Women in Strength (WISH Study): Interview with Women Participating in Muscle-Strengthening Exercises – How Are They Doing It?

Women in Strength (WISH Study): Interview with Women Participating in Muscle-Strengthening Exercises – How Are They Doing It? | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Women in Strength (WISH Study): Interview with Women Participating in Muscle-Strengthening Exercises – How Are They Doing It? Nur Dania Rosaini, Stuart R. Gray, Esther Oyebola, Gemma C. Ryde This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7461038/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 21 Jan, 2026 Read the published version in BMC Public Health → Version 1 posted 12 You are reading this latest preprint version Abstract Background: While the benefits of muscle-strengthening activities are well established, national surveillance reported that women did fewer muscle-strengthening activities than men. The current study aimed to understand the barriers and facilitators among women who are currently meeting the muscle-strengthening activities guidelines and identify ways to improve participation for women. Methods: 24 women, aged 18 to 64, from the United Kingdom who participated in muscle-strengthening exercises at least two days per week were invited to an online or in-person interview. Reflexive thematic analysis was used to identify key themes related to the challenges and facilitators of participation, as well as potential improvements. Results: Qualitative findings revealed four overarching themes 14 subthemes: (1) reason for participating in muscle-strengthening exercises (health concerns and sports performance), (2) challenges to muscle-strengthening exercise participation (perceived time constraint, low motivation, cultural stigma and societal perceptions, confidence in ability and accessibility), (3) facilitators to participating in muscle-strengthening exercises (resources or information, accountability, social support, ability to choose and positive changes) and (4) suggestions for improvement (what an individual can do and what others can do). The themes reflect the complex interaction of personal, social, and environmental factors that influence women’s participation in muscle-strengthening exercises. Conclusion: This study further enhances the understanding of women’s engagement in muscle-strengthening activities by highlighting not only the persistent barriers but also practical strategies to overcome them. Incorporating lived experience strategies, such as scheduling, goal setting, and social support, alongside broader structural changes, such as creating an inclusive gym environment and providing credible online resources, would offer valuable guidance for more tailored interventions and policies to increase participation among women and promote equitable opportunities for women’s health throughout their lives. muscle-strengthening exercise participation women female motivator barriers strength training Figures Figure 1 BACKGROUND Regular participation in physical activity reduces the risk of chronic diseases and improves mental health and well-being for the general population. For women, particularly, participating in muscle-strengthening activities offers additional benefits beyond that of cardiovascular activity alone, including reproductive health outcomes [1], reducing the risk of osteoporosis, sarcopenia and frailty [2, 3], and helping with postpartum depression and anxiety [4]. Studies have established that women face an earlier strength loss than men, from menopause due to the decrease in oestrogen [5-7] and involvement in muscle-strengthening activities is important to mitigate this decline. This underscores the importance of muscle-strengthening for women across their lifespan. Current guidelines from the 2020 World Health Organisation and 2019 UK Physical Activity Guidelines recommend at least two days a week of muscle-strengthening activities, targeting the major muscle groups [8, 9]. National surveillance data from 2012 to 2023 consistently reveal that women are less likely than men to meet these recommendations, with particularly low adherence observed among women in certain life stages, such as during childbearing years [10-12]. For instance, the 2021 Health Survey for England reported that only 29% of women (vs 36% of men) meet the recommended muscle-strengthening activities guidelines [11]. Similarly, the 2023 Scottish Health Survey reported that only 26% of women (vs 32 % of men) met the recommendation [12]. These persistent participation gaps over the years between sexes suggest that the standard strategies to promote participation in muscle-strengthening exercises may not be successful in addressing the specific barriers to participation that women may face. In our previous work on the Muscle-Strengthening Participation Survey, we identified substantial sex differences and variation in the muscle-strengthening exercises that UK adult women participated in [13]. Specifically, women tend to favour bodyweight exercises and holistic exercises, such as Pilates and yoga, as opposed to weight machine-based exercise, which is more common in men [13]. However, little is known about why women prefer these specific types of exercises or what barriers they face in participating in other types of muscle-strengthening activities, such as weight machine-based exercises. While preferences offer valuable insight, they only partially explain the persistent gap in participation. A more comprehensive understanding of how women achieve the muscle-strengthening recommendations is needed to develop interventions for those not currently meeting these recommendations. Therefore, the present study aimed to explore the barriers and facilitators to participation in muscle-strengthening exercises among women who are currently meeting the muscle-strengthening activities guidelines and identify ways to improve participation for women. METHODS Study Design This qualitative study is part of the Muscle-Strengthening Participation research project. This study was approved by the College of Medical, Veterinary and Life Sciences Ethics Committee at the University of Glasgow (Reference Number: 200230238) and adhered to the Declaration of Helsinki. Participants Participants who completed a previous Muscle-Strengthening Participation Survey [13] and expressed their interest in participating in follow-up research were contacted to participate by email. Recruitment to the original survey is described further in the previous report [13] but includes using promotional posters and posting a survey link on neighbourhood application (Nextdoor), Microsoft Viva Engage, LinkedIn, X and paid advertising via Meta Ads. To be included in the current study, women had to be aged between 18 and 64 years old when they participated in the original survey, living in the United Kingdom, and, for the current paper, participating in muscle-strengthening exercises for two or more days a week. Each participant was compensated with a £20 Amazon voucher for their time after completion of the interview. Interview Participants were given the option to have an online or in-person interview. Online interviews took place on Microsoft Teams, and in-person interviews took place at the University of Glasgow. Each interview slot was one hour long, and interviews were audio-recorded via Teams or a digital audio recorder if in person. Verbal (for online interview) or written (for in-person interview) consent for participating and for publication was gained before the interview. Interview questions included experiences in participating in muscle-strengthening exercises, barriers faced and facilitators for their muscle-strengthening exercises participation. The full interview topic guide is included in the supplementary material I. Participants’ Demographics Demographic and exercise background data were also collected (age, deprivation category, working status, academic level, marital status, frequency of muscle-strengthening exercises participation, exercise setting for muscle-strengthening and type of exercises participated) as part of the interviews. Data Analyses All audio recordings from the interviews were transcribed using Otter.ai and checked by NR. The transcripts from the interviews were analysed using the codebook form of Reflexive Thematic Analysis [14, 15]. Reflexive Thematic Analysis includes familiarisation of the interview transcripts, creating a coding framework, theme extraction, review and naming, and narrative analysis [16]. An initial codebook was created by NR and EO separately, with both coders meeting to agree on a preliminary structure of the codes. Codes were further discussed between NR, SG, and GR before being applied to the dataset. NVivo 12 Pro (QSR International Pty Ltd, Doncaster, Victoria, Australia) was used to code all the transcripts based on the finalised codebook. NR created initial higher-order themes with three subsequent meetings (6 hours total) between NR and GR to agree on theme names, descriptors and a thematic map. *Table 1 here* RESULTS Response Rate 137 participants who expressed interest in participating in follow-up research from the original survey were contacted, with 54 expressing their interest in participating in the interviews, and 24 consenting to the interviews. Demographic Demographic and exercise background data of the 24 participants are displayed in Table 1. Most of the participants were aged between 45 to 64 years old (67%), lived in the least deprived area (38%), were employed (58%), had a university degree (79%), and were married with children (54%). For exercise location, 33% of participants reported doing muscle-strengthening exercises at the gym, while 29% reported a combination of exercise locations. Of the 24 participants, 58% reported doing a combination of more than one type of muscle-strengthening exercise. Thematic Map Interviews produced 466 minutes and 44 seconds of recorded audio. 4 themes and 14 subthemes were identified (Figure 1). The themes are: Reason for participating in muscle-strengthening exercises (Table 2) Challenges to muscle-strengthening exercise participation (Table 3). Facilitators to participating in muscle-strengthening exercises (Table 4). Suggestions for improvement (Table 5). *Figure 1 here* Theme 1: Reasons for Participating in Muscle-Strengthening Exercises This theme highlights the benefits of participating in muscle-strengthening exercises as a reason to begin participating. Initial reasons for taking part in muscle-strengthening exercises were linked to concerns about health, including injuries, family health, ageing, menopause, and the realisation of the need to maintain strength as they aged, as well as for improving sports performance for some. Table 2 presents the indicative quotes according to the reasons given by the participants. Health concern: Having injuries and family health Having an injury was the most frequently mentioned reason by the participants as to why they started to participate in muscle-strengthening exercises. Some of the injuries mentioned were pain involving the back, such as sciatic pain, herniated or disk degeneration, and bone-related injuries such as plantar fasciitis, osteoarthritis and osteoporosis. Though this was not limited to their own injury or health conditions, as participants also mentioned that looking at their families' health, such as parental health deterioration, including dementia, motivated them to start participating in muscle-strengthening exercises. Health concern: Ageing, menopause and awareness of maintaining strength Participants mentioned ageing as a reason for beginning participation, whether from their own ageing or from observing family members ageing. The concerns with ageing are also related to menopause. Participants who have reached menopause said that it caused them to gain weight, and taking up muscle-strengthening exercises has helped them. Several participants mentioned having awareness or realisation that they need to maintain their muscle strength as they age has been a factor in their participation. Sports performance Some participants mentioned that they began participating in muscle-strengthening exercises to improve their sports performance. Participants agreed that the strength they gained from muscle-strengthening exercises had benefited their sports performance. *Table 2 here* Theme 2: Challenges to Muscle-Strengthening Exercise Participation Participants reported several challenges that arose regarding their participation in muscle-strengthening exercises. These challenges included perceived time constraints due to study and work commitments, lack of confidence in their ability to do the exercises, the accessibility regarding the cost and equipment availability, the cultural stigma and societal perception of muscle-strengthening exercises for women, and low motivation. These factors often competed with participants’ intention to exercise, thus creating barriers that they must overcome to exercise. The quote for this theme is presented in Table 3. Perceived time constraints One of the main challenges was perceived time constraints. Participants who studied and worked full-time found it hard to find the time for exercise. However, despite time being a challenge, participants shared that they will still find time or ways to exercise. Although this was not always the case, with the age demographic of this study being varied, some participants did not find time challenging, as they have now retired and had no caring responsibilities once their children grew up. Confidence in ability Most participants said that confidence in their ability challenges their participation in muscle-strengthening exercises. This is mainly because they are not sure how to do the exercises and whether they are doing them correctly or not. Therefore, they mainly participated in exercises that they were more confident in. Accessibility Participants also reported that accessibility is a challenge in participation in muscle-strengthening exercise. A common aspect of accessibility is cost, as some participants find that it is expensive to go to the gym or have a personal trainer, whereas some participants found that not having access to the equipment and space needed was a challenge for them. Cultural stigma and societal perception The culture of stigma and societal perception of muscle-strengthening exercises for women was also one of the common challenges. Participants felt like the gym environment was more male-dominated and catered towards men, making them feel conscious, uncomfortable and intimidated. They also faced the societal perception of women not wanting to do muscle-strengthening exercises due to not wanting to look big, bulky and hurting themselves. Low motivation Finally, some participants mentioned that despite mostly achieving the guidelines, some days the motivation to do muscle-strengthening exercises is low, making it hard to do them. Participant also mentioned that sometimes they are not motivated to step out of their comfort zone once they find the exercise easy to do. *Table 3 here* Theme 3: Facilitators to Participating in Muscle-Strengthening Exercise This section covers the participants’ experiences and facilitators for their continued muscle-strengthening exercise participation. Participants mentioned several facilitators that helped them to overcome the challenges that they faced. These facilitators include the usage of information and resources, finding ways to make themselves accountable to do the exercises, having social support, and having choices of location and exercises. As they continued with these activities, they emphasised the benefits that influenced their long-term participation, including the positive changes in their physical and mental health that they observed. By identifying strategies to facilitate exercise, they discovered that these approaches are more effective for long-term participation. Table 4 shows the reported facilitators to participate in muscle-strengthening exercises by the participants. Use of information and resources Having resources and information available helped participants. When asking about the kind of resources and information that they used, several examples were given (Table 4). One participant explained that having these resources available has helped her to progress in her muscle-strengthening exercise journey. Another participant uses group exercise classes as a gateway to get comfortable and more confident in doing the exercise. Accountability Participants shared several other ways that made them accountable to do their muscle-strengthening exercises. While cost was reported as a challenge, some found that paying for gym membership, classes or personal trainers helped them to stay accountable and do the exercise. Many participants also mentioned that setting goals such as aiming to increase strength, being able to lift heavier and look better helped them to be consistent in their participation in muscle-strengthening exercises. A 57-year-old participant addressed the importance of keeping goals simple and not making the exercise too difficult. To overcome the time constraint barriers, one participant found that creating a schedule where they set a specific time to exercise was helpful in creating a routine for exercising. Social support Companionship and support systems were also mentioned by the participants to help them maintain their muscle-strengthening exercise participation. While some participants said that they preferred to exercise alone, others found that it was helpful to have friends or partners exercise with them, as it made them motivated and accountable to do the exercise. Words of encouragement received by the participants from their family and friends have also made them more motivated to continue participating in muscle-strengthening exercises. Several participants also shared that doing exercises that they enjoyed helped them to continue participating in muscle-strengthening exercises. Ability to choose Having the ability to choose the exercise location was also a factor that facilitated participants’ journey in muscle-strengthening exercises, as it relates to accessibility and comfort. Participants addressed that having the gym location nearby and accessible made it easier for them to do the exercise. For the same reasons, some participants chose exercising at home as it is easier and more convenient for them. Participants emphasised that being able to choose to do something they like, such as going to the exercise classes, has helped them stay motivated to finish the exercise. Positive changes When asked what helps motivate them to continue participating in muscle-strengthening exercises, participants mainly said that increases in their confidence and the changes they saw in themselves encouraged them to keep going. While participants found that participating in muscle-strengthening exercises helped them improve their mental health, one participant found that getting involved in these kinds of exercises has become her therapy. Participants also reported that participation in muscle-strengthening exercises also resulted in physical changes, such as changes in body shape and feeling stronger and flexible. Participants agreed that participating in muscle-strengthening exercises helped them to reduce and manage their pain, which then encourages them to keep participating. *Table 4 here* Theme 4: Suggestions For Others This section refers to participants' advice and suggestions to help women participate in muscle-strengthening exercises. These suggestions were framed at both what an individual can do and what others could do to encourage participation in muscle-strengthening exercises. These suggestions show how individual motivation, social, and environmental factors can encourage and maintain an exercise habit. This theme, with its indicative quotes, is described in Table 5. What an individual can do At an individual level, participants emphasised keeping it simple and using different modalities, such as doing bodyweight exercises, using resistance bands or trying out Pilates and yoga as a start to build their confidence in participating. Many participants emphasise the importance of knowing that starting with muscle-strengthening exercises does not mean it must be at the gym. Participants suggest that women who want to get started can do simple activities using resistance bands or body weight, and search online for how to do strength exercises and examples to build their confidence. Some also suggest that participants, who are able, can sign up with a personal trainer or join exercise classes to build their confidence and to learn the correct way of doing the exercises. What others can do As some women find it challenging to start doing muscle-strengthening exercises, the participants suggested that spreading awareness of the importance of muscle-strengthening exercises