Physical activity levels and sedentary behavior in people who have experienced gender-based violence: A systematic review

Background and aims: Experiencing gender-based violence (GBV) is a risk factor for numerous noncommunicable diseases, many of which are associated with physical inactivity. This systematic review aims to determine if physical activity levels and sedentary behavior differ between people who have experienced GBV and people who have not been exposed to GBV. Methods: Five databases were searched from inception to May 2023. Eligible studies were original research publications that reported a quantitative measure of physical activity and/or sedentary behavior for people who have experienced GBV and a comparator group. Synthesis without meta-analysis was performed due to inconsistent measures of physical activity. Results: Eleven studies with 38,679 people who have experienced GBV and 159,103 comparators were included. Most studies were conducted in the United States (k = 9, 82%) with exclusively female participants (k = 9, 82%). All studies reported on mean time in physical activity or proportion of people engaging in certain levels of physical activity and sedentary behavior. No study used a validated tool to measure physical activity levels. Nineteen comparisons between a GBV population group and comparator were identified in the 11 studies. Findings were mixed, with 10 comparisons (52.5%) finding no significant difference, six comparisons (32%) finding lower physical activity engagement in the GBV-exposed population group, and three comparisons (15.5%) reporting similar values in both groups (without a between group test). The overall quality of studies was poor-fair. Conclusion: There is mixed evidence for whether physical activity levels differ among people who have experienced GBV compared to individuals who have not. High quality studies using validated assessment methods are needed.