How can we encourage engagement in physical activity among older adults in Chinese diasporas? Mixed methods evidence synthesis using the COM-B model

Globally, 31% of adults are physically inactive, with higher rates in older adults. This situation is even more pronounced among older adults from ethnic minority backgrounds, including those from the Chinese diaspora—a rapidly growing but often overlooked population. To explore the barriers and facilitators to engaging in physical activity (PA) among older adults from the Chinese diaspora. A mixed-methods systematic review was conducted following Joanna Briggs Institute methodology guidelines. We searched seven databases: Embase, MEDLINE, PsycINFO, CINAHL Plus, Sociological Abstracts, Cochrane Central Register of Controlled Trials, and the Chinese Biomedical Database in September 2024. We included qualitative and quantitative studies related to views and experiences regarding participation in PA of adults aged 50 years or older, from the Chinese diaspora. A thematic synthesis approach was used to summarise the findings. Risk of bias was assessed using MMAT, and confidence in the evidence using GRADE-CERQual. The protocol was registered on PROSPERO (CRD42023392522). Ten qualitative studies, four quantitative cross-sectional surveys, and one mixed-methods study were included. Twenty-three factors were identified; over half had high certainty. Barriers and facilitators to PA among older Chinese adults aligned with the COM-B model: capability (e.g., health, skills, knowledge, language), opportunity (e.g., PA programme, environment, resources, social support, time), and motivation (e.g., beliefs, concerns, family harmony, enjoyment, habit, reinforcement). Unique factors included language and cultural barriers, family obligations as barriers, and family harmony as a facilitator. The findings of this review support the development of tailored PA promotion interventions for older adults from the Chinese diaspora by enhancing their capability, opportunity, and motivation. Interventions should incorporate culturally sensitive elements, such as promoting PA benefits through traditional Chinese philosophy, offering traditional exercise programmes, developing Chinese exercise groups, and emphasising family harmony to boost motivation.