would be helpful. Participants suggested that focusing on the health benefits, not just losing weight or gaining strength, would help other women understand that participating in muscle strength is an investment for their future health. The most repeated suggestion was creating women-only spaces or sessions. As participants previously mentioned, going to the gym feels intimidating, making them feel self-conscious and intimidated. Having women-only spaces or sessions was suggested as it would make them feel much more comfortable. One participant also suggested that having kid-friendly classes would be beneficial, as women who have childcare responsibilities can still join the classes without having to find childcare. Participants also suggested that more personal trainers who specialised in women's fitness would be helpful as women experience different stages of development throughout their lives, such as puberty, pregnancy and menopause. Participants suggested looking for online content that is made by women and is suitable for people of various abilities would help women get started in muscle-strengthening exercises. While others agreed that there is a lot of information online which is easily accessible, participants also raised some concerns about whether the information is reliable. It is acknowledged that more valid and reliable resources would be helpful for women. However, participants still agree that online would be a great tool to use to make muscle-strengthening exercises more accessible, as most of the content is free. The availability of online resources helped to deal with accessibility issues such as cost and distance. *Table 5 here* DISCUSSION Considering the importance of muscular strength for women, understanding the barriers they face and facilitators for their participation in this is crucial. This current study explored the barriers and facilitators to participation in muscle-strengthening exercises among women who are currently meeting the muscle-strengthening activities guidelines. Challenges include perceived time constraints, limited accessibility, and low confidence. Conversely, facilitators such as accountability, the ability to make choices, and the utilisation of available resources fostered sustained adherence. Having women-only spaces and using different modalities for muscle-strengthening exercises, such as their own bodyweight and resistance, has been suggested to help women who do not participate in muscle-strengthening exercises begin their participation. These insights provide a nuanced understanding of how women initiate and sustain participation in muscle-strengthening exercises, while also offering suggestions for creating more tailored and gender-specific interventions, environments, and policy development. Participants reported a range of reasons for starting muscle-strengthening exercise, with health concerns emerging as the main reason, followed by sports performance. Some participants in this current study mentioned that they began muscle-strengthening exercises as prevention and management strategies to maintain their strength and independence, as some of them faced health concerns, such as having back and bone-related injuries, as well as seeing parental health deterioration. A smaller group of women in the present study were driven by the improvement in physical performance for sports which they already engaged in, such as producing more strength and power. Whilst there is less existing qualitative evidence on why people decided to start muscle strengthening activities, there is related evidence on factors that influence continued participation in muscle strengthening activities that align with these findings. For example, a 2025 cross-sectional survey by Jones et al. [ 17 ] of 269 women aged 18–34 years reported that positive health changes and gaining strength and endurance were predictors of participation in muscle-strengthening activities. These women were younger than the current sample and did not yet face age-related health concerns; therefore, while emphasising the benefits of muscle-strengthening activities remains important, interventions that reach women at the point when they begin to perceive health-related changes may be particularly effective. Participants described a range of challenges that they faced when participating in muscle-strengthening exercises. In the present study, perceived time constraints emerged as the most common challenge to participation in muscle-strengthening exercises, aligning with numerous studies that have cited time constraints as a universal barrier to exercise in general and muscle-strengthening exercises among adults regardless of gender [ 18 – 21 ]. Hurley and colleagues in 2018 [ 21 ] surveyed 116 college women to explore their perceived benefits and barriers to resistance training participation. Using hierarchical multiple regression to assess what predicts the barriers to participation in resistance training, they found that the most significant predictors of reduced participation were the perceived time and effort barriers [ 21 ]. Engagement in muscle-strengthening exercises is lower when there is a higher perception that time and effort as barriers [ 21 ]. Whilst time constraints were frequently reported as the main barrier, participants in this present study described strategies that have helped them to overcome this challenge. As this challenge is closely determined by one’s lifestyle, participants in this present study reported that creating a schedule and blocking specific time for exercising has helped them to maintain their participation. In an online survey conducted by Luckin and colleagues in 2021 [ 20 ] on identifying barriers to strength training among 390 athletes, they also reported a similar finding. The study reported that creating an exercise program that aligns with an individual’s preferences regarding the types and schedule for exercise can effectively reduce the perception of time as a challenge to exercise participation [ 20 ]. The findings collectively highlight that while perceived time constraints were often cited as one of the barriers to participation in muscle-strengthening exercises, having a personalised schedule for exercise according to their preferences can help to overcome this challenge. In addition to perceived time constraints, participants in this current study reported that having low confidence in their abilities, such as performing the exercises and using the equipment or modalities, was a challenge to their participation in muscle-strengthening exercises, consistent with other studies where knowledge and education were reported as factors impacting women’s participation in muscle-strengthening exercises [ 20 , 22 , 23 ]. For example, Luckin et al. [ 20 ] reported that 58% of females reported that ‘being unsure’ (28% on what exercise to do, 16% on how to progress and 14% on the exercise technique) is their main perceived barrier to participation. For this barrier, participants in the present study used resources available, such as hiring a personal trainer, using online resources, or exercise classes, which have helped them to be more confident in doing the exercises and increasing their knowledge. These are simple strategies that can be taken forward by other women, although some may have concerns regarding the additional cost. Having access and guidance from professionals, such as a personal trainer, reduced the concern of not knowing how to do the exercise and made muscle-strengthening exercises feel more approachable. This aligns with the survey findings in the randomised control trial by Heiestad and colleagues in 2016 [ 23 ], who found that, in previously inactive overweight women (n = 143), adherence to muscle-strengthening exercises was much higher among those who exercised with guidance from a professional, such as a personal trainer. While getting a personal trainer will have an additional cost burden to some, participants in this present study also emphasised the usefulness of the freely available resources online to increase their knowledge and understanding of performing the exercises, whilst acknowledging issues around the reliability of resources. Corroboratively, studies by Luckin et al. [ 20 ] and Petrov et al. [ 22 ] reported that increasing knowledge will indirectly increase confidence and self-efficacy in performing the exercises, both of which are important to sustained participation in muscle-strengthening activities. Similarly, Hurley et al. [ 21 ] also reported that holding education sessions around muscle strengthening exercises may help reduce the perceived challenges to participation. Taken together, these findings suggest that the utilisation range of resources, whether through online platforms or personal trainers, can improve confidence and self-efficacy in performing muscle-strengthening exercises, thereby helping women to overcome the barriers related to low confidence in ability. The gender-based stigma and societal perception, such as women not needing muscle-strengthening exercises, have initially created a barrier to the participation of women in this current study. In 2009, Velija and Kumar [ 24 ] did a focus group interview with 16 young girls aged 14 to 16 to examine their exercise experiences and found that perceptions of physical education are influenced by gender roles within the activity. Younger girls were being directed to participate in traditionally feminine activities like aerobics and avoiding more “masculine” tasks such as lifting weights [ 24 ]. This gender-based stereotype at a younger age may mould the way that these girls think as they get into adulthood, where resistance training or muscle-strengthening activities are still perceived as masculine activities. Despite some women engaging in muscle-strengthening exercises, these activities remain predominantly male-oriented. In a systematic review and meta-synthesis of 20 studies (n = 402) by Vasudevan and Ford in 2022 [ 25 ] on motivation and barriers to women's initiation and participation in strength training, gender-based and social stigma were the most prominent barriers in several studies, no matter the women’s age (college students and older women) [ 26 – 28 ]. Women tend to be more uncomfortable and self-conscious when doing the exercises in a male-dominated area due to the unwanted comments and attention [ 25 ]. In the 2018 qualitative study by Coen et al. [ 29 ] reported that women interviewed felt uncomfortable and unwanted in the gym when the men were taking up the spaces, hogging equipment and being loud. To overcome this barrier, women in this current study suggested that having women-only spaces and kid-friendly spaces would help other women to participate in muscle-strengthening exercises. This aligns with Hurley et al. [ 21 ], who reported that barriers such as feeling uncomfortable can be reduced when there are women-only classes or a women-only area in the fitness centre. Similarly to our study, participants found that exercising in a group setting, with a training partner or personal trainer, has helped them to keep going. By not being alone when exercising, it has helped themselves to feel less self-conscious while also increasing their knowledge and confidence in doing the exercises. The results of the current study show that cultural stigma and societal perception surrounding women’s participation in muscle-strengthening exercises are still an ongoing experience, and to address this barrier, a more complex and systems-level approach is needed, such as having women-only spaces. Implications for future research and practice These findings offer practical strategies both for women not yet engaging in muscle-strengthening activities and for practitioners and policymakers aiming to increase participation. While some of the barriers and facilitators identified are already well recognised and relevant across genders, the persistence of low participation among women indicates that current approaches remain insufficient. The results of the present study point to the need for more nuanced, gender-sensitive strategies that address cultural, environmental, and educational influences on participation. Communicating these strategies directly to women, for example, through targeted health promotion and social marketing campaigns, may enhance their reach and effectiveness. Such campaigns should highlight not only the physical and mental health benefits of muscle-strengthening exercise but also tackle issues of confidence, accessibility, and cultural stigma. Tailoring messages, resources, and interventions to specific life stages, including perimenopause and retirement, may further improve engagement by aligning recommendations with women’s real-life experiences and priorities. Practical implementation could include developing women-only or family-friendly exercise spaces, embedding professional guidance within community and digital programmes, and ensuring access to reliable, evidence-based resources to strengthen women’s confidence and self-efficacy. Strengths and limitations While the previous systematic review and meta-synthesis by Vasudevan and Ford [ 25 ] examined the barriers and facilitators to women’s participation in strength training, this current study offers a UK-specific, solution-oriented exploration according to the lived experiences of women who met the recommended guideline. By focusing on the context-specific barriers and actionable strategies, it provides practical insights on developing more tailored and gender-specific interventions, environments, and policy development. Nonetheless, certain limitations were found within this present study. Considering the low sample size, it may not be generalisable to the experiences that other women faced. In addition to that, since this study did not consider the cultural and ethnic diversity within its participants, it also restricts the application of the findings to a larger population with different ethnicities and cultural backgrounds, as experiences may differ. Understanding the challenges and facilitators across different groups may help to have a more successful intervention and policy development. The self-reported nature of this study may also be subject to recall or social desirability bias from the participants. Future research might address these limitations by implementing a mixed-method approach and including a more diverse population, for a longer term and conducting an implementation trial to better inform the scalable policy and to see how the recommended strategies will work in a real-life setting. CONCLUSION This study provides new insights into the experiences of women who already meet muscle-strengthening guidelines. While many barriers remain consistent with earlier studies, our findings reveal how women overcome barriers with lived experience-based strategies such as scheduling, goal setting, social support, and building confidence using online resources and professional guidance. Importantly, participants also went beyond their own strategies and offered solutions around more complex changes such as adapting gym environments, creating women-only spaces, and improving the validity of online resources. Together, these findings extend current knowledge by showing not only the barriers to women’s participation but also how women overcome these in practice. They provide valuable guidance for interventions and policies aiming to close gender gaps in muscle-strengthening activity and to promote equitable opportunities for women’s health across the life course. Abbreviations MSE Muscle-Strengthening Exercises Declarations Competing Interest None declared. Ethical Approval and Consent Information This study was approved by the College of Medical, Veterinary and Life Sciences Ethic Committee at the University of Glasgow (Reference Number: 200230238). Informed consent for data collection and publication was collected from the participant before the interview. Funding NR is supported by a doctoral scholarship from Majlis Amanah Rakyat (MARA), Malaysia, through the Graduate Excellence Programme (GReP). Authors’ Contribution NR: Conceptualisation, Visualisation, Methodology, Investigation, Data Curation, Data Analysis, Writing - Original Draft, Writing - Review & Editing, Project Administration. SG: Conceptualisation, Visualisation, Data Analysis, Supervision, Writing – Review & Editing. EO: Data Analysis. GR: Conceptualisation, Visualisation, Methodology, Data Analysis, Supervision, Writing - Original Draft, Writing - Review & Editing. Acknowledgement We wished to thank all women who participated in this study. Data Availability Data will be made available upon reasonable request from the corresponding author. Patient and Public Involvement Participants were not involved in the design, conduct, reporting or dissemination of this study. References Sabag A, Patten RK, Moreno-Asso A, Colombo GE, Dafauce Bouzo X, Moran LJ, Harrison C, Kazemi M, Mousa A, Tay CT et al : Exercise in the management of polycystic ovary syndrome: A position statement from Exercise and Sports Science Australia . J Sci Med Sport 2024, 27 (10):668-677. Sundell J: Resistance Training Is an Effective Tool against Metabolic and Frailty Syndromes . Adv Prev Med 2011, 2011 :984683. Hong AR, Kim SW: Effects of Resistance Exercise on Bone Health . Endocrinol Metab (Seoul) 2018, 33 (4):435-444. Deprato A, Ruchat SM, Ali MU, Cai C, Forte M, Gierc M, Meyer S, Sjwed TN, Shirazi S, Matenchuk BA et al : Impact of postpartum physical activity on maternal depression and anxiety: a systematic review and meta-analysis . Br J Sports Med 2025, 59 (8):550-561. Calmels P, Vico L, Alexandre C, Minaire P: Cross-sectional study of muscle strength and bone mineral density in a population of 106 women between the ages of 44 and 87 years: relationship with age and menopause . Eur J Appl Physiol Occup Physiol 1995, 70 (2):180-186. Phillips SK, Rook KM, Siddle NC, Bruce SA, Woledge RC: Muscle weakness in women occurs at an earlier age than in men, but strength is preserved by hormone replacement therapy . Clin Sci (Lond) 1993, 84 (1):95-98. Montero-Fernandez N, Serra-Rexach JA: Role of exercise on sarcopenia in the elderly . Eur J Phys Rehabil Med 2013, 49 (1):131-143. Physical Activity Guidelines: UK Chief Medical Officers’ Report [https://www.gov.uk/government/publications/physical-activity-guidelines-uk-chief-medical-officers-report] World Health Organization: WHO Guidelines on Physical Activity and Sedentary Behaviour . In: WHO Guidelines on Physical Activity and Sedentary Behaviour. edn. Geneva; 2020. Strain T, Fitzsimons C, Kelly P, Mutrie N: The forgotten guidelines: cross-sectional analysis of participation in muscle strengthening and balance & co-ordination activities by adults and older adults in Scotland . BMC Public Health 2016, 16 (1):1108. Health Survey for England, 2021 part 2 [https://digital.nhs.uk/data-and-information/publications/statistical/health-survey-for-england/2021-part-2/physical-activity#references] The Scottish Health Survey 2023 - volume 1: main report. 