Barriers and Facilitators of Adolescent Physical Activity Participation: A Systematic Review and Meta-Analysis of Quantitative Effect Sizes

Abstract

Physical activity participation among adolescents has declined globally, with severe consequences for public health. Although systematic reviews have identified barriers and facilitators of adolescent physical activity, there has been limited quantitative synthesis of effect sizes. Understanding the magnitude of these effects is crucial for evidence-based intervention development. To conduct a systematic review and meta-analysis of quantitative effect sizes for barriers and facilitators of physical activity participation among adolescents aged 10–19. We conducted a comprehensive search across multiple databases (Scopus, PubMed, and Web of Science) from 2015 to 2025.  Studies investigating barriers and facilitators of physical activity participation among adolescents with extractable quantitative effect sizes were included. Two-stage screening was performed using predefined inclusion/exclusion criteria. Fixed-effects meta-analyses were performed using inverse variance weighting for odds ratios and Fisher's z-transformation for correlations. Heterogeneity was assessed using I² and Q statistics. Of the 600 studies initially identified, 3 demonstrated quantifiable effect sizes (total N = 64,258). The meta-analysis of odds ratios showed that both barriers (OR = 0.851, 95% CI: 0.830–0.873, p < 0.001) and facilitators (OR = 1.384, 95% CI: 1.360–1.410, p < 0.001) had significant pooled effects. Individual factors showed the strongest effects, with male gender (OR = 2.094) and high subjective health (OR = 1.550) being the most potent facilitators. Meta-analysis of correlation coefficients showed a pooled facilitator effect of r = 0.212 (95% CI: 0.185-0.240, p < 0.001). Substantial heterogeneity was observed among facilitators (I² = 99.5%), indicating diverse mechanisms of action. This review gives a summary of association between chosen barriers, facilitators and adolescent physical activity participation. Individual-level factors showed strong links while social support showed steady small-to-moderate links. The results underline the benefit of multi-level strategies that tackle individual, social and contextual determinants. However, the conclusions should be viewed with caution because three studies met the inclusion criteria and there was large variation, among them. More quality quantitative and longitudinal studies are needed to strengthen the evidence base and to clarify the determinants of adolescent physical activity.