Open Access Research article

Factors influencing adherence to regular exercise in middle-aged women: a qualitative study to inform clinical practice

Deanne McArthur1, Alex Dumas2, Kirsten Woodend3, Sarah Beach4 and Dawn Stacey14*

Author Affiliations

1 School of Nursing, Faculty of Health Sciences, University of Ottawa, 451 Smyth Road, Room RGN 1118, Ottawa, Ontario K1H 8M5, Canada

2 School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, 125 University Private, MNT 366, Ottawa, Ontario K1N 6 N5, Canada

3 Trent/Fleming School of Nursing, Trent University, 1600 W Bank Dr, Peterborough, ON K9J 7B8, Canada

4 Centre for Practice-Changing Research, Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, Box 201B, Ottawa, Ontario K1H 8 L6, Canada

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BMC Women's Health 2014, 14:49  doi:10.1186/1472-6874-14-49

Published: 26 March 2014



About half of women decrease their regular exercise during middle age. Concurrently, they experience a reduction in basal metabolic rate and loss of lean muscle as they transition to menopause. The combined effects place these women at increased risk for body weight gain and associated co-morbidities. Further research is required to better assess their barriers to regular exercise and to develop more applied knowledge aimed to improve the applicability of clinical interventions aimed at this population. The main aim of this study was to identify enablers and barriers influencing adherence to regular exercise in middle-aged women who exercise.


An interpretive description qualitative study was conducted using individual interviews. The two key questions were focused on planning to engage in physical activity and succeeding or planning to engage in physical activity and not succeeding. Inductive content analysis was used.


Fifty-three women interviewed were aged 40–62 years and experiencing mild to moderate menopausal symptoms. Six broad themes influencing adhering to regular exercise were: routine, intrinsic motivation, biophysical issues, psychosocial commitments, environmental factors, and resources. Common sub-themes were identified as enabling factors: daily structure that incorporated physical activity (broad theme routine), anticipated positive feelings associated with physical activity (intrinsic), and accountability to others (psychosocial). Other common sub-themes identified as barriers were disruptions in daily structure (routine), competing demands (routine) and self-sacrifice (psychosocial).


The most common barrier middle-aged women describe as interfering with adhering to regular exercise was attributable to the demands of this life stage at home and with others. Lack of time and menopausal symptoms were not identified as the common barriers. To support women to adhere to regular exercise, healthcare professionals should consider a narrative approach to assessing barriers and focus on enablers to overcoming identified barriers.

Women; Middle-life; Physical activity; Barriers; Qualitative study; Enablers