9.Physical Activity [https://www.gov.scot/publications/scottish-health-survey-2023-volume-1-main-report/pages/0/] Rosaini ND, Dighriri A, Gray SR, Ryde GC: Exploration of Activities People Participate in to Meet the Muscle-Strengthening Physical Activity Guidelines . [manuscript submitted for publication] 2025. Braun V, Clarke V: One size fits all? What counts as quality practice in (reflexive) thematic analysis? Qualitative Research in Psychology 2021, 18 (3):328-352. Braun V, Clarke V: Reflecting on reflexive thematic analysis . Qualitative Research in Sport, Exercise and Health 2019, 11 (4):589-597. Braun V, Clarke V: Using thematic analysis in psychology . Qualitative Research in Psychology 2006, 3 (2):77-101. Jones CS, Spring KE, Wadsworth DD: Factors influencing regular exercise in young women: a survey study assessing the preferences and motivators for aerobic and muscle-strengthening exercise . Health Psychol Behav Med 2025, 13 (1):2465613. Ashton LM, Hutchesson MJ, Rollo ME, Morgan PJ, Thompson DI, Collins CE: Young adult males' motivators and perceived barriers towards eating healthily and being active: a qualitative study . Int J Behav Nutr Phys Act 2015, 12 :93. Kulavic K, Hultquist CN, McLester JR: A comparison of motivational factors and barriers to physical activity among traditional versus nontraditional college students . J Am Coll Health 2013, 61 (2):60-66. Luckin KM, Badenhorst CE, Cripps AJ, Landers GJ, Merrells RJ, Bulsara MK, Hoyne GF: Strength Training in Long-Distance Triathletes: Barriers and Characteristics . J Strength Cond Res 2021, 35 (2):495-502. Hurley KS, Flippin KJ, Blom LC, Bolin JE, Hoover DL, Judge LW: Practices, Perceived Benefits, and Barriers to Resistance Training Among Women Enrolled in College . Int J Exerc Sci 2018, 11 (5):226-238. Petrov Fieril K, Fagevik Olsen M, Glantz A, Larsson M: Experiences of exercise during pregnancy among women who perform regular resistance training: a qualitative study . Phys Ther 2014, 94 (8):1135-1143. Heiestad H, Rustaden AM, Bo K, Haakstad LA: Effect of Regular Resistance Training on Motivation, Self-Perceived Health, and Quality of Life in Previously Inactive Overweight Women: A Randomized, Controlled Trial . Biomed Res Int 2016, 2016 :3815976. Velija P, Kumar G: GCSE physical education and the embodiment of gender . Sport, Education and Society 2009, 14 (4):383-399. Vasudevan A, Ford E: Motivational Factors and Barriers Towards Initiating and Maintaining Strength Training in Women: a Systematic Review and Meta-synthesis . Prev Sci 2022, 23 (4):674-695. Peters NA, Schlaff RA, Knous JL, Baruth M: Barriers to resistance training among college-aged women . J Am Coll Health 2019, 67 (1):4-9. Burton E, Farrier K, Lewin G, Pettigrew S, Hill AM, Airey P, Bainbridge L, Hill KD: Motivators and Barriers for Older People Participating in Resistance Training: A Systematic Review . J Aging Phys Act 2017, 25 (2):311-324. Cavill NA, Foster CE: Enablers and barriers to older people’s participation in strength and balance activities: A review of reviews . Journal of frailty, sarcopenia and falls 2018, 3 (2):105. Coen SE, Rosenberg MW, Davidson J: "It's gym, like g-y-m not J-i-m": Exploring the role of place in the gendering of physical activity . Soc Sci Med 2018, 196 :29-36. Tables Table 1. Demographic characteristics of participants. Participants (N = 24) Age Group 18 to 30 years old 2 (8.3) 31 to 47 years old 6 (25.0) 48 to 64 years old 16 (66.7) Deprivation Category, n (%) Most deprived 4 (16.7) 2 nd most deprived 1 (4.2) Median quantile 6 (25.0) 2 nd least deprived 4 (16.7) Least deprived 9 (37.5) Working Status, n (%) Full time student 4 (16.7) Employed or self employed 14 (58.3) Doing unpaid work 0 (0.0) Unemployed 1 (4.2) Retired 5 (20.8) Academic Level, n (%) No formal qualification after school 1 (4.2) Trade, technical certificate, apprenticeship or diploma 4 (16.7) University degree or higher 19 (79.2) Marital Status, n (%) Single 7 (29.2) Married (without children) 0 (0.0) Married (with children) 13 (54.2) Divorced/Separated (with children) 4 (16.7) Frequency of Muscle-Strengthening Exercise Participation 2 to 3 days a week 17 (70.8) 4 to 5 days a week 4 (16.7) 6 to 7 days a week 3 (12.5) Exercise Setting Gym 8 (33.3) Home 5 (20.8) Group exercise classes 4 (16.7) Combination 7 (29.2) Type of Exercises Bodyweight exercises 1 (4.2) Weight machines or resistance exercises 6 (25.0) Holistic exercises (i.e. yoga, Pilates) 3 (12.5) Combination 14 (58.3) The deprivation category is based on the quintile of the index of multiple deprivation (IMD). The full category of working status is as follows: 1) Full-time student, 2) Employed or self-employed, 3) Doing unpaid work (for own or family business/volunteering/looking after family or home), 4) Unemployed (looking for a job/unable to work due to illness or disability), 5) Retired, 6) Not specified. The total sample represents the total responses in each category whereas the percentage represents the percentage within the group. Table 2. Reasons for participating in muscle-strengthening exercises. Codes Subcodes Indicative quote(s) Health concerns Having injuries “Two years ago, I had really bad back. I had a herniated disc. It probably took a year to clear up completely, though. So, when my back was bad, I went to physio and was given a physio programme and that’s basically what started me doing the muscle-strengthening exercises, and then I started going to Pilates…I think I sort of had the motivation. The motivation came from not wanting to be injured. Again.” (P25) Family health “I supposed the big motivation factor is my mom (health) was really poor. She had multisystem atrophy. So, we watched her kind of decline. And in the back of my mind is kind of like if I did better on baseline fitness, that if I do anything like that, I might have a better starting point than what she did.” (P09) Ageing “I think it’s sort of for our future proofing, investing in my health, particularly to have seen my parents’ health deteriorate.” (P22) Menopause “I’ve had children and in the middle of perimenopause. I found that I put on quite a lot of weight when I started menopause, and I found that this (muscle-strengthening exercises) has helped me stabilise my weight a lot more than cardio.” (P01) Having awareness or realisation of maintaining muscular strength “I think the realisation that you have to keep your muscle strength comes when you’re in your 30s. I think maybe when you realise that you do need to stay fit to look after your family…I probably always knew that everybody should do it. When I was young, doing nursing, it was very popular back then in the 80s and 90s to go to step classes and aerobics…as you got a bit older, you realised that you need muscle strength to kind of balance it.” (P24) Sports performance Improving sports performance “I do a lot of leg work because that strengthens my rowing.” (P02) “I recently took up weights to improve my karate.” (P06) “When I was starting, I was doing sport (rowing). And I think some part of it was to get better at rowing is to be able to produce more strength in it.” (P10) Table 3. Challenges to muscle-strengthening exercise participation. Codes Subcodes Indicative quote(s) Perceived time constraint Study and work commitment “I worked full-time. So, finding a slot where I could do it because obviously with personal training, there’s only a certain amount of hours in the day and stuff. But I’ve now realised that I have to make the time because it’s good for me and it’s my time.” (P07) “Yeah, it’s one of the reasons why I do exercise at home because it can be done quickly. You can do it in maybe half an hour. Whereas at the gym it can take a long time.” (P19) Free time and no caring responsibilities “Before I retired, everything was a challenge because I had no time, and I was too tired. So not having to go out to work has made it very easy for me.” (P15) “Got lucky with that. My children are around 20 to 25…So I don’t really have any responsibilities around that anymore. It certainly would’ve been a bigger barrier years ago, trying to deal with childcare, and you prioritise the children's activities than your own.” (P23) Confidence in ability Unsure on how to do the exercises “I would never go to a gym and use their equipment because I will be thinking, gosh, I’ve never been to the gym. I don’t know where to start. I don’t know how to use this (equipment). I’d feel stupid.” (P05) “…we’ve been away in our motorhome for four weeks. We took all our resistance bands so that we could do our strength training in the van. Well, they never came out. They never got out once…I am not confident with using resistance bands. So, I don’t really know how they work. So, I couldn’t pick one up and know instantly how to do the exercise.” (P17) “My knowledge of using machines isn’t good. So, I tend to go to different classes, whether it’s like legs, bums, and tums, or circuits. I supposed my knowledge is recent, not basic. I suppose I would want to get better at identifying proper exercises.” (P23) Accessibility Cost “When I was a student here (university), I got a discount but as a working adult, some other gyms get quite expensive.” (P06) “I would love to sign up for a PT, but, you know, there’s one thing paying £25 a month for gym membership, but it was close to £25 a session for an hour minimum for a PT.” (P23) Space and equipment availability “Depends what time you go. It could be that it’s so busy that you just cannot do the exercise that you have planned. And I’m autistic. So, I stick to the plan. And that’s a big challenge. If I can’t do my plan, and there’s a lot of waiting.” (P08) “At home, the challenge probably needing the equipment for lifting heavier weights. Possibly the environment, the space.” (P19) “In certain gyms, they have 15kg bars, which for a lot of women, it makes upper body workouts more accessible with a barbell. But some gyms will only have a 20kg bar. For women starting at 20kg is just too heavy.” (P20) Cultural stigma and societal perception Male-dominated and oriented and catered towards men “Sometimes in the weight room, you can imagine the man are all grunting and throwing the weights around and that’s quite just not very pleasant.” (P04) “When it's really busy in the gym, I’m not gonna go and park myself in an area of the gym that’s full of men training.” (P09) “So much of the gym equipment isn’t designed for women. Like racks of dumbbells at 17 and a half, but there’s only one set of 12 and there are loads and loads of 2kg weights. That is patronising towards women…I would love to visit a gym that has been designed by women for women and see what it looks like. It doesn’t mean everything is pink…One of the reasons I don’t like (going to the gym) at six o’clock is it’s all regulars. They are very male. They know exactly what they are doing. They monopolise the equipment.” (P22) Societal perception of women not needing muscle-strengthening exercises “There’s a bit of a generation thing as well, because like my mom, in her generation, if you said to her you need to lift weights or do resistance training, they’re kind of like, well I don’t want big bum. But that’s not the point of it.” (P02) “My husband laughed when I told him I was going to do it and his initial thoughts was I was going to look like one of the bodybuilders with the bikini and everything…so I explained to him that I wasn’t going to go on steroids and that I am not going to look like that.” (P07) “I think unfortunately, there is still this assumption that it’s probably going to change from women doing cardio to now they do yoga and Pilates, and the guys go to the gym. But I think that guys can get an awful lot of flexibility, just as much as women can get an awful lot out of strength...There are also a lot of misconceptions out there about strength where you can damage yourself or that as a woman you can get bulky. People come to me and go, oh, I don’t wanna get bulky, and I’ve said, well, you’re a woman, you haven’t got the testosterone in your body.” (P20) Low Motivation Low motivation to do exercise “The only challenge I find is motivating myself to do it…with the videos, because I will think, oh, tomorrow I’ll do that. Then tomorrow comes and you don’t do it for one reason or another.” (P05) Low motivation to step out of the comfort zone “It does get to a point where you tend to do the same things because it’s easier. It’s harder to motivate yourself to progress on your own.” (P19) Table 4. Facilitators to participating in muscle-strengthening exercise. Codes Subcodes Indicative quote(s) Use of information and resources Using available resources and information “Having a personal trainer” (P07, P14, P20, P22, P25) , “Using an application” (P10, P14, P22, P23, P25) , “Going online such as Google and YouTube” (P05, P10, P15, P18, P19, P22, P24), “Going to exercise classes” (P05, P07, P11, P16, P22, P23, P24) “Buying online exercise course” (P17) “I went to the gym a bit and signed up for a class…I started to go on an organised class to sort of see what it was all about, how I felt, get comfortable with the physical location and see how I felt with the exercises. So, I started doing classes, then I got a personal trainer. Then I moved with that, and I’ve gained more confidence to use all the equipment and free weights myself.” (P22) Group exercise classes “I used to do that (classes) before I felt confident enough to just go to the gym by myself. But then as soon as I transitioned into that, I just stuck with no classes.” (P10) Accountability Cost “If you sign up for a class, there’s accountability because you pay the classes involved in the monthly payment and if you cancel, you kind of let yourself down, if that makes sense. If you don’t show up, then it’s kind of like three strikes system then you’re blocked for a week.” (P23) “I’m up north so gym membership isn’t expensive. Discretionary spend for some but if I were putting something down, whether it is an essential spend or discretionary, I would put gym membership as an essential spend…I realised the importance of it for my own health and healthy heart, importance of strength training as well.” (P22) Goal setting “I think, psychologically, not making it too difficult. Which is why I only use very light hand weights. Because I know I am not going to be too sore afterwards. I think that I just wanted to be as fit as I can be at this stage of life that I am.” (P24) Scheduling “I was confident enough when I was working to schedule it in my diary, so people knew. I used to have team meetings with my boss, and it started at quarter past nine in the morning, and I asked if we could change it to half past nine so that I could go to the gym, and with that extra 15 minutes, I was less sweaty and flustered and feeling rushed to it. I thought I felt confident enough to say, well if I don’t ask, I won’t know…So it’s being confident saying, this is what I do, this is my time, and sort of scheduling it.” (P22) Social support Companionship “Having a friend to do it with me and not being on my own. Because that gives you a competitive edge to it. Like when you lift something, I always lift more when I’m with my friend. If I was on my own, I’d probably just be like, oh, I’m tired, I am going to leave now, you know. Having a person with you is great and also having someone telling you, you’re doing great, and coming up with ideas, oh, we’re doing stuff like this.” (P08) “Meeting my friends when I first joined this new gym was brilliant. Because we held each other accountable, you won’t want to let them down for not meeting them. That was really helpful.” (P22) “I think I am more motivated that my partner does it with me in the morning on a workday. Because I think, to be honest, if I was in the house on my own, and it was like seven in the morning, I would probably just have two coffees. But because he motivated me to do 20 minutes, then I do the 20 minutes and then I have a coffee.” (P24) Words of encouragements “For me, I would say that I have support at home. I have a very supportive partner. He will look after our child and his support allows me to spend time doing the things that I want to do.” (P04) “I have a partner who’s very encouraging. Like, if I’m not feeling like going one day, maybe he will push me to go because he knows I would like it.” (P10) “I think I probably surprised people. My husband said he’s really proud of me because I really sort of stuck at it. I think other people have said, I never saw her at the gym but now every time I go in there, she’s there!” (P25) Ability to choose Exercise “I like lifting heavy things. I would say I like moving, particularly swinging a really heavy kettlebell or throwing a barbell around. Personally, I found that empowering as a woman.” (P20) “I think I like being flexible. I like doing things that make me feel flexible. So like getting into weird positions in yoga. For somebody who is 57, I like to think that I am a bit flexible. I also really like the fact that things like Pilates and yoga work quite a lot on your core. But you don’t really get in a sweat or out of breath.” (P24) Location or logistic “My access to the gym has made it really easy for me. It’s all in my route going to the university, as well as within walking distance. I think if it wasn’t that it would be a bit of a challenge.” “It’s convenient and quick. Quicker than having to actually go somewhere. Being able to do it at home is part of why I would do it. It’s not like I couldn’t go to the gym. There’s a local gym. It’s just that I find the gym is not very welcoming a lot of the time.” (P19) “Motivation is good when I’m in a class because we are doing it together. If I were to do it myself, I don’t think I would do it.” (P11) “The feeling of achievement when I finished the class. I also enjoy it because it’s a group setting. I tried to go to the gym before, I just did not enjoy it. I did not feel motivated to finish the exercise. In the class, I like the structure of the class. I like that it’s like having a personal trainer, but in a group setting…also the motivation side of it when seeing people doing and pushing forward just made me want to do more.” (P16) Positive changes Confidence “When I started it, I wanted to avoid the pain that I was having and for the state of my body. But now as you study more about the human body, it’s also for the health benefits that you get. When you first started, you were not sure about techniques, so you carried small weights and everything. Your confidence with the practice will then increase and yeah, you go and challenge yourself more. So that’s why it becomes more rewarding, and you become happier doing this stuff.” (P16) Mental health “I started lifting because my eldest daughter was quite unwell and her psychiatrist said I needed to have counselling, to talk about her mental illness. We talked about it a lot and I couldn’t do that anymore. So, one day I started to go to the gym, and I found lifting heavy deadlifts became my therapy…that was the thing I did because you can’t think about anything else. When you pick something heavy off the floor, you’ve got to concentrate on it, you can’t be distracted, you can’t have any noise in your head, you just have to focus on what you’re doing and be in the moment and be present.” (P20) Positive body image “…I supposed that kind of secondary benefit is that you look better in your clothes.” (P04) “My husband says my body shape is now back to what I had in my 20s…I definitely feel stronger, and you know, my body shape has changed considerably.” (P07) Pain management “I have been diagnosed in the past as having disc degeneration in my lower back. I think it’s probably worse if I don’t exercise. So, I can use it as an excuse (to not exercise), but when I do exercise, it’s actually lessened the pain and much better.” (P19) Table 5. Suggestions for improvement. Codes Subcodes Indicative quote(s) What an individual can do Simplicity “Participating in muscle-strengthening, as I say, doesn’t necessarily need to be in a gym. I think that a lot of women have that as a massive stumbling block to approach, signing up for the gym, being in a gym with the environment being male-dominated, and so many things. If they are not confident yet in their knowledge or ability, it’s a massive thing to ask them to do…so I think that targeting what people can do at home is a very good point to start.” (P13) “Have some gentle and we're starting off gentle anyway. Because a lot of it is very simple, isn't it? I think when you see these, when you go online, some of these exercises are really simple to do. And people perhaps don't think that they, it's something they might think, "oh, well, I haven't done any exercise for yours. I can't do it." But when you see how simple it's just a matter of, you know, raising your heels and standing on your toes or something as a start. It's very, you know, it's very simple. So, everyone can do it. But I think maybe a lot of people think that it's just not for them.” (P05) Using other modalities “You could do something. I mean, you could get some resistance bands and do things at home as simple as that would benefit your health.” (P02) “Yeah, depends on who you are. Start off slowly. Maybe do a bit of yoga, Pilates, but the things that's really going to make a difference is using weights. And that takes less time. Quicker, more effective. That would be my advice. But again, everybody is different. I know some people prefer just the bodyweight only.” (P18) What others can do Spreading awareness “I guess if people were more educated on how important it is, throughout their life. I think one of the reasons that women get intimidated about it is because of that kind of thing when people are building muscle for the way they look and want to have big biceps, all that kind of stuff. Most women don’t want that. That’s not a priority for them. They don’t want to be big and muscular. I think if there was more emphasis on muscle strength and how it helps your overall metabolism, how you burn calories, how you are going to stay strong and not fall over and all that kind of stuff. I think it would improve people’s perception of strength training.” (P19) Women-only spaces and kid-friendly classes “I think seeing people like yourself (women) in that space will make you feel welcome.” (P04) “One of my old gyms had a female-only group. I think that was quite beneficial. I mean, because I trained around guys in karate all the time, it doesn’t bother me going to the gym full of guys. But yeah, I certainly feel like a lot of people, well, I would still find it assuring when I see other girls around the gym. It is sort of a peer influence.” (P06) “When I first worked as PT, there was a rule that babies could not be on the gym floor. So, you’d have a woman with