This study evaluated the perceived barriers and facilitators to physical activity in Zimbabwean university students and associated factors. Overall, our study outcomes show that university students were strongly knowledgeable of the exercise benefits with physical performance, life enhancement and psychological impacts cited as major benefits. Time constraints, physical exertion, and lack of exercise infrastructure were major barriers to exercise. A higher quality of life was associated with an increased perception of benefits. Also, lower socio-economic status and poor mental health were associated with increased barriers to exercise.
Participants scored highly on the benefits subscale, i.e., mean of 95 ± 11.4. Our results are comparable to studies done on American and Saudi Arabian university students, which yielded mean EBBS benefits subscales scores of 94 ± 11 and 95 ± 10, respectively [14, 26]. University students will likely have high health literacy, contributing to the high perception of exercise benefits [8]. A high educational level is linked to increased positive health-information-seeking behaviours, resulting in favourable perceptions of exercise benefits [27]. Also, university students are exposed to various health promotional activities, e.g., campus-wide health expos, which may increase their knowledge of exercise benefits [28]. At the sub-domain level, university students highly endorsed the positive effects of exercise on physical performance, life enhancement and psychological impacts. Elsewhere, South African physiotherapy students (N = 296) highly ranked the physical performance and psychological impacts of exercise [8]. This was attributable to the advanced health education in the physiotherapy training curriculum [8, 14]. Other studies have shown that preventive health, physical performance and life enhancement are high motivators of exercise engagement among university students [11, 14].
University students experienced moderate barriers to exercising, with mean barriers subscale of 28.6 ± 5.4. These results are comparable to studies done on American and Indian university students, which yielded mean EBBS barriers subscales of 28.5 ± 6.7 and 29.5 ± 7, respectively [26, 29]. The high comparability suggests that barriers to exercise among university students are universal across socio-economic contexts. At the subscale level, the most perceived barriers to exercising were time constraints, physical exertion, and lack of exercise infrastructure. Most students perceived exercise as being time-consuming. This finding was similarly reported in Spanish [30], Saudi Arabian [31] and German students [32], who reported that they would instead use their free time to prepare for exams or socialising than engage in physical exercise. As reported in a systematic review [33], our study also shows that physical exertion is a salient barrier to exercising. Exercise can be physically and cognitively demanding, and if not addressed, perpetual fatigue may lead to decreased PA engagement [20]. Also, the lack of exercise facilities was a significant barrier to exercise engagement in this study. This was unsurprising as there are few to no state-subsidised on-campus exercise facilities in Zimbabwe. Elsewhere, 75% of Saudi university students cited the lack of public exercise facilities as a barrier to exercising [34]. In contrast, only 2.9% of Germany students expressed the lack of facilities as a barrier to exercise [32]. Germany students have easy access to on-campus exercise facilities at low or no cost [32].
Regression analysis showed that poor mental health, low socio-economic status, and chronic illness are salient barriers to PA engagement in university students. Our study findings showed a high burden of CMDs in university students, which was associated with an increased likelihood of perceived barriers to exercise. Poor mental health functioning is associated with a lack of energy and motivation for PA engagement, creating a vicious cycle of poor physical and mental health [35, 36]. Also, participants with chronic conditions reported more exercise barriers. Chronic illness is associated with lethargy, bodily pain and fatigue, reducing physical endurance and lowering PA engagement [16, 33]. Importantly, comorbid chronic conditions (e.g. CMDs) may exacerbate exercise-avoidance behaviours [35, 36].
University students of lower socio-economic status were likelier to experience significant exercise barriers. A scoping review has linked reduced PA engagement among the low SES population due to a lack of resources, low motivation, fatigue and lack of energy [37]. Last, our study also shows that university students with a higher self-assessed HRQoL were likelier to perceive exercise benefits. Other studies have shown that perceived benefits to PA were associated with an increased compulsion to greater physical engagement. Increased PA engagement reduces the risk of NCDs and increases HRQoL [8, 38, 39].