Author(s): BARRAUD, A., PITEL, A.L., CABÉ, N., Institution: UNIVERSITÉ CAEN NORMANDIE, Country: FRANCE, Abstract-ID: 1024

INTRODUCTION:
Physical activity (PA) and exercise appear promising as adjunctive interventions in Alcohol Use Disorder (AUD). However, findings regarding alcohol craving, psychoaffective symptoms, and alcohol outcomes remain inconsistent and may be partly explained by poor PA adherence. Therefore, understanding how to enhance engagement and adherence to PA is essential to favor its effects.
Our mixed-methods systematic review aimed to identify barriers and facilitators that could impact PA adherence in individuals with AUD. We included both intervention and observational studies, as well as qualitative research, conducted among populations presenting with mild to severe AUD.
METHODS:
This review was conducted using five health-related databases and registers up to September 2024. Original peer-reviewed articles published in English or French and conducted in adult human populations with AUD were eligible. Only studies reporting study attrition, PA adherence or explicit facilitators and barriers to PA were included. The risk of bias was assessed using the Mixed Methods Appraisal Tool (MMAT). A convergent integrated approach and descriptive analysis were used for data synthesis.
RESULTS:
This review initially included 36 eligible references. One study was excluded due to poor methodological quality, and multiple publications derived from the same clinical trials were grouped and considered as single studies, resulting in a final sample of 29 studies: 20 intervention studies, 5 observational studies, 3 qualitative studies and 1 mixed-methods study.
Data synthesis revealed substantial variability in dropout rates within exercise intervention groups, with 11 out of 20 studies reporting attrition rates exceeding 20%. Barriers and facilitators to PA were identified across all the four levels of the socio-ecological model (intraindividual, interpersonal, environmental and policy). A greater number of factors were reported at the environmental and intraindividual levels, particularly those related to PA intervention design, substance use, momentary emotional and physical states, as well as beliefs and attitudes toward PA.
CONCLUSION:
This review highlights the central role of PA engagement and adherence, when evaluating PA-based interventions in AUD and identifies key multilevel barriers and facilitators influencing PA participation in both daily life and clinical settings. While adherence to PA, and to treatment more broadly, remains a major challenge in AUD care, future research should explicitly integrate these barriers and facilitators into intervention design. Developing PA programs tailored to the specific needs, constraints, and motivational profiles of individuals with AUD may be crucial to improving adherence and, ultimately, alcohol-related outcomes.