a small baby, and she was told that she couldn’t bring it with a carrycot into the gym. Well, that child is safe in that. They’re not gonna come into harm. So, from a safety point of view, there’s not an issue, but because there was a rule that you couldn’t have a crying baby in a gym or whatever. Equally with my studio here, when I have clients as I am pre and postnatal trained, I’ve had clients that had children and I will say, well, bring your baby. Because I can coach you and if the baby wakes up, I can hold your baby and I can still coach you. So, you haven’t got that added barrier of who am I going to take the baby to for childcare? What is the cost of childcare and the added logistic burden of actually getting the babies somewhere else and then going to pick them up afterwards? They can just go to the gym with the baby.” (P20) Women’s fitness specialist “I can tell you from my perspective because I am in a team sport, like a league as well. There’s a big thing about being well-informed about perimenopause. We have quite a lot of female focus (trainers) in our league. So, they have been working to raise awareness about perimenopause.” (P08) “I chose my personal trainer very carefully, who understood menopause as well. I think it’s the same with new mums. You have to be careful, don’t you? Because of your muscles and you are getting back to exercise as well. So, it’s finding the right group of experts. I think it’s really important.” (P22) “I think looking for content, like YouTube content, for example, with women. That way, you can see, because most people at the gym are fit and muscular, so it’s good to be able to see a woman. It would help you realise that it’s possible. It helps you realise what you can end up looking like. Because obviously, you wouldn’t look like a man.” (P10) Reliable and accessible resources “I went on the internet to see how much information is out there for people. If you just googled strengthening exercises, there’s tonnes of information, there’s tonnes of videos, there’s tonnes of posters. So, one of the things I like to think of is whether it is validated. If the information has come from some sort of NHS or academic, I think you can believe in it.” (P05) “There’s so much out there. And I don’t know if it’s true. I can always go by myself (to exercise). And it made me feel stronger, rather than those videos. But of course, I do get sucked into all these videos that say, these five exercises to work on will change your life, and then I do fall for those sometimes. I don’t know which one is the best.” (P18) “There’s lots of free stuff. People put things on YouTube, who knows what they talk about and are good trainers. You don’t have to pay for it. But I do think even if you are paying for it, it’s a good thing. It’s better than doing nothing at all. And I think maybe if they pay for it, that might motivate them to do it. I know that nobody knows that you pay for it. So, it’s not accountable to anyone but yourself. I think maybe that’s true. I’ve never paid for YouTube trainers, but my husband has, and it motivates him to do it.” (P19) Additional Declarations No competing interests reported. Supplementary Files SupplementaryMaterial1WISHTopicGuide.pdf Cite Share Download PDF Status: Published Journal Publication published 21 Jan, 2026 Read the published version in BMC Public Health → Version 1 posted Editorial decision: Revision requested 21 Oct, 2025 Reviews received at journal 20 Oct, 2025 Reviewers agreed at journal 19 Oct, 2025 Reviews received at journal 06 Oct, 2025 Reviewers agreed at journal 03 Oct, 2025 Reviewers agreed at journal 01 Oct, 2025 Reviewers agreed at journal 01 Oct, 2025 Reviewers agreed at journal 23 Sep, 2025 Reviewers invited by journal 22 Sep, 2025 Editor assigned by journal 26 Aug, 2025 Submission checks completed at journal 26 Aug, 2025 First submitted to journal 26 Aug, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7461038","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":523879095,"identity":"756530f4-cac7-4d0c-8169-421170a7913a","order_by":0,"name":"Nur Dania Rosaini","email":"","orcid":"","institution":"University of Glasgow","correspondingAuthor":false,"prefix":"","firstName":"Nur","middleName":"Dania","lastName":"Rosaini","suffix":""},{"id":523879098,"identity":"b5afb179-8edb-4114-8ede-f3e736b7abc5","order_by":1,"name":"Stuart R. Gray","email":"","orcid":"","institution":"University of Glasgow","correspondingAuthor":false,"prefix":"","firstName":"Stuart","middleName":"R.","lastName":"Gray","suffix":""},{"id":523879104,"identity":"e5469807-da73-43e1-b4dd-f6be44201b06","order_by":2,"name":"Esther Oyebola","email":"","orcid":"","institution":"University of Stirling","correspondingAuthor":false,"prefix":"","firstName":"Esther","middleName":"","lastName":"Oyebola","suffix":""},{"id":523879109,"identity":"51c4e8f4-4356-4889-9f23-b0328bb24c2c","order_by":3,"name":"Gemma C. Ryde","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABC0lEQVRIiWNgGAWjYFCDA8wHGB4g8Q2I0MKWwJBAohYeA+K0yLt3p274wXAvse94z+cXCTV1dv0SCYwffjAcNsalxfDM2W03exiKE2cCGRYJxw4nz5yRwCzZw3DYDKeWGbnbbvAwJCRuuJG7zSCB7UCywe0EBmkGhsM2OLXMf7vt5h+Qlvtvnhkk/KsDaWH+jU+LvATvttsQW3iYHyS2MdsBtbCBbMHpMAOe3G23ZQwSjGeeSTNjSOw7nCA5/2GbZY9BOk7vy7cDvf+mIkG27/jhxx8+fKuz5+c5fPjGjwprwwZcthwAkwyOQAVsEkBmYgMDYwPeiJSHmmUPxMwfoIxRMApGwSgYBSgAACxWYubsSu0RAAAAAElFTkSuQmCC","orcid":"","institution":"University of Glasgow","correspondingAuthor":true,"prefix":"","firstName":"Gemma","middleName":"C.","lastName":"Ryde","suffix":""}],"badges":[],"createdAt":"2025-08-26 09:08:29","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7461038/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7461038/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12889-026-26207-9","type":"published","date":"2026-01-21T15:58:21+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":92691245,"identity":"486b0046-2eb8-4387-b7e4-aac7bc336300","added_by":"auto","created_at":"2025-10-03 05:08:55","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":137927,"visible":true,"origin":"","legend":"","description":"","filename":"WISHInterviewwithWomenParticipatinginMuscleStrengtheningExercisesHowAreTheyDoingIt.docx","url":"https://assets-eu.researchsquare.com/files/rs-7461038/v1/63cbcc1d89f65a4c5d174f3f.docx"},{"id":92691216,"identity":"505db5e7-7f48-4290-99ad-ef0e5720d1ac","added_by":"auto","created_at":"2025-10-03 05:08:54","extension":"json","order_by":2,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":7022,"visible":true,"origin":"","legend":"","description":"","filename":"0910a2eee1614a8298280f2c18a6e8b5.json","url":"https://assets-eu.researchsquare.com/files/rs-7461038/v1/ef4db38c37094bef5c758cb2.json"},{"id":92691244,"identity":"7311e1bc-0bd1-4e05-8937-d9fe12b87057","added_by":"auto","created_at":"2025-10-03 05:08:55","extension":"pdf","order_by":3,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":149000,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementaryMaterial1WISHTopicGuide.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7461038/v1/3b94560bd653bb8b42c4efcf.pdf"},{"id":92691273,"identity":"f24b954d-9971-4ade-8ca6-e7086ce0904f","added_by":"auto","created_at":"2025-10-03 05:09:00","extension":"xml","order_by":4,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":134602,"visible":true,"origin":"","legend":"","description":"","filename":"0910a2eee1614a8298280f2c18a6e8b51enriched.xml","url":"https://assets-eu.researchsquare.com/files/rs-7461038/v1/a915470fc20df85e88065a9d.xml"},{"id":92691214,"identity":"871e7504-835f-4ddf-88a1-1789f95138c0","added_by":"auto","created_at":"2025-10-03 05:08:54","extension":"jpg","order_by":5,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":948638,"visible":true,"origin":"","legend":"","description":"","filename":"Figure1.ThematicMap.jpg","url":"https://assets-eu.researchsquare.com/files/rs-7461038/v1/03813d13625db1445f562a31.jpg"},{"id":92691215,"identity":"544f2e1a-e763-4ce8-aebe-5b8729a77dd9","added_by":"auto","created_at":"2025-10-03 05:08:54","extension":"png","order_by":6,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":545939,"visible":true,"origin":"","legend":"","description":"","filename":"OnlineFigure1.ThematicMap.png","url":"https://assets-eu.researchsquare.com/files/rs-7461038/v1/2eebde22a431f0e3155ba2fb.png"},{"id":92691212,"identity":"2071960e-a53e-4fc7-97b1-fd5b3c3082fd","added_by":"auto","created_at":"2025-10-03 05:08:53","extension":"xml","order_by":7,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":131455,"visible":true,"origin":"","legend":"","description":"","filename":"0910a2eee1614a8298280f2c18a6e8b51structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-7461038/v1/923553b9bf9db5ad9c74e081.xml"},{"id":92691276,"identity":"edd9e7b5-8841-48d9-8de9-05d8d31178d9","added_by":"auto","created_at":"2025-10-03 05:09:00","extension":"html","order_by":8,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":146949,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7461038/v1/2d91891986b49caf62df9666.html"},{"id":92691274,"identity":"e45fea57-96fc-486d-9a3c-81d72d7c9c63","added_by":"auto","created_at":"2025-10-03 05:09:00","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":948638,"visible":true,"origin":"","legend":"\u003cp\u003eFinalised thematic map demonstrating 4 themes. MSE refers to muscle-strengthening exercises.\u003c/p\u003e","description":"","filename":"Figure1.ThematicMap.jpg","url":"https://assets-eu.researchsquare.com/files/rs-7461038/v1/72ddf435a74ce6758be5475f.jpg"},{"id":101151844,"identity":"292fbac2-7d4e-4595-b06c-f29dc95e05f5","added_by":"auto","created_at":"2026-01-26 16:06:47","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":3287829,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7461038/v1/2dbc075d-c015-4635-9f9f-094d12337c13.pdf"},{"id":92691275,"identity":"c806f5b1-8f49-4e53-80b2-6ce126c1757d","added_by":"auto","created_at":"2025-10-03 05:09:00","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":149000,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementaryMaterial1WISHTopicGuide.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7461038/v1/8f9ab5e7f3244523c83f2dec.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Women in Strength (WISH Study): Interview with Women Participating in Muscle-Strengthening Exercises – How Are They Doing It?","fulltext":[{"header":"BACKGROUND","content":"\u003cp\u003eRegular participation in physical activity reduces the risk of chronic diseases and improves mental health and well-being for the general population. For women, particularly, participating in muscle-strengthening activities offers additional benefits beyond that of cardiovascular activity alone, including reproductive health outcomes [1], reducing the risk of osteoporosis, sarcopenia and frailty [2, 3], and helping with postpartum depression and anxiety [4]. Studies have established that women face an earlier strength loss than men, from menopause due to the decrease in oestrogen [5-7] and involvement in muscle-strengthening activities is important to mitigate this decline. This underscores the importance of muscle-strengthening for women across their lifespan.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eCurrent guidelines from the 2020 World Health Organisation and 2019 UK Physical Activity Guidelines recommend at least two days a week of muscle-strengthening activities, targeting the major muscle groups [8, 9]. National surveillance data from 2012 to 2023 consistently reveal that women are less likely than men to meet these recommendations, with particularly low adherence observed among women in certain life stages, such as during childbearing years [10-12]. For instance, the 2021 Health Survey for England reported that only 29% of women (vs 36% of men) meet the recommended muscle-strengthening activities guidelines [11]. Similarly, the 2023 Scottish Health Survey reported that only 26% of women (vs 32 % of men) met the recommendation [12]. These persistent participation gaps over the years between sexes suggest that the standard strategies to promote participation in muscle-strengthening exercises may not be successful in addressing the specific barriers to participation that women may face.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn our previous work on the Muscle-Strengthening Participation Survey, we identified substantial sex differences and variation in the muscle-strengthening exercises that UK adult women participated in [13]. Specifically, women tend to favour bodyweight exercises and holistic exercises, such as Pilates and yoga, as opposed to weight machine-based exercise, which is more common in men [13]. However, little is known about why women prefer these specific types of exercises or what barriers they face in participating in other types of muscle-strengthening activities, such as weight machine-based exercises. While preferences offer valuable insight, they only partially explain the persistent gap in participation. A more comprehensive understanding of how women achieve the muscle-strengthening recommendations is needed to develop interventions for those not currently meeting these recommendations. Therefore, the present study aimed to explore the barriers and facilitators to participation in muscle-strengthening exercises among women who are currently meeting the muscle-strengthening activities guidelines and identify ways to improve participation for women.\u003c/p\u003e"},{"header":"METHODS","content":"\u003ch3\u003eStudy Design\u003c/h3\u003e\n\u003cp\u003eThis qualitative study is part of the Muscle-Strengthening Participation research project. This study was approved by the College of Medical, Veterinary and Life Sciences Ethics Committee at the University of Glasgow (Reference Number: 200230238) and adhered to the Declaration of Helsinki.\u0026nbsp;\u003c/p\u003e\n\u003ch3\u003eParticipants\u003c/h3\u003e\n\u003cp\u003eParticipants who completed a previous Muscle-Strengthening Participation Survey [13] and expressed their interest in participating in follow-up research were contacted to participate by email. Recruitment to the original survey is described further in the previous report [13] but includes using promotional posters and posting a survey link on neighbourhood application (Nextdoor), Microsoft Viva Engage, LinkedIn, X and paid advertising via Meta Ads. To be included in the current study, women had to be aged between 18 and 64 years old when they participated in the original survey, living in the United Kingdom, and, for the current paper, participating in muscle-strengthening exercises for two or more days a week. Each participant was compensated with a £20 Amazon voucher for their time after completion of the interview.\u0026nbsp;\u003c/p\u003e\n\u003ch3\u003eInterview\u003c/h3\u003e\n\u003cp\u003eParticipants were given the option to have an online or in-person interview. Online interviews took place on Microsoft Teams, and in-person interviews took place at the University of Glasgow. Each interview slot was one hour long, and interviews were audio-recorded via Teams or a digital audio recorder if in person. Verbal (for online interview) or written (for in-person interview) consent for participating and for publication was gained before the interview. Interview questions included experiences in participating in muscle-strengthening exercises, barriers faced and facilitators for their muscle-strengthening exercises participation. The full interview topic guide is included in the supplementary material I.\u0026nbsp;\u003c/p\u003e\n\u003ch3\u003eParticipants’ Demographics\u0026nbsp;\u003c/h3\u003e\n\u003cp\u003eDemographic and exercise background data were also collected (age, deprivation category, working status, academic level, marital status, frequency of muscle-strengthening exercises participation, exercise setting for muscle-strengthening and type of exercises participated) as part of the interviews.\u0026nbsp;\u003c/p\u003e\n\u003ch3\u003eData Analyses\u003c/h3\u003e\n\u003cp\u003eAll audio recordings from the interviews were transcribed using Otter.ai and checked by NR. The transcripts from the interviews were analysed using the codebook form of Reflexive\u0026nbsp;Thematic Analysis [14, 15]. Reflexive\u0026nbsp;Thematic Analysis includes familiarisation of the interview transcripts, creating a coding framework, theme extraction, review and naming, and narrative analysis [16]. An initial codebook was created by NR and EO separately, with both coders meeting to agree on a preliminary structure of the codes. Codes were further discussed between NR, SG, and GR before being applied to the dataset. NVivo 12 Pro (QSR International Pty Ltd, Doncaster, Victoria, Australia) was used to code all the transcripts based on the finalised codebook. NR created initial higher-order themes with three subsequent meetings (6 hours total) between NR and GR to agree on theme names, descriptors and a thematic map.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e*Table 1 here*\u003c/em\u003e\u003c/p\u003e"},{"header":"RESULTS","content":"\u003ch3\u003eResponse Rate\u003c/h3\u003e\n\u003cp\u003e137 participants who expressed interest in participating in follow-up research from the original survey were contacted, with 54 expressing their interest in participating in the interviews, and 24 consenting to the interviews.\u003c/p\u003e\n\u003ch3\u003eDemographic\u003c/h3\u003e\n\u003cp\u003eDemographic and exercise background data of the 24 participants are displayed in Table 1. Most of the participants were aged between 45 to 64 years old (67%), lived in the least deprived area (38%), were employed (58%), had a university degree (79%), and were married with children (54%). For exercise location, 33% of participants reported doing muscle-strengthening exercises at the gym, while 29% reported a combination of exercise locations. Of the 24 participants, 58% reported doing a combination of more than one type of muscle-strengthening exercise.\u003c/p\u003e\n\u003ch3\u003eThematic Map\u003c/h3\u003e\n\u003cp\u003eInterviews produced 466 minutes and 44 seconds of recorded audio. 4 themes and 14 subthemes were identified (Figure 1). The themes are:\u003c/p\u003e\n\u003col\u003e\n \u003cli\u003eReason for participating in muscle-strengthening exercises (Table 2)\u003c/li\u003e\n \u003cli\u003eChallenges to muscle-strengthening exercise participation (Table 3).\u003c/li\u003e\n \u003cli\u003eFacilitators to participating in muscle-strengthening exercises (Table 4).\u003c/li\u003e\n \u003cli\u003eSuggestions for improvement (Table 5).\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003e\u003cem\u003e*Figure 1 here*\u003c/em\u003e\u003c/p\u003e\n\u003ch4\u003eTheme 1: Reasons for Participating in Muscle-Strengthening Exercises\u003c/h4\u003e\n\u003cp\u003eThis theme highlights the benefits of participating in muscle-strengthening exercises as a reason to begin participating. Initial reasons for taking part in muscle-strengthening exercises were linked to concerns about health, including injuries, family health, ageing, menopause, and the realisation of the need to maintain strength as they aged, as well as for improving sports performance for some. Table 2 presents the indicative quotes according to the reasons given by the participants.\u0026nbsp;\u003c/p\u003e\n\u003ch5\u003eHealth concern: Having injuries and family health\u003c/h5\u003e\n\u003cp\u003eHaving an injury was the most frequently mentioned reason by the participants as to why they started to participate in muscle-strengthening exercises. Some of the injuries mentioned were pain involving the back, such as sciatic pain, herniated or disk degeneration, and bone-related injuries such as plantar fasciitis, osteoarthritis and osteoporosis. Though this was not limited to their own injury or health conditions, as participants also mentioned that looking at their families\u0026apos; health, such as parental health deterioration, including dementia, motivated them to start participating in muscle-strengthening exercises.\u0026nbsp;\u003c/p\u003e\n\u003ch5\u003eHealth concern: Ageing, menopause and awareness of maintaining strength\u003c/h5\u003e\n\u003cp\u003eParticipants mentioned ageing as a reason for beginning participation, whether from their own ageing or from observing family members ageing. The concerns with ageing are also related to menopause. Participants who have reached menopause said that it caused them to gain weight, and taking up muscle-strengthening exercises has helped them. Several participants mentioned having awareness or realisation that they need to maintain their muscle strength as they age has been a factor in their participation.\u0026nbsp;\u003c/p\u003e\n\u003ch5\u003eSports performance\u0026nbsp;\u003c/h5\u003e\n\u003cp\u003eSome participants mentioned that they began participating in muscle-strengthening exercises to improve their sports performance. Participants agreed that the strength they gained from muscle-strengthening exercises had benefited their sports performance.