Duncan MJ, Spence JC, Mummery WK. Perceived environment and physical activity: a meta-analysis of selected environmental characteristics. Int J Behav Nutr Phys Act. 2005;2Google Scholar
  12. Baker PR, Costello JT, Dobbins M, Waters EB. The benefits and challenges of conducting an overview of systematic reviews in public health: a focus on physical activity. J Public Health. 2014;36(3):517–21.Google Scholar
  13. Bauman AE, Reis RS, Sallis JF, Wells JC, Loos RJ, Martin BW. Correlates of physical activity: why are some people physically active and others not? Lancet (London, England). 2012, 380(9838):258–271.Google Scholar
  14. Sallis JF, Prochaska JJ, Taylor WC. A review of correlates of physical activity of children and adolescents. Med Sci Sports Exerc. 2000;32(5):963–75.View ArticlePubMedGoogle Scholar
  15. Shea BJ, Grimshaw JM, Wells GA, Boers M, Andersson N, Hamel C, Porter AC, Tugwell P, Moher D, Bouter LM. Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews. BMC Med Res Methodol. 2007;7:10.View ArticlePubMed CentralPubMedGoogle Scholar
  16. Pieper D, Antoine SL, Mathes T, Neugebauer EA, Eikermann M. Systematic review finds overlapping reviews were not mentioned in every other overview. J Clin Epidemiol. 2014;67(4):368–75.View ArticlePubMedGoogle Scholar
  17. Rhodes RE, Martin AD, Taunton JE, Rhodes EC, Donnelly M, Elliot J. Factors associated with exercise adherence among older adults. An individual perspective. Sports Med. 1999;28(6):397–411.View ArticlePubMedGoogle Scholar
  18. Humpel N, Owen N, Leslie E. Environmental factors associated with adults' participation in physical activity: a review. Am J Prev Med. 2002;22(3):188–99.View ArticlePubMedGoogle Scholar
  19. Plonczynski DJ. Physical activity determinants of older women: what influences activity? Medsurg Nurs. 2003;12(4):213–21. 259; quiz 222PubMedGoogle Scholar
  20. Cunningham GO, Michael YL. Concepts guiding the study of the impact of the built environment on physical activity for older adults: a review of the literature. Am J Health Promot. 2004;18(6):435–43.View ArticlePubMed CentralPubMedGoogle Scholar
  21. Owen N, Humpel N, Leslie E, Bauman A, Sallis JF. Understanding environmental influences on walking: review and research agenda. Am J Prev Med. 2004;27(1):67–76.View ArticlePubMedGoogle Scholar
  22. Kaewthummanukul T, Brown KC. Determinants of employee participation in physical activity: critical review of the literature. AAOHN J. 2006;54(6):249–61.View ArticlePubMedGoogle Scholar
  23. Rhodes RE, Smith NEI. Personality correlates of physical activity: a review and meta-analysis. Br J Sports Med. 2006;40(12):958–65.View ArticlePubMed CentralPubMedGoogle Scholar
  24. Tucker P, Gilliland J. The effect of season and weather on physical activity: a systematic review. Public Health. 2007;121(12):909–22.View ArticlePubMedGoogle Scholar
  25. Wendel-Vos W, Droomers M, Kremers S, Brug J, van Lenthe F. Potential environmental determinants of physical activity in adults: a systematic review. Obes Rev. 2007;8(5):425–40.View ArticlePubMedGoogle Scholar
  26. Allender S, Hutchinson L, Foster C. Life-change events and participation in physical activity: a systematic review. Health Promot Int. 2008;23(2):160–72.View ArticlePubMedGoogle Scholar
  27. Saelens BE, Handy SL. Built environment correlates of walking: a review. Med Sci Sports Exerc. 2008;40(7 Suppl):S550–66.View ArticlePubMed CentralPubMedGoogle Scholar
  28. van Stralen MM, De Vries H, Mudde AN, Bolman C, Lechner L. Determinants of initiation and maintenance of physical activity among older adults: a literature review. Health Psychol Rev. 2009;3(2):147–207.View ArticleGoogle Scholar
  29. Panter JR, Jones A. Attitudes and the environment as determinants of active travel in adults: what do and don't we know? J Phys Act Health. 2010;7(4):551–61.View ArticlePubMedGoogle Scholar
