Table 2. Barriers and Facilitators to the Uptake and Maintenance of Healthy Behaviours by People in Mid-life.

Health behaviour / Theme	Health and quality of life	Sociocultural factors	Physical environment	Access (to facilities and resources)	Psychological factors	Health inequalities
Physical Activity
Barriers	Physical ailments or chronic conditions	Lack of time. Lack of knowledge. Self-consciousness or social concerns (in women). Low socioeconomic status. More time at home	Neighbourhood safety. Driving instead of walking. Weather	Financial costs. Transport. Lack of availability or access to community physical activity programmes or facilities. Programmes delivered by mobile phones/social networking	Lack of motivation. Low self-efficacy. Perception of lack of capability (in women). Entrenched attitudes and behaviours in midlife	Ethnic minority groups Language barriers. Cultural barriers. Gender Female gender and gender roles. Hair maintenance People with disabilities Barriers relating to the built and natural environment. Barriers relating to cost. Equipment related barriers. Information-related barriers. Emotional and psychological barriers. Perceptions and attitudes relating to accessibility and disability. Lack of resources. Low SES (as a barrier)
Facilitators	Enjoyment. Sense of wellbeing/Quality of life. Prevention of illness/Healthy Ageing. Health benefits in general. Previous experience of ill health. Focus on short term benefits. Weight loss/ body image. Specific tools. Integration of physical activity into lifestyle	Support. Being a good role model (men)	None found	Fast, easy websites	None found	Ethnic minority groups Type of activity. Having exercise equipment at home Gender Physically active, adult, female role models People with disabilities Facilitators relating to the built and natural environment. Facilitators relating to cost. Equipment related facilitators. Information-related facilitators. Emotional and psychological facilitators. Perceptions and attitudes relating to accessibility and disability. Resources
Diet
Barriers	Misinterpretation of health messages	Social environment around food. Food environment. Eating out of home. Competing priorities. Lack of time. Low socioeconomic status. Unplanned shopping routines. Alcohol consumption. Co-existence of other unhealthy lifestyle behaviours	None found	Financial costs. Food availability. Programmes delivered by mobile phones/social networking. Low SES groups. Access to supermarkets	Lack of motivation. Identity. Perception of lack of capability. Existing entrenched behaviours around eating	Low SES groups Access to supermarkets
Facilitators	Clear food choices. Health concerns. Previous experience of ill health. Swapping foods. Weight loss. Specific tools	Support. Social environment around food	None found	Accessibility. Fast, easy websites	Identity	Disadvantaged groups Access to supermarkets
Smoking
Barriers	None found	Low SES. Higher level of current smoking. Younger age of initiation of smoking	None found	None found	Lack of motivation	Unemployed young adults Lack of motivation. Low SES (as a barrier)
Facilitators	Development of disease (including initiation of prescribed medicine). Participation in other health behaviours (including PA)	For media campaigns in low SES populations. High exposure. Combination with community component. Appropriate media use, language preferences, literacy needs, cultural values	None found	Information	None found	Low SES populations (as listed for health and quality of life and sociocultural factors)
Smokeless Tobacco
Barriers	Misperception of benefits (some perceived health benefits include relief of abdominal problems, enhanced digestion, stress relief, as an aid to oral hygiene, relaxation and concentration). Limited knowledge of harmful health effects	Cultural and social acceptance (associated with socialising and family tradition)	Easy availability	Low cost. Lack of information and resources to aid quitting	Lack of motivation	Ethnic minority groups All data relating to smokeless tobacco was from one systematic review in South Asian populations in UK, India, Pakistan, Nepal.
Facilitators	None found	Social, physical and emotional support to quit. Advice from doctors or dentists (but devalued when they were users themselves)	None found	None found	None found	As above
Alcohol
Barriers	None found	Socioeconomic status. Neighbourhood disorder and crime	Advertising and media. Availability	None found	None found	Gender Female LGBT groups Disconnection from identity (lesbian women)
Facilitators	None found	None found	None found	None found	None found	None found
Eye Care
Barriers	Other medical problems prioritised	Lack of understanding of information (e.g. need for follow up examination)	Could not find transportation	Could not afford transportation. Appointment arrangements (e.g. forgetting, attending but not being seen by the clinician, no clinic contact details or location). Long waits	None found	Low SES All data reported for eye care was from a population with little or no health insurance in the US.
Facilitators	None found	None found	None found	Appointment arrangements (e.g. appointment reminders, same day appointments, decreased wait times, better information about appointment location and contact details, flexible clinic hours)	None found	As above
General Health Promoting Behaviours
Barriers	None found	Alcohol consumption. Lack of time	Distance	None found	None found	Gender Female Ethnic minority groups
Facilitators	Health check-ups. Knowledge. Physical activity. Experience or fear of ill health	Marital status. Education. Having a child at home	None found	None found	Self-efficacy	None found