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e*Table 2 here*\u003c/em\u003e\u003c/p\u003e\n\u003ch4\u003eTheme 2: Challenges to Muscle-Strengthening Exercise Participation\u003c/h4\u003e\n\u003cp\u003eParticipants reported several challenges that arose regarding their participation in muscle-strengthening exercises. These challenges included perceived time constraints due to study and work commitments, lack of confidence in their ability to do the exercises, the accessibility regarding the cost and equipment availability, the cultural stigma and societal perception of muscle-strengthening exercises for women, and low motivation. These factors often competed with participants\u0026rsquo; intention to exercise, thus creating barriers that they must overcome to exercise. The quote for this theme is presented in Table 3.\u0026nbsp;\u003c/p\u003e\n\u003ch5\u003ePerceived time constraints\u003c/h5\u003e\n\u003cp\u003eOne of the main challenges was perceived time constraints. Participants who studied and worked full-time found it hard to find the time for exercise. However, despite time being a challenge, participants shared that they will still find time or ways to exercise. Although this was not always the case, with the age demographic of this study being varied, some participants did not find time challenging, as they have now retired and had no caring responsibilities once their children grew up.\u0026nbsp;\u003c/p\u003e\n\u003ch5\u003eConfidence in ability\u003c/h5\u003e\n\u003cp\u003eMost participants said that confidence in their ability challenges their participation in muscle-strengthening exercises. This is mainly because they are not sure how to do the exercises and whether they are doing them correctly or not. Therefore, they mainly participated in exercises that they were more confident in.\u0026nbsp;\u003c/p\u003e\n\u003ch5\u003eAccessibility\u003c/h5\u003e\n\u003cp\u003eParticipants also reported that accessibility is a challenge in participation in muscle-strengthening exercise. A common aspect of accessibility is cost, as some participants find that it is expensive to go to the gym or have a personal trainer, whereas some participants found that not having access to the equipment and space needed was a challenge for them.\u0026nbsp;\u003c/p\u003e\n\u003ch5\u003eCultural stigma and societal perception\u003c/h5\u003e\n\u003cp\u003eThe culture of stigma and societal perception of muscle-strengthening exercises for women was also one of the common challenges. Participants felt like the gym environment was more male-dominated and catered towards men, making them feel conscious, uncomfortable and intimidated. They also faced the societal perception of women not wanting to do muscle-strengthening exercises due to not wanting to look big, bulky and hurting themselves.\u0026nbsp;\u003c/p\u003e\n\u003ch5\u003eLow motivation\u003c/h5\u003e\n\u003cp\u003eFinally, some participants mentioned that despite mostly achieving the guidelines, some days the motivation to do muscle-strengthening exercises is low, making it hard to do them. Participant also mentioned that sometimes they are not motivated to step out of their comfort zone once they find the exercise easy to do.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e*Table 3 here*\u003c/em\u003e\u003c/p\u003e\n\u003ch4\u003eTheme 3: Facilitators to Participating in Muscle-Strengthening Exercise\u0026nbsp;\u003c/h4\u003e\n\u003cp\u003eThis section covers the participants\u0026rsquo; experiences and facilitators for their continued muscle-strengthening exercise participation. Participants mentioned several facilitators that helped them to overcome the challenges that they faced. These facilitators include the usage of information and resources, finding ways to make themselves accountable to do the exercises, having social support, and having choices of location and exercises. As they continued with these activities, they emphasised the benefits that influenced their long-term participation, including the positive changes in their physical and mental health that they observed. By identifying strategies to facilitate exercise, they discovered that these approaches are more effective for long-term participation. Table 4 shows the reported facilitators to participate in muscle-strengthening exercises by the participants.\u0026nbsp;\u003c/p\u003e\n\u003ch5\u003eUse of information and resources\u003c/h5\u003e\n\u003cp\u003eHaving resources and information available helped participants. When asking about the kind of resources and information that they used, several examples were given (Table 4). One participant explained that having these resources available has helped her to progress in her muscle-strengthening exercise journey. Another participant uses group exercise classes as a gateway to get comfortable and more confident in doing the exercise.\u0026nbsp;\u003c/p\u003e\n\u003ch5\u003eAccountability\u003c/h5\u003e\n\u003cp\u003eParticipants shared several other ways that made them accountable to do their muscle-strengthening exercises. While cost was reported as a challenge, some found that paying for gym membership, classes or personal trainers helped them to stay accountable and do the exercise. Many participants also mentioned that setting goals such as aiming to increase strength, being able to lift heavier and look better helped them to be consistent in their participation in muscle-strengthening exercises. A 57-year-old participant addressed the importance of keeping goals simple and not making the exercise too difficult. To overcome the time constraint barriers, one participant found that creating a schedule where they set a specific time to exercise was helpful in creating a routine for exercising.\u0026nbsp;\u003c/p\u003e\n\u003ch5\u003eSocial support\u003c/h5\u003e\n\u003cp\u003eCompanionship and support systems were also mentioned by the participants to help them maintain their muscle-strengthening exercise participation. While some participants said that they preferred to exercise alone, others found that it was helpful to have friends or partners exercise with them, as it made them motivated and accountable to do the exercise. Words of encouragement received by the participants from their family and friends have also made them more motivated to continue participating in muscle-strengthening exercises. Several participants also shared that doing exercises that they enjoyed helped them to continue participating in muscle-strengthening exercises.\u0026nbsp;\u003c/p\u003e\n\u003ch5\u003eAbility to choose\u003c/h5\u003e\n\u003cp\u003eHaving the ability to choose the exercise location was also a factor that facilitated participants\u0026rsquo; journey in muscle-strengthening exercises, as it relates to accessibility and comfort. Participants addressed that having the gym location nearby and accessible made it easier for them to do the exercise. For the same reasons, some participants chose exercising at home as it is easier and more convenient for them. Participants emphasised that being able to choose to do something they like, such as going to the exercise classes, has helped them stay motivated to finish the exercise.\u0026nbsp;\u003c/p\u003e\n\u003ch5\u003ePositive changes\u0026nbsp;\u003c/h5\u003e\n\u003cp\u003eWhen asked what helps motivate them to continue participating in muscle-strengthening exercises, participants mainly said that increases in their confidence and the changes they saw in themselves encouraged them to keep going. While participants found that participating in muscle-strengthening exercises helped them improve their mental health, one participant found that getting involved in these kinds of exercises has become her therapy. Participants also reported that participation in muscle-strengthening exercises also resulted in physical changes, such as changes in body shape and feeling stronger and flexible. Participants agreed that participating in muscle-strengthening exercises helped them to reduce and manage their pain, which then encourages them to keep participating.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e*Table 4 here*\u003c/em\u003e\u003c/p\u003e\n\u003ch4\u003eTheme 4: Suggestions For Others\u003c/h4\u003e\n\u003cp\u003eThis section refers to participants\u0026apos; advice and suggestions to help women participate in muscle-strengthening exercises. These suggestions were framed at both what an individual can do and what others could do to encourage participation in muscle-strengthening exercises. These suggestions show how individual motivation, social, and environmental factors can encourage and maintain an exercise habit. \u0026nbsp;This theme, with its indicative quotes, is described in Table 5.\u003c/p\u003e\n\u003ch5\u003eWhat an individual can do\u003c/h5\u003e\n\u003cp\u003eAt an individual level, participants emphasised keeping it simple and using different modalities, such as doing bodyweight exercises, using resistance bands or trying out Pilates and yoga as a start to build their confidence in participating. Many participants emphasise the importance of knowing that starting with muscle-strengthening exercises does not mean it must be at the gym. Participants suggest that women who want to get started can do simple activities using resistance bands or body weight, and search online for how to do strength exercises and examples to build their confidence. Some also suggest that participants, who are able, can sign up with a personal trainer or join exercise classes to build their confidence and to learn the correct way of doing the exercises.\u0026nbsp;\u003c/p\u003e\n\u003ch5\u003eWhat others can do\u003c/h5\u003e\n\u003cp\u003eAs some women find it challenging to start doing muscle-strengthening exercises, the participants suggested that spreading awareness of the importance of muscle-strengthening exercises would be helpful. Participants suggested that focusing on the health benefits, not just losing weight or gaining strength, would help other women understand that participating in muscle strength is an investment for their future health.\u003c/p\u003e\n\u003cp\u003eThe most repeated suggestion was creating women-only spaces or sessions. As participants previously mentioned, going to the gym feels intimidating, making them feel self-conscious and intimidated. Having women-only spaces or sessions was suggested as it would make them feel much more comfortable. One participant also suggested that having kid-friendly classes would be beneficial, as women who have childcare responsibilities can still join the classes without having to find childcare.\u003c/p\u003e\n\u003cp\u003eParticipants also suggested that more personal trainers who specialised in women\u0026apos;s fitness would be helpful as women experience different stages of development throughout their lives, such as puberty, pregnancy and menopause.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eParticipants suggested looking for online content that is made by women and is suitable for people of various abilities would help women get started in muscle-strengthening exercises. While others agreed that there is a lot of information online which is easily accessible, participants also raised some concerns about whether the information is reliable. It is acknowledged that more valid and reliable resources would be helpful for women. However, participants still agree that online would be a great tool to use to make muscle-strengthening exercises more accessible, as most of the content is free. The availability of online resources helped to deal with accessibility issues such as cost and distance.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e*Table 5 here*\u003c/em\u003e\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eConsidering the importance of muscular strength for women, understanding the barriers they face and facilitators for their participation in this is crucial. This current study explored the barriers and facilitators to participation in muscle-strengthening exercises among women who are currently meeting the muscle-strengthening activities guidelines. Challenges include perceived time constraints, limited accessibility, and low confidence. Conversely, facilitators such as accountability, the ability to make choices, and the utilisation of available resources fostered sustained adherence. Having women-only spaces and using different modalities for muscle-strengthening exercises, such as their own bodyweight and resistance, has been suggested to help women who do not participate in muscle-strengthening exercises begin their participation. These insights provide a nuanced understanding of how women initiate and sustain participation in muscle-strengthening exercises, while also offering suggestions for creating more tailored and gender-specific interventions, environments, and policy development.\u003c/p\u003e\u003cp\u003eParticipants reported a range of reasons for starting muscle-strengthening exercise, with health concerns emerging as the main reason, followed by sports performance. Some participants in this current study mentioned that they began muscle-strengthening exercises as prevention and management strategies to maintain their strength and independence, as some of them faced health concerns, such as having back and bone-related injuries, as well as seeing parental health deterioration. A smaller group of women in the present study were driven by the improvement in physical performance for sports which they already engaged in, such as producing more strength and power. Whilst there is less existing qualitative evidence on why people decided to start muscle strengthening activities, there is related evidence on factors that influence continued participation in muscle strengthening activities that align with these findings. For example, a 2025 cross-sectional survey by Jones et al. [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e] of 269 women aged 18\u0026ndash;34 years reported that positive health changes and gaining strength and endurance were predictors of participation in muscle-strengthening activities. These women were younger than the current sample and did not yet face age-related health concerns; therefore, while emphasising the benefits of muscle-strengthening activities remains important, interventions that reach women at the point when they begin to perceive health-related changes may be particularly effective.\u003c/p\u003e\u003cp\u003e Participants described a range of challenges that they faced when participating in muscle-strengthening exercises. In the present study, perceived time constraints emerged as the most common challenge to participation in muscle-strengthening exercises, aligning with numerous studies that have cited time constraints as a universal barrier to exercise in general and muscle-strengthening exercises among adults regardless of gender [\u003cspan additionalcitationids=\"CR19 CR20\" citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. Hurley and colleagues in 2018 [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e] surveyed 116 college women to explore their perceived benefits and barriers to resistance training participation. Using hierarchical multiple regression to assess what predicts the barriers to participation in resistance training, they found that the most significant predictors of reduced participation were the perceived time and effort barriers [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. Engagement in muscle-strengthening exercises is lower when there is a higher perception that time and effort as barriers [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. Whilst time constraints were frequently reported as the main barrier, participants in this present study described strategies that have helped them to overcome this challenge. As this challenge is closely determined by one\u0026rsquo;s lifestyle, participants in this present study reported that creating a schedule and blocking specific time for exercising has helped them to maintain their participation. In an online survey conducted by Luckin and colleagues in 2021 [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e] on identifying barriers to strength training among 390 athletes, they also reported a similar finding. The study reported that creating an exercise program that aligns with an individual\u0026rsquo;s preferences regarding the types and schedule for exercise can effectively reduce the perception of time as a challenge to exercise participation [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. The findings collectively highlight that while perceived time constraints were often cited as one of the barriers to participation in muscle-strengthening exercises, having a personalised schedule for exercise according to their preferences can help to overcome this challenge.\u003c/p\u003e\u003cp\u003eIn addition to perceived time constraints, participants in this current study reported that having low confidence in their abilities, such as performing the exercises and using the equipment or modalities, was a challenge to their participation in muscle-strengthening exercises, consistent with other studies where knowledge and education were reported as factors impacting women\u0026rsquo;s participation in muscle-strengthening exercises [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. For example, Luckin et al. [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e] reported that 58% of females reported that \u0026lsquo;being unsure\u0026rsquo; (28% on what exercise to do, 16% on how to progress and 14% on the exercise technique) is their main perceived barrier to participation. For this barrier, participants in the present study used resources available, such as hiring a personal trainer, using online resources, or exercise classes, which have helped them to be more confident in doing the exercises and increasing their knowledge. These are simple strategies that can be taken forward by other women, although some may have concerns regarding the additional cost. Having access and guidance from professionals, such as a personal trainer, reduced the concern of not knowing how to do the exercise and made muscle-strengthening exercises feel more approachable. This aligns with the survey findings in the randomised control trial by Heiestad and colleagues in 2016 [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e], who found that, in previously inactive overweight women (n\u0026thinsp;=\u0026thinsp;143), adherence to muscle-strengthening exercises was much higher among those who exercised with guidance from a professional, such as a personal trainer. While getting a personal trainer will have an additional cost burden to some, participants in this present study also emphasised the usefulness of the freely available resources online to increase their knowledge and understanding of performing the exercises, whilst acknowledging issues around the reliability of resources. Corroboratively, studies by Luckin et al. [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e] and Petrov et al. [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e] reported that increasing knowledge will indirectly increase confidence and self-efficacy in performing the exercises, both of which are important to sustained participation in muscle-strengthening activities. Similarly, Hurley et al. [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e] also reported that holding education sessions around muscle strengthening exercises may help reduce the perceived challenges to participation. Taken together, these findings suggest that the utilisation range of resources, whether through online platforms or personal trainers, can improve confidence and self-efficacy in performing muscle-strengthening exercises, thereby helping women to overcome the barriers related to low confidence in ability.