2型糖尿病患者坚持体力活动的障碍和促进因素：使用COM-B模型和理论领域框架的混合方法系统综述

IF 1.7 3区心理学 Q3 PSYCHOLOGY, CLINICAL

International Journal of Behavioral Medicine Pub Date : 2025-10-15 DOI:10.1007/s12529-025-10400-y

Xiaojing Guo, Huixian Chen, Ran Xin, Jing Huang, Tianxue Long, Mingzi Li

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引用次数: 0

摘要

背景：虽然身体活动对2型糖尿病患者的健康益处已经得到证实，但缺乏身体活动仍然很普遍，现有的干预措施往往显示出有限的长期有效性。本综述旨在探讨2型糖尿病患者坚持体育锻炼的障碍和促进因素。方法：系统检索PubMed、Web of Science、EMBASE、CENTRAL和PsycINFO截止2025年7月27日发表的相关研究。合格的研究包括定性、定量和混合方法研究。采用混合方法评价工具评价研究质量。COM-B模型和理论领域框架被用来识别潜在的障碍和促进因素，而行为改变技术被用来识别潜在的干预策略。本研究注册号为CRD42024622295。结果：共纳入43项研究，其中随机对照试验17项，定性研究11项，混合方法研究6项，非随机研究5项，定量描述性研究4项。分析确定了影响依从性的46个障碍和促进因素。此外，还提取了26种潜在有效的行为改变技术，并将其归类为六大关键实施策略：灵活和个性化的体育活动计划、多维社会支持、参与者教育、增强自我效能和动机、监测和反馈以及管理情绪体验。结论：本综述系统地综合了2型糖尿病患者体力活动依从性的行为决定因素，并提出了相应的干预设计实施策略。未来的研究应完善、评估和验证这些策略，同时探索COM-B组分之间的动态相互作用，以提高干预效果。

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Barriers and Facilitators to Physical Activity Adherence in People With Type 2 Diabetes: A Mixed-Methods Systematic Review Using the COM-B Model and Theoretical Domains Framework.

Background: Although the health benefits of physical activity for individuals with type 2 diabetes are well-established, physical inactivity remains widespread, and existing interventions often demonstrate limited long-term effectiveness. This review aimed to explore the barriers and facilitators to physical activity adherence in individuals with type 2 diabetes.

Methods: PubMed, Web of Science, EMBASE, CENTRAL, and PsycINFO were systematically searched for relevant studies published up to 27 July 2025. Eligible studies included qualitative, quantitative, and mixed methods studies. Study quality was assessed using the Mixed Methods Appraisal Tool. The COM-B model and Theoretical Domains Framework were used to identify potential barriers and facilitators, while behavior change techniques were employed to identify potential intervention strategies. The registration number of this study is CRD42024622295.

Results: A total of 43 studies were included, including 17 randomized controlled trials, 11 qualitative studies, 6 mixed methods studies, 5 non-randomized studies, and 4 quantitative descriptive studies. The analysis identified 46 barriers and facilitators influencing adherence. Additionally, 26 potentially effective behavior change techniques were extracted and categorized into six key implementation strategies: flexible and personalized physical activity programs, multidimensional social support, participant education, enhancing self-efficacy and motivation, monitoring and feedback, and managing emotional experiences.

Conclusions: This review systematically synthesizes the behavioral determinants of physical activity adherence in individuals with type 2 diabetes and proposes corresponding implementation strategies for intervention design. Future research should refine, evaluate, and validate these strategies while exploring the dynamic interactions between COM-B components to enhance intervention effectiveness.

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来源期刊

International Journal of Behavioral Medicine PSYCHOLOGY, CLINICAL-

CiteScore

5.20

自引率

3.70%

发文量

期刊介绍： The International Journal of Behavioral Medicine (IJBM) is the official scientific journal of the International Society for Behavioral Medicine (ISBM). IJBM seeks to present the best theoretically-driven, evidence-based work in the field of behavioral medicine from around the globe. IJBM embraces multiple theoretical perspectives, research methodologies, groups of interest, and levels of analysis. The journal is interested in research across the broad spectrum of behavioral medicine, including health-behavior relationships, the prevention of illness and the promotion of health, the effects of illness on the self and others, the effectiveness of novel interventions, identification of biobehavioral mechanisms, and the influence of social factors on health. We welcome experimental, non-experimental, quantitative, qualitative, and mixed-methods studies as well as implementation and dissemination research, integrative reviews, and meta-analyses.