  30. McCormack GR, Shiell A. In search of causality: a systematic review of the relationship between the built environment and physical activity among adults. Int J Behav Nutr Phys Act. 2011;13(8):125.Google Scholar
  31. Van Cauwenberg J, De Bourdeaudhuij I, De Meester F, Van Dyck D, Salmon J, Clarys P, Deforche B. Relationship between the physical environment and physical activity in older adults: a systematic review. Health Place. 2011;17(2):458–69.View ArticlePubMedGoogle Scholar
  32. Kirk MA, Rhodes RE. Occupation correlates of adults' participation in leisure-time physical activity: a systematic review. Am J Prev Med. 2011;40(4):476–85.View ArticlePubMedGoogle Scholar
  33. Koeneman MA, Verheijden MW, Chinapaw MJM, Hopman-Rock M: Determinants of physical activity and exercise in healthy older adults: a systematic review. Int J Behav Nutr Phys Act. 2011;28(8):142.Google Scholar
  34. Engberg E, Alen M, Kukkonen-Harjula K, Peltonen JE, Tikkanen HO, Pekkarinen H. Life events and change in leisure time physical activity: a systematic review. Sports Med. 2012, 42(5):433–447.Google Scholar
  35. Van Holle V, Deforche B, Van Cauwenberg J, Goubert L, Maes L, Van de Weghe N, De Bourdeaudhuij I. Relationship between the physical environment and different domains of physical activity in European adults: a systematic review. BMC Public Health. 2012;12(1):807.View ArticlePubMed CentralPubMedGoogle Scholar
  36. Rhodes RE, Quinlan A. Predictors of physical activity change among adults using observational designs. Sports Med. 2015, 45(3):423–441.Google Scholar
  37. Day K. Built environmental correlates of physical activity in China: a review. Prev Med Rep. 2016;3:303–16.View ArticlePubMed CentralPubMedGoogle Scholar
  38. Prince SA, Reed JL, Martinello N, Adamo KB, Fodor JG, Hiremath S, Kristjansson EA, Mullen KA, Nerenberg KA, Tulloch HE, et al. Why are adult women physically active? A systematic review of prospective cohort studies to identify intrapersonal, social environmental and physical environmental determinants. Obes Rev. 2016;17(10):919–44.View ArticlePubMedGoogle Scholar
  39. Dishman RK, Sallis JF, Orenstein DR. The determinants of physical activity and exercise. Public Health Rep. 1985;100(2):158.PubMed CentralPubMedGoogle Scholar
  40. Dishman RK, Chubb M, Bouchard C, Shephard R, Stephens T, Sutton J, McPherson B. Determinants of participation in physical activity. In: Exercise, fitness, and health: a consensus of current knowledge: proceedings of the International Conference on Exercise, fitness and health, May 29–June 3, 1988. Toronto, Canada: Human Kinetics Publishers; 1990: 75–108.Google Scholar
  41. Dishman RK. Advances in exercise adherence: human kinetics publishers; 1994.Google Scholar
  42. Sallis JF, Owen N. Physical activity and behavioral medicine, vol. 3. Thousand Oaks: SAGE publications; 1998.Google Scholar
  43. Bandura A: Social foundations of thought and action: a social cognitive theory: prentice-hall, inc; 1986.Google Scholar
  44. Duncan TE, McAuley E. Social support and efficacy cognitions in exercise adherence: a latent growth curve analysis. J Behav Med. 1993;16(2):199–218.View ArticlePubMedGoogle Scholar
  45. McNeill LH, Wyrwich KW, Brownson RC, Clark EM, Kreuter MW. Individual, social environmental, and physical environmental influences on physical activity among black and white adults: a structural equation analysis. Ann Behav Med. 2006;31(1):36–44.View ArticlePubMedGoogle Scholar
  46. Smith V, Devane D, Begley CM, Clarke M. Methodology in conducting a systematic review of systematic reviews of healthcare interventions. BMC Med Res Methodol. 2011;11(1):15.View ArticlePubMed CentralPubMedGoogle Scholar
  47. Hartling L, Vandermeer B, Fernandes RM. Systematic reviews, overviews of reviews and comparative effectiveness reviews: a discussion of approaches to knowledge synthesis. Evid Based Child Health. 2014;9(2):486–94.View ArticlePubMedGoogle Scholar

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