\u003c/p\u003e\u003cp\u003eThe gender-based stigma and societal perception, such as women not needing muscle-strengthening exercises, have initially created a barrier to the participation of women in this current study. In 2009, Velija and Kumar [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e] did a focus group interview with 16 young girls aged 14 to 16 to examine their exercise experiences and found that perceptions of physical education are influenced by gender roles within the activity. Younger girls were being directed to participate in traditionally feminine activities like aerobics and avoiding more \u0026ldquo;masculine\u0026rdquo; tasks such as lifting weights [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. This gender-based stereotype at a younger age may mould the way that these girls think as they get into adulthood, where resistance training or muscle-strengthening activities are still perceived as masculine activities. Despite some women engaging in muscle-strengthening exercises, these activities remain predominantly male-oriented. In a systematic review and meta-synthesis of 20 studies (n\u0026thinsp;=\u0026thinsp;402) by Vasudevan and Ford in 2022 [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e] on motivation and barriers to women's initiation and participation in strength training, gender-based and social stigma were the most prominent barriers in several studies, no matter the women\u0026rsquo;s age (college students and older women) [\u003cspan additionalcitationids=\"CR27\" citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. Women tend to be more uncomfortable and self-conscious when doing the exercises in a male-dominated area due to the unwanted comments and attention [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. In the 2018 qualitative study by Coen et al. [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e] reported that women interviewed felt uncomfortable and unwanted in the gym when the men were taking up the spaces, hogging equipment and being loud. To overcome this barrier, women in this current study suggested that having women-only spaces and kid-friendly spaces would help other women to participate in muscle-strengthening exercises. This aligns with Hurley et al. [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e], who reported that barriers such as feeling uncomfortable can be reduced when there are women-only classes or a women-only area in the fitness centre. Similarly to our study, participants found that exercising in a group setting, with a training partner or personal trainer, has helped them to keep going. By not being alone when exercising, it has helped themselves to feel less self-conscious while also increasing their knowledge and confidence in doing the exercises. The results of the current study show that cultural stigma and societal perception surrounding women\u0026rsquo;s participation in muscle-strengthening exercises are still an ongoing experience, and to address this barrier, a more complex and systems-level approach is needed, such as having women-only spaces.\u003c/p\u003e\u003cp\u003eImplications for future research and practice\u003c/p\u003e\u003cp\u003eThese findings offer practical strategies both for women not yet engaging in muscle-strengthening activities and for practitioners and policymakers aiming to increase participation. While some of the barriers and facilitators identified are already well recognised and relevant across genders, the persistence of low participation among women indicates that current approaches remain insufficient. The results of the present study point to the need for more nuanced, gender-sensitive strategies that address cultural, environmental, and educational influences on participation. Communicating these strategies directly to women, for example, through targeted health promotion and social marketing campaigns, may enhance their reach and effectiveness. Such campaigns should highlight not only the physical and mental health benefits of muscle-strengthening exercise but also tackle issues of confidence, accessibility, and cultural stigma. Tailoring messages, resources, and interventions to specific life stages, including perimenopause and retirement, may further improve engagement by aligning recommendations with women\u0026rsquo;s real-life experiences and priorities. Practical implementation could include developing women-only or family-friendly exercise spaces, embedding professional guidance within community and digital programmes, and ensuring access to reliable, evidence-based resources to strengthen women\u0026rsquo;s confidence and self-efficacy.\u003c/p\u003e\u003cp\u003eStrengths and limitations\u003c/p\u003e\u003cp\u003eWhile the previous systematic review and meta-synthesis by Vasudevan and Ford [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e] examined the barriers and facilitators to women\u0026rsquo;s participation in strength training, this current study offers a UK-specific, solution-oriented exploration according to the lived experiences of women who met the recommended guideline. By focusing on the context-specific barriers and actionable strategies, it provides practical insights on developing more tailored and gender-specific interventions, environments, and policy development.\u003c/p\u003e\u003cp\u003eNonetheless, certain limitations were found within this present study. Considering the low sample size, it may not be generalisable to the experiences that other women faced. In addition to that, since this study did not consider the cultural and ethnic diversity within its participants, it also restricts the application of the findings to a larger population with different ethnicities and cultural backgrounds, as experiences may differ. Understanding the challenges and facilitators across different groups may help to have a more successful intervention and policy development. The self-reported nature of this study may also be subject to recall or social desirability bias from the participants. Future research might address these limitations by implementing a mixed-method approach and including a more diverse population, for a longer term and conducting an implementation trial to better inform the scalable policy and to see how the recommended strategies will work in a real-life setting.\u003c/p\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003e This study provides new insights into the experiences of women who already meet muscle-strengthening guidelines. While many barriers remain consistent with earlier studies, our findings reveal how women overcome barriers with lived experience-based strategies such as scheduling, goal setting, social support, and building confidence using online resources and professional guidance. Importantly, participants also went beyond their own strategies and offered solutions around more complex changes such as adapting gym environments, creating women-only spaces, and improving the validity of online resources. Together, these findings extend current knowledge by showing not only the barriers to women\u0026rsquo;s participation but also how women overcome these in practice. They provide valuable guidance for interventions and policies aiming to close gender gaps in muscle-strengthening activity and to promote equitable opportunities for women\u0026rsquo;s health across the life course.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eMSE\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eMuscle-Strengthening Exercises\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003e\u003cem\u003eCompeting Interest\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone declared.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eEthical Approval and Consent Information\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by the College of Medical, Veterinary and Life Sciences Ethic Committee at the University of Glasgow (Reference Number: 200230238). Informed consent for data collection and publication was collected from the participant before the interview.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eFunding\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNR is supported by a doctoral scholarship from Majlis Amanah Rakyat (MARA), Malaysia, through the Graduate Excellence Programme (GReP).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAuthors’ Contribution\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eNR:\u003c/em\u003e\u003c/strong\u003e Conceptualisation, Visualisation, Methodology, Investigation, Data Curation, Data Analysis, Writing - Original Draft, Writing - Review \u0026amp; Editing, Project Administration. \u003cstrong\u003e\u003cem\u003eSG:\u0026nbsp;\u003c/em\u003e\u003c/strong\u003eConceptualisation, Visualisation, Data Analysis, Supervision, Writing – Review \u0026amp; Editing. \u003cstrong\u003e\u003cem\u003eEO:\u003c/em\u003e\u003c/strong\u003e Data Analysis. \u003cstrong\u003e\u003cem\u003eGR:\u003c/em\u003e\u003c/strong\u003e Conceptualisation, Visualisation, Methodology, Data Analysis, Supervision, Writing - Original Draft, Writing - Review \u0026amp; Editing.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAcknowledgement\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe wished to thank all women who participated in this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eData Availability\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData will be made available upon reasonable request from the corresponding author.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003ePatient and Public Involvement\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eParticipants were not involved in the design, conduct, reporting or dissemination of this study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eSabag A, Patten RK, Moreno-Asso A, Colombo GE, Dafauce Bouzo X, Moran LJ, Harrison C, Kazemi M, Mousa A, Tay CT\u003cem\u003e\u0026nbsp;et al\u003c/em\u003e: \u003cstrong\u003eExercise in the management of polycystic ovary syndrome: A position statement from Exercise and Sports Science Australia\u003c/strong\u003e. \u003cem\u003eJ Sci Med Sport\u0026nbsp;\u003c/em\u003e2024, \u003cstrong\u003e27\u003c/strong\u003e(10):668-677.\u003c/li\u003e\n \u003cli\u003eSundell J: \u003cstrong\u003eResistance Training Is an Effective Tool against Metabolic and Frailty Syndromes\u003c/strong\u003e. \u003cem\u003eAdv Prev Med\u0026nbsp;\u003c/em\u003e2011, \u003cstrong\u003e2011\u003c/strong\u003e:984683.\u003c/li\u003e\n \u003cli\u003eHong AR, Kim SW: \u003cstrong\u003eEffects of Resistance Exercise on Bone Health\u003c/strong\u003e. \u003cem\u003eEndocrinol Metab (Seoul)\u0026nbsp;\u003c/em\u003e2018, \u003cstrong\u003e33\u003c/strong\u003e(4):435-444.\u003c/li\u003e\n \u003cli\u003eDeprato A, Ruchat SM, Ali MU, Cai C, Forte M, Gierc M, Meyer S, Sjwed TN, Shirazi S, Matenchuk BA\u003cem\u003e\u0026nbsp;et al\u003c/em\u003e: \u003cstrong\u003eImpact of postpartum physical activity on maternal depression and anxiety: a systematic review and meta-analysis\u003c/strong\u003e. \u003cem\u003eBr J Sports Med\u0026nbsp;\u003c/em\u003e2025, \u003cstrong\u003e59\u003c/strong\u003e(8):550-561.\u003c/li\u003e\n \u003cli\u003eCalmels P, Vico L, Alexandre C, Minaire P: \u003cstrong\u003eCross-sectional study of muscle strength and bone mineral density in a population of 106 women between the ages of 44 and 87 years: relationship with age and menopause\u003c/strong\u003e. \u003cem\u003eEur J Appl Physiol Occup Physiol\u0026nbsp;\u003c/em\u003e1995, \u003cstrong\u003e70\u003c/strong\u003e(2):180-186.\u003c/li\u003e\n \u003cli\u003ePhillips SK, Rook KM, Siddle NC, Bruce SA, Woledge RC: \u003cstrong\u003eMuscle weakness in women occurs at an earlier age than in men, but strength is preserved by hormone replacement therapy\u003c/strong\u003e. \u003cem\u003eClin Sci (Lond)\u0026nbsp;\u003c/em\u003e1993, \u003cstrong\u003e84\u003c/strong\u003e(1):95-98.\u003c/li\u003e\n \u003cli\u003eMontero-Fernandez N, Serra-Rexach JA: \u003cstrong\u003eRole of exercise on sarcopenia in the elderly\u003c/strong\u003e. \u003cem\u003eEur J Phys Rehabil Med\u0026nbsp;\u003c/em\u003e2013, \u003cstrong\u003e49\u003c/strong\u003e(1):131-143.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003ePhysical Activity Guidelines: UK Chief Medical Officers\u0026rsquo; Report\u0026nbsp;\u003c/strong\u003e[https://www.gov.uk/government/publications/physical-activity-guidelines-uk-chief-medical-officers-report]\u003c/li\u003e\n \u003cli\u003eWorld Health Organization: \u003cstrong\u003eWHO Guidelines on Physical Activity and Sedentary Behaviour\u003c/strong\u003e. In: \u003cem\u003eWHO Guidelines on Physical Activity and Sedentary Behaviour.\u003c/em\u003e edn. Geneva; 2020.\u003c/li\u003e\n \u003cli\u003eStrain T, Fitzsimons C, Kelly P, Mutrie N: \u003cstrong\u003eThe forgotten guidelines: cross-sectional analysis of participation in muscle strengthening and balance \u0026amp; co-ordination activities by adults and older adults in Scotland\u003c/strong\u003e. \u003cem\u003eBMC Public Health\u0026nbsp;\u003c/em\u003e2016, \u003cstrong\u003e16\u003c/strong\u003e(1):1108.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eHealth Survey for England, 2021 part 2\u0026nbsp;\u003c/strong\u003e[https://digital.nhs.uk/data-and-information/publications/statistical/health-survey-for-england/2021-part-2/physical-activity#references]\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eThe Scottish Health Survey 2023 - volume 1: main report. 9.Physical Activity\u0026nbsp;\u003c/strong\u003e[https://www.gov.scot/publications/scottish-health-survey-2023-volume-1-main-report/pages/0/]\u003c/li\u003e\n \u003cli\u003eRosaini ND, Dighriri A, Gray SR, Ryde GC: \u003cstrong\u003eExploration of Activities People Participate in to Meet the Muscle-Strengthening Physical Activity Guidelines\u003c/strong\u003e. \u003cem\u003e[manuscript submitted for publication]\u0026nbsp;\u003c/em\u003e2025.\u003c/li\u003e\n \u003cli\u003eBraun V, Clarke V: \u003cstrong\u003eOne size fits all? What counts as quality practice in (reflexive) thematic analysis?\u003c/strong\u003e \u003cem\u003eQualitative Research in Psychology\u0026nbsp;\u003c/em\u003e2021, \u003cstrong\u003e18\u003c/strong\u003e(3):328-352.\u003c/li\u003e\n \u003cli\u003eBraun V, Clarke V: \u003cstrong\u003eReflecting on reflexive thematic analysis\u003c/strong\u003e. \u003cem\u003eQualitative Research in Sport, Exercise and Health\u0026nbsp;\u003c/em\u003e2019, \u003cstrong\u003e11\u003c/strong\u003e(4):589-597.\u003c/li\u003e\n \u003cli\u003eBraun V, Clarke V: \u003cstrong\u003eUsing thematic analysis in psychology\u003c/strong\u003e. \u003cem\u003eQualitative Research in Psychology\u0026nbsp;\u003c/em\u003e2006, \u003cstrong\u003e3\u003c/strong\u003e(2):77-101.\u003c/li\u003e\n \u003cli\u003eJones CS, Spring KE, Wadsworth DD: \u003cstrong\u003eFactors influencing regular exercise in young women: a survey study assessing the preferences and motivators for aerobic and muscle-strengthening exercise\u003c/strong\u003e. \u003cem\u003eHealth Psychol Behav Med\u0026nbsp;\u003c/em\u003e2025, \u003cstrong\u003e13\u003c/strong\u003e(1):2465613.\u003c/li\u003e\n \u003cli\u003eAshton LM, Hutchesson MJ, Rollo ME, Morgan PJ, Thompson DI, Collins CE: \u003cstrong\u003eYoung adult males\u0026apos; motivators and perceived barriers towards eating healthily and being active: a qualitative study\u003c/strong\u003e. \u003cem\u003eInt J Behav Nutr Phys Act\u0026nbsp;\u003c/em\u003e2015, \u003cstrong\u003e12\u003c/strong\u003e:93.\u003c/li\u003e\n \u003cli\u003eKulavic K, Hultquist CN, McLester JR: \u003cstrong\u003eA comparison of motivational factors and barriers to physical activity among traditional versus nontraditional college students\u003c/strong\u003e. \u003cem\u003eJ Am Coll Health\u0026nbsp;\u003c/em\u003e2013, \u003cstrong\u003e61\u003c/strong\u003e(2):60-66.\u003c/li\u003e\n \u003cli\u003eLuckin KM, Badenhorst CE, Cripps AJ, Landers GJ, Merrells RJ, Bulsara MK, Hoyne GF: \u003cstrong\u003eStrength Training in Long-Distance Triathletes: Barriers and Characteristics\u003c/strong\u003e. \u003cem\u003eJ Strength Cond Res\u0026nbsp;\u003c/em\u003e2021, \u003cstrong\u003e35\u003c/strong\u003e(2):495-502.\u003c/li\u003e\n \u003cli\u003eHurley KS, Flippin KJ, Blom LC, Bolin JE, Hoover DL, Judge LW: \u003cstrong\u003ePractices, Perceived Benefits, and Barriers to Resistance Training Among Women Enrolled in College\u003c/strong\u003e. \u003cem\u003eInt J Exerc Sci\u0026nbsp;\u003c/em\u003e2018, \u003cstrong\u003e11\u003c/strong\u003e(5):226-238.\u003c/li\u003e\n \u003cli\u003ePetrov Fieril K, Fagevik Olsen M, Glantz A, Larsson M: \u003cstrong\u003eExperiences of exercise during pregnancy among women who perform regular resistance training: a qualitative study\u003c/strong\u003e. \u003cem\u003ePhys Ther\u0026nbsp;\u003c/em\u003e2014, \u003cstrong\u003e94\u003c/strong\u003e(8):1135-1143.\u003c/li\u003e\n \u003cli\u003eHeiestad H, Rustaden AM, Bo K, Haakstad LA: \u003cstrong\u003eEffect of Regular Resistance Training on Motivation, Self-Perceived Health, and Quality of Life in Previously Inactive Overweight Women: A Randomized, Controlled Trial\u003c/strong\u003e. \u003cem\u003eBiomed Res Int\u0026nbsp;\u003c/em\u003e2016, \u003cstrong\u003e2016\u003c/strong\u003e:3815976.\u003c/li\u003e\n \u003cli\u003eVelija P, Kumar G: \u003cstrong\u003eGCSE physical education and the embodiment of gender\u003c/strong\u003e. \u003cem\u003eSport, Education and Society\u0026nbsp;\u003c/em\u003e2009, \u003cstrong\u003e14\u003c/strong\u003e(4):383-399.\u003c/li\u003e\n \u003cli\u003eVasudevan A, Ford E: \u003cstrong\u003eMotivational Factors and Barriers Towards Initiating and Maintaining Strength Training in Women: a Systematic Review and Meta-synthesis\u003c/strong\u003e. \u003cem\u003ePrev Sci\u0026nbsp;\u003c/em\u003e2022, \u003cstrong\u003e23\u003c/strong\u003e(4):674-695.\u003c/li\u003e\n \u003cli\u003ePeters NA, Schlaff RA, Knous JL, Baruth M: \u003cstrong\u003eBarriers to resistance training among college-aged women\u003c/strong\u003e. \u003cem\u003eJ Am Coll Health\u0026nbsp;\u003c/em\u003e2019, \u003cstrong\u003e67\u003c/strong\u003e(1):4-9.\u003c/li\u003e\n \u003cli\u003eBurton E, Farrier K, Lewin G, Pettigrew S, Hill AM, Airey P, Bainbridge L, Hill KD: \u003cstrong\u003eMotivators and Barriers for Older People Participating in Resistance Training: A Systematic Review\u003c/strong\u003e. \u003cem\u003eJ Aging Phys Act\u0026nbsp;\u003c/em\u003e2017, \u003cstrong\u003e25\u003c/strong\u003e(2):311-324.\u003c/li\u003e\n \u003cli\u003eCavill NA, Foster CE: \u003cstrong\u003eEnablers and barriers to older people\u0026rsquo;s participation in strength and balance activities: A review of reviews\u003c/strong\u003e. \u003cem\u003eJournal of frailty, sarcopenia and falls\u0026nbsp;\u003c/em\u003e2018, \u003cstrong\u003e3\u003c/strong\u003e(2):105.\u003c/li\u003e\n \u003cli\u003eCoen SE, Rosenberg MW, Davidson J: \u003cstrong\u003e\u0026quot;It\u0026apos;s gym, like g-y-m not J-i-m\u0026quot;: Exploring the role of place in the gendering of physical activity\u003c/strong\u003e. \u003cem\u003eSoc Sci Med\u0026nbsp;\u003c/em\u003e2018, \u003cstrong\u003e196\u003c/strong\u003e:29-36.\u003cem\u003e\u003cbr\u003e\u003c/em\u003e\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1.\u0026nbsp;\u003c/strong\u003eDemographic characteristics of participants.\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 473px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eParticipants\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(N = 24)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 473px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge Group\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 473px;\"\u003e\n \u003cp\u003e18 to 30 years old\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e2 (8.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 473px;\"\u003e\n \u003cp\u003e31 to 47 years old\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e6 (25.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 473px;\"\u003e\n \u003cp\u003e48 to 64 years old\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e16 (66.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 473px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDeprivation Category, n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 473px;\"\u003e\n \u003cp\u003eMost deprived\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e4 (16.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 473px;\"\u003e\n \u003cp\u003e2\u003csup\u003end\u003c/sup\u003e most deprived\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e1 (4.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 473px;\"\u003e\n \u003cp\u003eMedian quantile\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e6 (25.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 473px;\"\u003e\n \u003cp\u003e2\u003csup\u003end\u003c/sup\u003e least deprived\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e4 (16.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 473px;\"\u003e\n \u003cp\u003eLeast deprived\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e9 (37.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 473px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWorking Status, n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 473px;\"\u003e\n \u003cp\u003eFull time student\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e4 (16.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 473px;\"\u003e\n \u003cp\u003eEmployed or self employed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e14 (58.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 473px;\"\u003e\n \u003cp\u003eDoing unpaid work\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 473px;\"\u003e\n \u003cp\u003eUnemployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e1 (4.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 473px;\"\u003e\n \u003cp\u003eRetired\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e5 (20.