Physical activity preferences across demographic groups: a systematic review of population-based evidence and implications for public health and intervention design

Abstract

Background: Regular physical activity (PA) is a cornerstone of public health; however, participation rates remain below recommended levels worldwide. Understanding PA preferences across demographic groups can support the development of more engaging and sustainable interventions. Methods: This systematic review followed PRISMA 2020 guidelines and was prospectively registered in PROSPERO (CRD420250650308). Systematic searches were conducted in PubMed, Scopus, PsycINFO, and Web of Science (WoS) from inception to September 2025. Studies were included if they assessed PA preferences using validated instruments in general populations and excluded if they were qualitative, clinical, or lacked explicit preference assessment. Two reviewers independently extracted data on demographics, preference patterns, instruments, and study quality using a standardized template. Methodological quality was evaluated with the AXIS tool. Given heterogeneity across studies, subgroup analyses were conducted by age, gender, and socioeconomic status. Results: Twenty-two studies met inclusion criteria. Younger individuals preferred high-intensity, competitive, and social activities, whereas older adults favored low-impact, health-oriented, and independent forms of exercise. Males preferred competitive and strength-based activities, while females favored endurance and group-based options. Socioeconomic factors influenced choices, with lower-income groups more often engaging in community-based and supervised activities. Validated instruments, including the Activity Preference Assessment (APA), Decisional Preference in Exercising Test (DPEX), and Questionnaire on Physical Activity Preferences (QPAP), showed strong reliability and validity. Conclusion: Integrating preference assessment into public health strategies can enhance participation and long-term adherence to active lifestyles. Tailoring interventions to demographic-specific preferences may improve the effectiveness and equity of physical activity promotion.