Comparison of Physical Activity Awareness, Perceived Barriers and Practices between Urban and Rural Adults in Selected Districts of Bangladesh

Abstract Background Physical activity (PA) is one of the most important modifiable risk factors for non-communicable diseases (NCDs), which are increasing in Bangladesh. There may be differences between urban and rural adults in regard to PA levels, knowledge of guidelines, and perceived barriers, but few studies have looked at all three simultaneously. Methods A comparative cross-sectional study was carried out in 316 adults (158 urban and 158 rural) aged 18–64 years at selected sites of Dhaka, Rajshahi, Khulna and Sylhet with convenience sampling techniques. The WHO Global Physical Activity Questionnaire (GPAQ) was used to assess PA, while awareness and perceived barriers were assessed via structured, pre-tested items (23 items, α = 0.787 and 25 items, α = 0.848, respectively). The tests used were: Chi-square test, Fisher's exact test, Mann–Whitney U test, Kruskal–Wallis test, and binary logistic regression. Results The overall achievement at sufficient levels of PA was 55.1% of adults and was not found to differ between urban and rural areas (52.5% vs. 57.6%, p = 0.366). Occupational activity was significantly higher in rural adults (p < 0.001), and accounted for a larger proportion of total activity (81.8% vs. 58.6%) than in urban adults; recreation activity was higher in the urban adults (p < 0.001), and accounted for a larger proportion of total activity (37.1% vs. 12.8%); and sitting time was longer among urban adults than rural adults (p = 0.022). Overall awareness of PA recommendations was low (45.9%), with urban adults more likely to be aware than rural adults (54.4% vs. 37.3%, p = 0.003) and only 7.6% correctly identifying the WHO as the source of global recommendations. Awareness was not associated with PA status in adjusted analysis (AOR = 0.67, 95% CI 0.16–2.59, p = 0.6). High perceived barriers significantly increased the adjusted odds of low PA (AOR = 3.76, 95% CI 2.26–6.34, p < 0.001) and women had significantly higher adjusted odds than men of reporting high perceived barriers (AOR = 1.96, 95% CI 1.25–3.11, p = 0.004). Conclusion Overall, the level of PA sufficiency of the urban and rural adults were comparable, but the quantity, content, knowledge and barriers of PA varied significantly. Barriers, rather than awareness, were the primary determinants of PA status, and gender was a stronger predictor of barriers than residence was. PA promotion should take a combined approach of practical guideline education and intervention for structural, occupational and gender related barriers, which should be done separately for urban/rural and male/female groups.