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 473px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAcademic Level, n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 473px;\"\u003e\n \u003cp\u003eNo formal qualification after school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e1 (4.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 473px;\"\u003e\n \u003cp\u003eTrade, technical certificate, apprenticeship or diploma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e4 (16.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 473px;\"\u003e\n \u003cp\u003eUniversity degree or higher\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e19 (79.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 473px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital Status, n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 473px;\"\u003e\n \u003cp\u003eSingle\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e7 (29.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 473px;\"\u003e\n \u003cp\u003eMarried (without children)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 473px;\"\u003e\n \u003cp\u003eMarried (with children)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e13 (54.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 473px;\"\u003e\n \u003cp\u003eDivorced/Separated (with children)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e4 (16.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 473px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency of Muscle-Strengthening Exercise Participation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 473px;\"\u003e\n \u003cp\u003e2 to 3 days a week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e17 (70.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 473px;\"\u003e\n \u003cp\u003e4 to 5 days a week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e4 (16.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 473px;\"\u003e\n \u003cp\u003e6 to 7 days a week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e3 (12.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 473px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eExercise Setting\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 473px;\"\u003e\n \u003cp\u003eGym\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e8 (33.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 473px;\"\u003e\n \u003cp\u003eHome\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e5 (20.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 473px;\"\u003e\n \u003cp\u003eGroup exercise classes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e4 (16.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 473px;\"\u003e\n \u003cp\u003eCombination\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e7 (29.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 473px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eType of Exercises\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 473px;\"\u003e\n \u003cp\u003eBodyweight exercises\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e1 (4.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 473px;\"\u003e\n \u003cp\u003eWeight machines or resistance exercises\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e6 (25.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 473px;\"\u003e\n \u003cp\u003eHolistic exercises (i.e. yoga, Pilates)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e3 (12.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 473px;\"\u003e\n \u003cp\u003eCombination\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e14 (58.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eThe deprivation category is based on the quintile of the index of multiple deprivation (IMD). The full category of working status is as follows: 1) Full-time student, 2) Employed or self-employed, 3) Doing unpaid work (for own or family business/volunteering/looking after family or home), 4) Unemployed (looking for a job/unable to work due to illness or disability), 5) Retired, 6) Not specified. The total sample represents the total responses in each category whereas the percentage represents the percentage within the group.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2.\u0026nbsp;\u003c/strong\u003eReasons for participating in muscle-strengthening exercises.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCodes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSubcodes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 675px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIndicative quote(s)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eHealth concerns\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eHaving injuries\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 675px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;Two years ago, I had really bad back. I had a herniated disc. It probably took a year to clear up completely, though. So, when my back was bad, I went to physio and was given a physio programme and that\u0026rsquo;s basically what started me doing the muscle-strengthening exercises, and then I started going to Pilates\u0026hellip;I think I sort of had the motivation. The motivation came from not wanting to be injured. Again.\u0026rdquo; (P25)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eFamily health\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 675px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;I supposed the big motivation factor is my mom (health) was really poor. She had multisystem atrophy. So, we watched her kind of decline. And in the back of my mind is kind of like if I did better on baseline fitness, that if I do anything like that, I might have a better starting point than what she did.\u0026rdquo; (P09)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eAgeing\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 675px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;I think it\u0026rsquo;s sort of for our future proofing, investing in my health, particularly to have seen my parents\u0026rsquo; health deteriorate.\u0026rdquo; (P22)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eMenopause\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 675px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;I\u0026rsquo;ve had children and in the middle of perimenopause. I found that I put on quite a lot of weight when I started menopause, and I found that this (muscle-strengthening exercises) has helped me stabilise my weight a lot more than cardio.\u0026rdquo; (P01)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eHaving awareness or realisation of maintaining muscular strength\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 675px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;I think the realisation that you have to keep your muscle strength comes when you\u0026rsquo;re in your 30s. I think maybe when you realise that you do need to stay fit to look after your family\u0026hellip;I probably always knew that everybody should do it. When I was young, doing nursing, it was very popular back then in the 80s and 90s to go to step classes and aerobics\u0026hellip;as you got a bit older, you realised that you need muscle strength to kind of balance it.\u0026rdquo; (P24)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eSports performance\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eImproving sports performance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 675px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;I do a lot of leg work because that strengthens my rowing.\u0026rdquo; (P02)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;I recently took up weights to improve my karate.\u0026rdquo; (P06)\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;When I was starting, I was doing sport (rowing). And I think some part of it was to get better at rowing is to be able to produce more strength in it.\u0026rdquo; (P10)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3.\u0026nbsp;\u003c/strong\u003eChallenges to muscle-strengthening exercise participation.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCodes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSubcodes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 675px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIndicative quote(s)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003ePerceived time constraint\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eStudy and work commitment\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 675px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;I worked full-time. So, finding a slot where I could do it because obviously with personal training, there\u0026rsquo;s only a certain amount of hours in the day and stuff. But I\u0026rsquo;ve now realised that I have to make the time because it\u0026rsquo;s good for me and it\u0026rsquo;s my time.\u0026rdquo; (P07)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;Yeah, it\u0026rsquo;s one of the reasons why I do exercise at home because it can be done quickly. You can do it in maybe half an hour. Whereas at the gym it can take a long time.\u0026rdquo; (P19)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eFree time and no caring responsibilities\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 675px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;Before I retired, everything was a challenge because I had no time, and I was too tired. So not having to go out to work has made it very easy for me.\u0026rdquo; (P15)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;Got lucky with that. My children are around 20 to 25\u0026hellip;So I don\u0026rsquo;t really have any responsibilities around that anymore. It certainly would\u0026rsquo;ve been a bigger barrier years ago, trying to deal with childcare, and you prioritise the children\u0026apos;s activities than your own.\u0026rdquo; (P23)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eConfidence in ability\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eUnsure on how to do the exercises\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 675px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;I would never go to a gym and use their equipment because I will be thinking, gosh, I\u0026rsquo;ve never been to the gym. I don\u0026rsquo;t know where to start. I don\u0026rsquo;t know how to use this (equipment). I\u0026rsquo;d feel stupid.\u0026rdquo; (P05)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;\u0026hellip;we\u0026rsquo;ve been away in our motorhome for four weeks. We took all our resistance bands so that we could do our strength training in the van. Well, they never came out. They never got out once\u0026hellip;I am not confident with using resistance bands. So, I don\u0026rsquo;t really know how they work. So, I couldn\u0026rsquo;t pick one up and know instantly how to do the exercise.\u0026rdquo; (P17)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;My knowledge of using machines isn\u0026rsquo;t good. So, I tend to go to different classes, whether it\u0026rsquo;s like legs, bums, and tums, or circuits. I supposed my knowledge is recent, not basic. I suppose I would want to get better at identifying proper exercises.\u0026rdquo; (P23)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eAccessibility\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eCost\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 675px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;When I was a student here (university), I got a discount but as a working adult, some other gyms get quite expensive.\u0026rdquo; (P06)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;I would love to sign up for a PT, but, you know, there\u0026rsquo;s one thing paying \u0026pound;25 a month for gym membership, but it was close to \u0026pound;25 a session for an hour minimum for a PT.\u0026rdquo; (P23)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eSpace and equipment availability\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 675px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;Depends what time you go. It could be that it\u0026rsquo;s so busy that you just cannot do the exercise that you have planned. And I\u0026rsquo;m autistic. So, I stick to the plan. And that\u0026rsquo;s a big challenge. If I can\u0026rsquo;t do my plan, and there\u0026rsquo;s a lot of waiting.\u0026rdquo; (P08)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;At home, the challenge probably needing the equipment for lifting heavier weights. Possibly the environment, the space.\u0026rdquo; (P19)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;In certain gyms, they have 15kg bars, which for a lot of women, it makes upper body workouts more accessible with a barbell. But some gyms will only have a 20kg bar. For women starting at 20kg is just too heavy.\u0026rdquo; (P20)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eCultural stigma and societal perception\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eMale-dominated and oriented and catered towards men\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 675px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;Sometimes in the weight room, you can imagine the man are all grunting and throwing the weights around and that\u0026rsquo;s quite just not very pleasant.\u0026rdquo; (P04)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;When it\u0026apos;s really busy in the gym, I\u0026rsquo;m not gonna go and park myself in an area of the gym that\u0026rsquo;s full of men training.\u0026rdquo; (P09)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;So much of the gym equipment isn\u0026rsquo;t designed for women. Like racks of dumbbells at 17 and a half, but there\u0026rsquo;s only one set of 12 and there are loads and loads of 2kg weights. That is patronising towards women\u0026hellip;I would love to visit a gym that has been designed by women for women and see what it looks like. It doesn\u0026rsquo;t mean everything is pink\u0026hellip;One of the reasons I don\u0026rsquo;t like (going to the gym) at six o\u0026rsquo;clock is it\u0026rsquo;s all regulars. They are very male. They know exactly what they are doing. They monopolise the equipment.\u0026rdquo; (P22)\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eSocietal perception of women not needing muscle-strengthening exercises\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 675px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;There\u0026rsquo;s a bit of a generation thing as well, because like my mom, in her generation, if you said to her you need to lift weights or do resistance training, they\u0026rsquo;re kind of like, well I don\u0026rsquo;t want big bum. But that\u0026rsquo;s not the point of it.\u0026rdquo; (P02)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;My husband laughed when I told him I was going to do it and his initial thoughts was I was going to look like one of the bodybuilders with the bikini and everything\u0026hellip;so I explained to him that I wasn\u0026rsquo;t going to go on steroids and that I am not going to look like that.\u0026rdquo; (P07)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;I think unfortunately, there is still this assumption that it\u0026rsquo;s probably going to change from women doing cardio to now they do yoga and Pilates, and the guys go to the gym. But I think that guys can get an awful lot of flexibility, just as much as women can get an awful lot out of strength...There are also a lot of misconceptions out there about strength where you can damage yourself or that as a woman you can get bulky. People come to me and go, oh, I don\u0026rsquo;t wanna get bulky, and I\u0026rsquo;ve said, well, you\u0026rsquo;re a woman, you haven\u0026rsquo;t got the testosterone in your body.\u0026rdquo; (P20)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eLow Motivation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eLow motivation to do exercise\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 675px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;The only challenge I find is motivating myself to do it\u0026hellip;with the videos, because I will think, oh, tomorrow I\u0026rsquo;ll do that. Then tomorrow comes and you don\u0026rsquo;t do it for one reason or another.\u0026rdquo; (P05)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eLow motivation to step out of the comfort zone\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 675px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;It does get to a point where you tend to do the same things because it\u0026rsquo;s easier. It\u0026rsquo;s harder to motivate yourself to progress on your own.\u0026rdquo; (P19)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4.\u0026nbsp;\u003c/strong\u003eFacilitators to participating in muscle-strengthening exercise.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCodes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSubcodes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 666px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIndicative quote(s)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eUse of information and resources\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eUsing available resources and information\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 666px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;Having a personal trainer\u0026rdquo; (P07, P14, P20, P22, P25)\u003c/em\u003e,\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;Using an application\u0026rdquo; (P10, P14, P22, P23, P25)\u003c/em\u003e,\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;Going online such as Google and YouTube\u0026rdquo; (P05, P10, P15, P18, P19, P22, P24),\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;Going to exercise classes\u0026rdquo; (P05, P07, P11, P16, P22, P23, P24)\u003c/em\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;Buying online exercise course\u0026rdquo; (P17)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;I went to the gym a bit and signed up for a class\u0026hellip;I started to go on an organised class to sort of see what it was all about, how I felt, get comfortable with the physical location and see how I felt with the exercises. So, I started doing classes, then I got a personal trainer. Then I moved with that, and I\u0026rsquo;ve gained more confidence to use all the equipment and free weights myself.\u0026rdquo; (P22)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eGroup exercise classes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 666px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;I used to do that (classes) before I felt confident enough to just go to the gym by myself. But then as soon as I transitioned into that, I just stuck with no classes.\u0026rdquo; (P10)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eAccountability\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eCost\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 666px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;If you sign up for a class, there\u0026rsquo;s accountability because you pay the classes involved in the monthly payment and if you cancel, you kind of let yourself down, if that makes sense. If you don\u0026rsquo;t show up, then it\u0026rsquo;s kind of like three strikes system then you\u0026rsquo;re blocked for a week.\u0026rdquo; (P23)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;I\u0026rsquo;m up north so gym membership isn\u0026rsquo;t expensive. Discretionary spend for some but if I were putting something down, whether it is an essential spend or discretionary, I would put gym membership as an essential spend\u0026hellip;I realised the importance of it for my own health and healthy heart, importance of strength training as well.\u0026rdquo; (P22)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eGoal setting\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 666px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;I think, psychologically, not making it too difficult. Which is why I only use very light hand weights. Because I know I am not going to be too sore afterwards. I think that I just wanted to be as fit as I can be at this stage of life that I am.\u0026rdquo; (P24)\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eScheduling\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 666px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;I was confident enough when I was working to schedule it in my diary, so people knew. I used to have team meetings with my boss, and it started at quarter past nine in the morning, and I asked if we could change it to half past nine so that I could go to the gym, and with that extra 15 minutes, I was less sweaty and flustered and feeling rushed to it. I thought I felt confident enough to say, well if I don\u0026rsquo;t ask, I won\u0026rsquo;t know\u0026hellip;So it\u0026rsquo;s being confident saying, this is what I do, this is my time, and sort of scheduling it.