Exploring psychosocial barriers in digital walking interventions for the chronically ill: a scoping review.

内容摘要

This scoping review aimed to identify and systematically map existing evidence on psychosocial barriers in digital physical activity interventions promoting walking among individuals with chronic illness. Digital interventions promoting walking are widely used in chronic disease management and demonstrate short-term effectiveness. Psychosocial barriers, such as stigma, illness-related beliefs, and internalized meanings, may play a critical role in shaping both intervention engagement and behavioral outcomes, yet their conceptualization and integration into intervention design remain unclear. Quantitative and qualitative studies on psychosocial barriers in digital physical activity interventions focusing on walking among individuals with chronic illness. A three-step search strategy was conducted across PubMed, Web of Science, Scopus, and PsycINFO, complemented by gray literature. Studies in English with no date restrictions were included. Screening was conducted according to predefined inclusion criteria, with backward citation searching applied. Data on study characteristics, participants, intervention features, and psychosocial barriers were extracted. Descriptive statistics and qualitative synthesis were used to map barrier domains. A total of 28 studies were included, resulting in 105 psychosocial barrier instances grouped into seven domains. The most frequent were belief-based (21.0%) and emotional barriers (21.0%), followed by self-regulation-related barriers (15.2%). Barriers were predominantly identified in qualitative and mixed-methods studies, indicating an exploratory evidence base. Outcome mapping showed that barriers were commonly reported in relation to intervention-process outcomes (54.3%), including engagement, adherence, and usability, followed by behavioral outcomes (28.6%) such as walking and physical activity, and psychological and self-management outcomes (14.3%). Belief-based, digital capability, and emotional barriers were primarily associated with intervention-process outcomes such as engagement, adherence, and acceptability. In contrast, walking-related outcomes were most frequently mapped alongside belief-based, motivational, emotional, and relational factors. Psychosocial barriers in digital walking interventions operate as multi-level, functionally distinct mechanisms influencing both engagement and behavior. Current evidence is conceptually rich but methodologically heterogeneous and predominantly process-oriented. Future interventions should move beyond generic behavior change techniques to explicitly target psychosocial barriers to improve sustained engagement. https://osf.io/2hrmy.