Biopsychosocial determinants of physical activity and healthy eating for people with disability living in supported accommodation: A systematic review of qualitative research

Background: People with disability living in supported accommodation experience ongoing health disparities. Physical activity and dietary quality are factors that may minimise the risk of chronic disease, however this population may experience a range of biopsychosocial barriers to physical activity and healthy eating. Objective: The aim of this review was to synthesise the biopsychosocial determinants of physical activity and healthy eating for people with disability living in supported accommodation, as reported by existing qualitative research. Methods: A systematic review of qualitative evidence was conducted according to the JBI's methodological guidance. In September 2023, five academic databases were searched for relevant literature published since database inception. A secondary analysis of the results of included studies was guided by the International Framework for Functioning, Disability, and Health (ICF), using the ICF Linking Rules. Results: A total of 31 articles were included. The analysis identified 154 determinants of physical activity and 112 determinants of healthy eating. Determinants were most prominently representative of environmental factors that captured the health promoting role and attitudes of staff, alongside the influence of the organisational context. Conclusion: This review provided evidence for the complex interactions between body functions and structures, activities and participation, personal factors, and the environment that influence physical activity and healthy eating within supported accommodation. Although there is a limited body of evidence to guide practice, the findings highlight the multifactorial nature of interventions that can be utilised by direct care professionals and adapted to the individual needs and interests of people with disability.