\u0026rdquo; (P22)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eSocial support\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eCompanionship\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 666px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;Having a friend to do it with me and not being on my own. Because that gives you a competitive edge to it. Like when you lift something, I always lift more when I\u0026rsquo;m with my friend. If I was on my own, I\u0026rsquo;d probably just be like, oh, I\u0026rsquo;m tired, I am going to leave now, you know. Having a person with you is great and also having someone telling you, you\u0026rsquo;re doing great, and coming up with ideas, oh, we\u0026rsquo;re doing stuff like this.\u0026rdquo; (P08)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;Meeting my friends when I first joined this new gym was brilliant. Because we held each other accountable, you won\u0026rsquo;t want to let them down for not meeting them. That was really helpful.\u0026rdquo; (P22)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;I think I am more motivated that my partner does it with me in the morning on a workday. Because I think, to be honest, if I was in the house on my own, and it was like seven in the morning, I would probably just have two coffees. But because he motivated me to do 20 minutes, then I do the 20 minutes and then I have a coffee.\u0026rdquo; (P24)\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eWords of encouragements\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 666px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;For me, I would say that I have support at home. I have a very supportive partner. He will look after our child and his support allows me to spend time doing the things that I want to do.\u0026rdquo; (P04)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;I have a partner who\u0026rsquo;s very encouraging. Like, if I\u0026rsquo;m not feeling like going one day, maybe he will push me to go because he knows I would like it.\u0026rdquo; (P10)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;I think I probably surprised people. My husband said he\u0026rsquo;s really proud of me because I really sort of stuck at it. I think other people have said, I never saw her at the gym but now every time I go in there, she\u0026rsquo;s there!\u0026rdquo; (P25)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eAbility to choose\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eExercise\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 666px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;I like lifting heavy things. I would say I like moving, particularly swinging a really heavy kettlebell or throwing a barbell around. Personally, I found that empowering as a woman.\u0026rdquo; (P20)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;I think I like being flexible. I like doing things that make me feel flexible. So like getting into weird positions in yoga. For somebody who is 57, I like to think that I am a bit flexible. I also really like the fact that things like Pilates and yoga work quite a lot on your core. But you don\u0026rsquo;t really get in a sweat or out of breath.\u0026rdquo; (P24)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eLocation or logistic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 666px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;My access to the gym has made it really easy for me. It\u0026rsquo;s all in my route going to the university, as well as within walking distance. I think if it wasn\u0026rsquo;t that it would be a bit of a challenge.\u0026rdquo;\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;It\u0026rsquo;s convenient and quick. Quicker than having to actually go somewhere. Being able to do it at home is part of why I would do it. It\u0026rsquo;s not like I couldn\u0026rsquo;t go to the gym. There\u0026rsquo;s a local gym. It\u0026rsquo;s just that I find the gym is not very welcoming a lot of the time.\u0026rdquo; (P19)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;Motivation is good when I\u0026rsquo;m in a class because we are doing it together. If I were to do it myself, I don\u0026rsquo;t think I would do it.\u0026rdquo; (P11)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;The feeling of achievement when I finished the class. I also enjoy it because it\u0026rsquo;s a group setting. I tried to go to the gym before, I just did not enjoy it. I did not feel motivated to finish the exercise. In the class, I like the structure of the class. I like that it\u0026rsquo;s like having a personal trainer, but in a group setting\u0026hellip;also the motivation side of it when seeing people doing and pushing forward just made me want to do more.\u0026rdquo; (P16)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003ePositive changes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eConfidence\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 666px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;When I started it, I wanted to avoid the pain that I was having and for the state of my body. But now as you study more about the human body, it\u0026rsquo;s also for the health benefits that you get. When you first started, you were not sure about techniques, so you carried small weights and everything. Your confidence with the practice will then increase and yeah, you go and challenge yourself more. So that\u0026rsquo;s why it becomes more rewarding, and you become happier doing this stuff.\u0026rdquo; (P16)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eMental health\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 666px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;I started lifting because my eldest daughter was quite unwell and her psychiatrist said I needed to have counselling, to talk about her mental illness. We talked about it a lot and I couldn\u0026rsquo;t do that anymore. So, one day I started to go to the gym, and I found lifting heavy deadlifts became my therapy\u0026hellip;that was the thing I did because you can\u0026rsquo;t think about anything else. When you pick something heavy off the floor, you\u0026rsquo;ve got to concentrate on it, you can\u0026rsquo;t be distracted, you can\u0026rsquo;t have any noise in your head, you just have to focus on what you\u0026rsquo;re doing and be in the moment and be present.\u0026rdquo; (P20)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003ePositive body image\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 666px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;\u0026hellip;I supposed that kind of secondary benefit is that you look better in your clothes.\u0026rdquo; (P04)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;My husband says my body shape is now back to what I had in my 20s\u0026hellip;I definitely feel stronger, and you know, my body shape has changed considerably.\u0026rdquo; (P07)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003ePain management\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 666px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;I have been diagnosed in the past as having disc degeneration in my lower back. I think it\u0026rsquo;s probably worse if I don\u0026rsquo;t exercise. So, I can use it as an excuse (to not exercise), but when I do exercise, it\u0026rsquo;s actually lessened the pain and much better.\u0026rdquo; (P19)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5.\u0026nbsp;\u003c/strong\u003eSuggestions for improvement.\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCodes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSubcodes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 647px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIndicative quote(s)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eWhat an individual can do\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eSimplicity\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 647px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;Participating in muscle-strengthening, as I say, doesn\u0026rsquo;t necessarily need to be in a gym. I think that a lot of women have that as a massive stumbling block to approach, signing up for the gym, being in a gym with the environment being male-dominated, and so many things. If they are not confident yet in their knowledge or ability, it\u0026rsquo;s a massive thing to ask them to do\u0026hellip;so I think that targeting what people can do at home is a very good point to start.\u0026rdquo; (P13)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;Have some gentle and we\u0026apos;re starting off gentle anyway. Because a lot of it is very simple, isn\u0026apos;t it? I think when you see these, when you go online, some of these exercises are really simple to do. And people perhaps don\u0026apos;t think that they, it\u0026apos;s something they might think, \u0026quot;oh, well, I haven\u0026apos;t done any exercise for yours. I can\u0026apos;t do it.\u0026quot; But when you see how simple it\u0026apos;s just a matter of, you know, raising your heels and standing on your toes or something as a start. It\u0026apos;s very, you know, it\u0026apos;s very simple. So, everyone can do it. But I think maybe a lot of people think that it\u0026apos;s just not for them.\u0026rdquo; (P05)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eUsing other modalities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 647px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;You could do something. I mean, you could get some resistance bands and do things at home as simple as that would benefit your health.\u0026rdquo; (P02)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;Yeah, depends on who you are. Start off slowly. Maybe do a bit of yoga, Pilates, but the things that\u0026apos;s really going to make a difference is using weights. And that takes less time. Quicker, more effective. That would be my advice. But again, everybody is different. I know some people prefer just the bodyweight only.\u0026rdquo; (P18)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eWhat others can do\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eSpreading awareness\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 647px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;I guess if people were more educated on how important it is, throughout their life. I think one of the reasons that women get intimidated about it is because of that kind of thing when people are building muscle for the way they look and want to have big biceps, all that kind of stuff. Most women don\u0026rsquo;t want that. That\u0026rsquo;s not a priority for them. They don\u0026rsquo;t want to be big and muscular. I think if there was more emphasis on muscle strength and how it helps your overall metabolism, how you burn calories, how you are going to stay strong and not fall over and all that kind of stuff. I think it would improve people\u0026rsquo;s perception of strength training.\u0026rdquo; (P19)\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eWomen-only spaces and kid-friendly classes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 647px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;I think seeing people like yourself (women) in that space will make you feel welcome.\u0026rdquo; (P04)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;One of my old gyms had a female-only group. I think that was quite beneficial. I mean, because I trained around guys in karate all the time, it doesn\u0026rsquo;t bother me going to the gym full of guys. But yeah, I certainly feel like a lot of people, well, I would still find it assuring when I see other girls around the gym. It is sort of a peer influence.\u0026rdquo; (P06)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;When I first worked as PT, there was a rule that babies could not be on the gym floor. So, you\u0026rsquo;d have a woman with a small baby, and she was told that she couldn\u0026rsquo;t bring it with a carrycot into the gym. Well, that child is safe in that. They\u0026rsquo;re not gonna come into harm. So, from a safety point of view, there\u0026rsquo;s not an issue, but because there was a rule that you couldn\u0026rsquo;t have a crying baby in a gym or whatever. Equally with my studio here, when I have clients as I am pre and postnatal trained, I\u0026rsquo;ve had clients that had children and I will say, well, bring your baby. Because I can coach you and if the baby wakes up, I can hold your baby and I can still coach you. So, you haven\u0026rsquo;t got that added barrier of who am I going to take the baby to for childcare? What is the cost of childcare and the added logistic burden of actually getting the babies somewhere else and then going to pick them up afterwards? They can just go to the gym with the baby.\u0026rdquo; (P20)\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eWomen\u0026rsquo;s fitness specialist\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 647px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;I can tell you from my perspective because I am in a team sport, like a league as well. There\u0026rsquo;s a big thing about being well-informed about perimenopause. We have quite a lot of female focus (trainers) in our league. So, they have been working to raise awareness about perimenopause.\u0026rdquo; (P08)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;I chose my personal trainer very carefully, who understood menopause as well. I think it\u0026rsquo;s the same with new mums. You have to be careful, don\u0026rsquo;t you? Because of your muscles and you are getting back to exercise as well. So, it\u0026rsquo;s finding the right group of experts. I think it\u0026rsquo;s really important.\u0026rdquo; (P22)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;I think looking for content, like YouTube content, for example, with women. That way, you can see, because most people at the gym are fit and muscular, so it\u0026rsquo;s good to be able to see a woman. It would help you realise that it\u0026rsquo;s possible. It helps you realise what you can end up looking like. Because obviously, you wouldn\u0026rsquo;t look like a man.\u0026rdquo; (P10)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eReliable and accessible resources\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 647px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;I went on the internet to see how much information is out there for people. If you just googled strengthening exercises, there\u0026rsquo;s tonnes of information, there\u0026rsquo;s tonnes of videos, there\u0026rsquo;s tonnes of posters. So, one of the things I like to think of is whether it is validated. If the information has come from some sort of NHS or academic, I think you can believe in it.\u0026rdquo; (P05)\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;There\u0026rsquo;s so much out there. And I don\u0026rsquo;t know if it\u0026rsquo;s true. I can always go by myself (to exercise). And it made me feel stronger, rather than those videos. But of course, I do get sucked into all these videos that say, these five exercises to work on will change your life, and then I do fall for those sometimes. I don\u0026rsquo;t know which one is the best.\u0026rdquo; (P18)\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026ldquo;There\u0026rsquo;s lots of free stuff. People put things on YouTube, who knows what they talk about and are good trainers. You don\u0026rsquo;t have to pay for it. But I do think even if you are paying for it, it\u0026rsquo;s a good thing. It\u0026rsquo;s better than doing nothing at all. And I think maybe if they pay for it, that might motivate them to do it. I know that nobody knows that you pay for it. So, it\u0026rsquo;s not accountable to anyone but yourself. I think maybe that\u0026rsquo;s true. I\u0026rsquo;ve never paid for YouTube trainers, but my husband has, and it motivates him to do it.\u0026rdquo; (P19)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"muscle-strengthening exercise, participation, women, female, motivator, barriers, strength training","lastPublishedDoi":"10.21203/rs.3.rs-7461038/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7461038/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e While the benefits of muscle-strengthening activities are well established, national surveillance reported that women did fewer muscle-strengthening activities than men. The current study aimed to understand the barriers and facilitators among women who are currently meeting the muscle-strengthening activities guidelines and identify ways to improve participation for women.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e 24 women, aged 18 to 64, from the United Kingdom who participated in muscle-strengthening exercises at least two days per week were invited to an online or in-person interview. Reflexive thematic analysis was used to identify key themes related to the challenges and facilitators of participation, as well as potential improvements.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e Qualitative findings revealed four overarching themes 14 subthemes: (1) reason for participating in muscle-strengthening exercises (health concerns and sports performance), (2) challenges to muscle-strengthening exercise participation (perceived time constraint, low motivation, cultural stigma and societal perceptions, confidence in ability and accessibility), (3) facilitators to participating in muscle-strengthening exercises (resources or information, accountability, social support, ability to choose and positive changes) and (4) suggestions for improvement (what an individual can do and what others can do). The themes reflect the complex interaction of personal, social, and environmental factors that influence women’s participation in muscle-strengthening exercises.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003eThis study further enhances the understanding of women’s engagement in muscle-strengthening activities by highlighting not only the persistent barriers but also practical strategies to overcome them. Incorporating lived experience strategies, such as scheduling, goal setting, and social support, alongside broader structural changes, such as creating an inclusive gym environment and providing credible online resources, would offer valuable guidance for more tailored interventions and policies to increase participation among women and promote equitable opportunities for women’s health throughout their lives.\u003c/p\u003e","manuscriptTitle":"Women in Strength (WISH Study): Interview with Women Participating in Muscle-Strengthening Exercises – How Are They Doing It?","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-03 05:08:36","doi":"10.21203/rs.3.rs-7461038/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-10-21T10:00:02+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-20T14:22:50+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"321097217677707061878378139198297603060","date":"2025-10-19T12:37:24+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-06T13:00:26+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"74463748398000285064281336567502114767","date":"2025-10-03T12:31:39+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"310803422003170920981466347101824435852","date":"2025-10-01T13:19:22+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"178394270973109253481154292547953000478","date":"2025-10-01T07:27:38+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"137165210947123555159393478301408071028","date":"2025-09-23T10:36:22+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-09-22T07:15:18+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-08-27T01:32:46+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-08-27T01:32:26+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Public Health","date":"2025-08-26T09:03:03+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"5bac804a-6dc3-48cb-a3b3-ba5e55c2308d","owner":[],"postedDate":"October 3rd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-01-26T16:03:08+00:00","versionOfRecord":{"articleIdentity":"rs-7461038","link":"https://doi.org/10.1186/s12889-026-26207-9","journal":{"identity":"bmc-public-health","isVorOnly":false,"title":"BMC Public Health"},"publishedOn":"2026-01-21 15:58:21","publishedOnDateReadable":"January 21st, 2026"},"versionCreatedAt":"2025-10-03 05:08:36","video":"","vorDoi":"10.1186/s12889-026-26207-9","vorDoiUrl":"https://doi.org/10.1186/s12889-026-26207-9","workflowStages":[]},"version":"v1","identity":"rs-7461038","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7461038","identity":"rs-7461038","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}