Physical activity is a major determinant of health that is associated with reductions in premature mortality and the global burden of non-communicable disease (NCD).1 Despite the known benefits of physical activity, physical inactivity continues to account for an estimated 6–10% of the global burden of disease attributed to coronary heart disease, type 2 diabetes, and breast and colon cancer, as well as 9% of all premature mortality.2 Physical inactivity increases with age, accounting for an estimated 3.2 million deaths each year.3 Strategies to encourage participation in physical activity, particularly leisure activity targeting adults, are an integral part of the NCD-risk reduction programs in many countries.4
Physical activity behaviours occur within an ecosystem of individual, household, community, and societal attributes that shape individual behaviors.5 Research suggests that a number of attributes are consistent predictors of initiation and adherence to physical activity by adult women, including age, education, marital status, self-efficacy, and health status.6–10
A substantial body of research supports the link between self-efficacy, defined by Bandura as “people’s beliefs about their capabilities to exercise control over their own level of functioning and over events that affect their lives,”11 [p. 118] and certain health behaviors.12–16 High levels of perceived self-efficacy have been positively associated with smoking cessation, recovery from post-traumatic stress, HIV preventive behaviours, and treatment adherence for a variety of communicable and non-communicable diseases. In Kenya, a number of recreational programs targeting girls and young adult women have been shown to promote health, lower risk behaviours, and build self-efficacy.17,18
Studies investigating self-efficacy in exercise groups show a consistent positive relationship between efficacy and exercise participation.19 Perceived self-efficacy has been shown to be a significant predictor of exercise adherence and compliance, as well as a consequence of physical activity participation.9 Self-efficacy beliefs about one’s ability to carry out a task may influence the adoption of physical activity while outcome expectations due to those beliefs may influence adherence.20
Women in Sub-Saharan Africa face a number of socio-cultural, environmental, and behavioural obstacles in terms of access and engagement in leisure-time physical activity. In countries in Sub-Saharan Africa, physical inactivity has been linked to overweight/obesity, hypertension, and diabetes among women.21–25 A 2011 study of physical activity in 22 African countries found that approximately 76% of females and 83.8% of males met the World Health Organization recommendations for at least 150 minutes of moderate-intensity physical activity per week. Importantly, the study found that the majority of physical activity stemmed from work or transportation and physical activity during leisure was rare.26 Reasons for high rates of physical inactivity among women in this setting include a lack of material resources, cultural norms discouraging the wearing of tight-fitting clothes when participating in sports, and the gendered nature of domestic and household chores that afford women limited time for leisure activities of any kind.21,27 Women in Nigeria were reported to experience structural, interpersonal and intrapersonal constraints to participating in recreational sports activities, with lack of time and norms reinforcing women’s responsibilities as mothers and homemakers presenting the biggest obstacles.28 While opportunities exist in the region for adults to participate in sports like soccer, rugby, and boxing, these are considered traditionally ‘male’ activities; sports remains a gendered domain that preclude adult women from participating in organized leisure sports.22 Several studies, for the most part conducted in Nigeria or South Africa, have variously identified self-efficacy, social support, marital status, high parity, and norms regarding women's roles as significant predictors of adult women's participation in physical activities.22,29−31
The burden of non-communicable diseases in Kenya is on the rise, with NCDs accounting for 27% of all deaths and 50% of all hospital admissions in 2015.32 Among the risk factors to which this increase in NCDs is attributed is the corresponding decrease in physical activity in the population; reversing this trend has been identified as a central objective in the country’s national strategy for combatting NCDs.33
Research examining the relationship between self-efficacy and physical inactivity in Sub-Saharan Africa has largely focused on patient populations with health conditions such as hypertension and type-2 diabetes.30,31,34 A few studies link higher levels of self-efficacy to physical activity in university students in low-, middle-, and high-income countries35 and healthy women ages 18–64 years study in Nigeria.29
Despite a growing burden of non-communicable diseases in East Africa and the adoption of healthy lifestyles as a risk-reduction strategy in countries like Kenya, almost no research has been conducted to date on adult women’s engagement in organized recreational sports nor on the psycho-social attributes that might encourage their participation in and adherence to such activities. This study contributes to filling that gap by examining the relationship between women’s self-efficacy and their participation in a recreational soccer league in rural southeastern Kenya. We hypothesized that women’s participation in the soccer league would be positively associated with self-efficacy that this relationship would be bi-directional.