Exercise empowerment: a scoping review of randomized controlled trials and quasi-experimental physical activity interventions.

backgroundPhysical inactivity is a leading contributor to chronic disease and premature mortality across the globe. Traditional physical activity interventions often promote physical activity initiation but have limited long-term effectiveness. Empowerment has been recognized as a potentially powerful tool in health behavior change, but it is unclear how empowerment is operationalized in physical activity interventions. One current gap in the literature is the role of empowerment in physical activity interventions. Therefore, this review aims to determine how exercise empowerment is defined, measured, and theoretically framed in randomized controlled trials and quasi-experiments across various populations. We are also interested in understanding the strategies for facilitating empowerment, whether empowering interventions increase physical activity, and if physical activity outcomes are assessed.

methodsA scoping review adhering to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews was conducted across five electronic databases (PubMed, Embase, PsycINFO, Web of Science, Cochrane Library, CINAHL). Inclusion criteria included adults and children, participation in a physical activity intervention, and an empowerment strategy. Exclusion criteria included qualitative studies, studies published before 1994, and studies not in English.

resultsForty papers were included in this scoping review, but no interventions explicitly defined exercise empowerment. Empowerment was not directly measured in any of the included interventions. Empowerment theory or a derivative informed nine (22.5%) of the included articles, while six (15%) lacked theoretical underpinnings. Most interventions (55%) utilized an educational approach. Physical activity was measured subjectively in 27 (67.5%) interventions. Physical activity increased in most studies (n = 29; 72.5%).

conclusionsThis review highlights the disconnect between the multidimensional framework of empowerment theory and interventions designed to empower participants. We identified several opportunities to increase intervention effectiveness, including developing and applying a consensus definition of exercise empowerment that creates better alignment with empowerment theory. Exercise empowerment should be defined as the perceived confidence and control over exercise choices that lead to sustained exercise and a sense of fulfillment. It can be experienced both individually and collectively. The process of building exercise empowerment depends on developing personal confidence and control over exercise choices, engaging with supportive social networks to initiate and sustain exercise, and utilizing available community-based exercise resources.