The present qualitative study was conducted to identify the factors affecting physical activity in the personnel of Iran University of Medical Sciences to help design interventions to promote physical activity among university personnel. The content thematic analysis of the interviews led to the identification of three main themes, including challenges and barriers, strategies, and incentives (facilitators).

Challenges and barriers were categorized as policy-making and legislation, organizational factors, structural factors, and personal factors. In previous studies, barriers have been categorized into groups such as organizational views, operational outlook, and personal views [12] or into physical, psychological and environmental dimensions [6]. The various qualitative studies on this subject have found similar themes for the barriers to physical activity in the workplace, aside from these categories. The participants of the present study considered the shortage of time, physical exhaustion, and the lack of a suitable space for exercise as the biggest barrier to their physical activity, with the first two items being placed in the theme of personal factors. In other studies, the greatest barriers to exercise were noted as “having to invest time”, “fatigue” [20], “physical limitations due to pain and frailty”, “lack of motivation”, “lack of time”, and “job commitment” [6], “excessive exhaustion”, and “work commitment/long work hours” [21]. In some studies, the greatest barriers differed depending on the job category or type of work. For example, in one study, the managers recalled structural/organizational barriers, including regulations, costs, and the competitive aspect of work, while the employees tended to focus on personal limitations, such as the time and physical place for exercise [10]. As another example, employees in the transport industry, who are at a greater risk of inactivity compared to other jobs, regarded the changes in their work schedule, bad weather conditions, and the lack of planned holidays as the main barriers to their physical activity [22]. For midwives working in hospitals and health centers in Scotland, the barriers and facilitators of physical activity included fatigue, stress, family responsibilities, unpredictable rest hours and work shifts [23]. These items were more or less discussed similarly by the hospital staff surveyed in the present study. Some of these participants considered organizational culture a barrier to physical activity in the workplace and discussed particular cultural and other types of barriers in line with the study by Cooper et al. [24]. Similar to previous studies [6], psychosocial and environmental barriers appear to be a greater obstacle to physical activity than physical disorders.

Incentives (facilitators) were placed in organizational and motivational categories in our study. In previous studies, the most powerful incentives for physical activity have included family interactions, social support, the perceived health benefits of physical activity [6], subsidies given for exercise classes, and breaks given at specific times during work days [23]. The work environment and resources offered can be both a barrier and facilitator of physical activity [23]. In the present study, creating a space enabling exercise with family and friends was cited as a factor contributing to the motivation to exercise. Moreover, organizational incentives such as the payment of subsidies by the organization for exercise classes, including the personnel’s physical activity in the performance evaluation system, building a culture of exercise and creating motivation in the personnel to exercise were regarded as key incentives for performing physical activity. The results obtained by Brakenridge et al. show that workplace interventions supported by the organization are acceptable and can lead to long-term changes in awareness and culture [14]. Moreover, evidence-based interventions supported by key individuals as role models can spread to other workplaces [14]. Similar to in previous studies [25], some of the participants in the present study stated that urban design should be such that access to suitable spaces for playing sports is facilitated.

In the present study, the strategies for increasing physical activity were placed in three subthemes, including policy-making and legislation, organizational factors, and environmental factors. In Planchard’s study, interventions were classified as preparation, empowerment, reinforcement, environmental factors and policies [6].

Workplace wellness programs promoting physical activity can help businesses create effective policies and programs to meet their employees’ and businesses’ priorities [11]. In line with previous studies [23], the present study showed that interventions should focus on improving interpersonal relationships, reducing workplace stresses, and increasing social support. Just like previous studies [26], the present findings emphasized the need to pay further attention to women, especially working mothers, because the needs of this group should be further addressed through health counseling [26].

Although most barriers discussed by the participants were placed in the personal factors category, the majority of the strategies were related to organizational factors and policy-making and legislation categories. For instance, the lack of awareness about the risks of inactivity, which falls in the personal factors category of the theme of barriers, can be resolved by holding physical activity training courses, which falls in the organizational factors category of the theme of strategies. Various studies, including the present one, have emphasized the importance of organizational support strategies [12, 14, 15], even though multiple studies have also discussed organizations’ shortfalls in addressing these issues. For instance, in a study by Bailey et al. on the policies supporting physical activity in the workplace, a small number of the examined organizations had a written policy for increasing physical activity and allocating time to exercise during work hours, and the lack of such policy was described by the participants as a barrier to greater physical activity in the personnel [11]. In another study, Chau et al. investigated the views of the personnel of 12 different organizations and concluded that physical activity has not been a priority in these organizations’ occupational health programs [10]. Physical activity must be supported from all levels of an organization in order to make it an integral part of daily work [10].

The limitations of this study include restricting the data collection to focus group discussions, even though individual interviews could have provided more information about the personal barriers to physical activity. Nevertheless, the participants of this study worked in different centers and had limited time at their hands, which made it difficult to coordinate and conduct individual interviews. Also, we did not have sufficient financial resources and manpower for holding elaborate individual interviews. To understand the perspectives of the employees, the focus group method was chosen for data collection in this study because it encourages everyone to participate in a discussion guided by a facilitator (i.e., the researcher), and we wanted to know the most important barriers and facilitators. To sum up, we might have missed some information about the personal barriers. Moreover, moderator bias and social desirability bias are other potential limitations of this study.

A strength of this study that somewhat makes up for the discussed limitation is holding several focus group meetings in different university departments to ensure the maximum diversity of views and examine the subject from the perspective of administrative, health, medical, and headquarter staff alike.