Title: Barriers and Facilitators to Attending and Being Physically Active during Recreation
Time among Women Incarcerated
Version: 1 Date: 27 Apr 2022
Reviewer's report:
Thank you for the opportunity to review this manuscript.
This paper investigates the barriers and facilitators to physical activity among incarcerated
women. The authors collected data from 100 women in an AZ correctional facility, using a self-
rated questionnaire asking sociodemographic questions, participation in rec-time and physical
activity, as well as barriers and facilitators.  The authors conclude that the major barriers reported
are environmental and health related. The authors derive recommendations such as structured
physical activity and providing appropriate footwear.
Regarding the background:
The paper in its present form still feels much like a report of a government evaluation study that is
not yet sufficiently “modified” into an academic paper. I feel that the paper would benefit greatly
from the authors presenting a stronger argument for why the readership of a journal on women’s
health should be interested in incarcerated women’s barriers to physical activity. For instance,
the authors could present arguments why this topic is relevant for various stakeholders – for
science, for society, for the prison system, for the women themselves, and present these in a more
structured manner in the background. I encourage the authors to also try to answer for which
readership the research is particularly relevant, and why. I would recommend showing in your
introduction “a preview” from other research as to which (potentially far-reaching) implications
a minor change within the prison system might have.
In the background, it was indicated that some research exists in the prison setting, while the
jail setting had been neglected so far. This implies that there is a difference between the two
settings, one difference was mentioned explicitly (short-term vs. long-term incarceration). But
which other differences might be expected between the two settings? Why is a new study in the
jail setting necessary? Why are the findings from the prison setting not directly applicable?
Regarding the methods:
The authors investigated an important field within women’s health, in a population that is
difficult to reach for most researchers. As such, the data gathered and its potential to provide
new insights is invaluable. With its focus on descriptive statistics, however, I feel the paper falls
short what it could possibly present to its readers, given the data collected. I would encourage
the authors to consider reporting some inductive statistics as well. For instance, analyses
could be conducted showing which how certain characteristics correlate with participation/non-
participation in rec-time and physical activity, or how psychological and other health variables
relate to rec-time participation and physical activity. I would encourage presenting the entire
survey instrument in a table or as supplementary material. The sample was not randomly drawn.
What might the voluntary nature of participation mean in terms of potential bias in the survey
results? Who is more likely to participate and what effect might that have? Please discuss
what implications this might have regarding potential bias in the findings. For instance, it was
indicated that this sample appears to be more physically active than previously studied samples.
Might this be a bias due to the sampling? What makes the authors confident in their findings,
despite the sampling?
Section “Variables”: Consider presenting the full questionnaire in a table or in the supplementary
materials. In its present form, it is difficult to judge the quality of the questionnaire items. This
is particularly important as it does not appear that any validated survey instruments were used.
Section “General Information”: I am wondering why the socio-demographic and related
variables are not included in the section “Variables". To put them into a different subheading
indicates that they are not variables, which is misleading.
Section “Health”: Here also, questionnaire items are being presented. All of these items
including those mentioned above should either fall under the heading “Variables”, “Measures”,
or similar and not be in a separate heading from “Variables”. For all measures used, please
indicate if you are using validated instruments, single items of validated instruments, or
instruments you developed by you, the authors. If it is a mix of validated and self-constructed
items, indicate which items are which.
Section “Rec-time”: This should also belong to the “Variables”. See comments above.
Regarding the discussion:
The authors juxtapose their findings with those of the literature but do not appear to follow up
with what the implications of those similarities or differences are. Please discuss your findings
and the literature in more depth in the discussion section. In particular, the topic of motivation
being a barrier was presented in the background and as a result but appears to have been
omitted in the discussion. However, self-efficacy appeared in the discussion, but is not clearly
theoretically linked to the physical activity. What is their relation?
I am not fully convinced that eliminating the material barriers to physical activity would
necessarily lead to more physical activity. I believe motivation might be a remaining barrier
that might not lead to the increase in physical activity of incarcerated women, as hoped. Please
review and discuss pertinent literature.
I would recommend introducing subheadings in the discussion section to make it easier to follow
which domain of the results is being discussed.
Some other things to clarify/edit in the text:
- On the study design: I would argue that it is the study that is cross-sectional, not the
questionnaire. Please state the proper name of the study design that was conducted. Quantitative
cross-sectional survey might be a suitable classification.
- Are the reported household incomes during or pre-incarceration? Do incarcerated women have
means of generating income while in jail? Please make the context clearer for readers unfamiliar
with the U.S. jail/prison system.
- It should read “fewer participants”, not “less participants”.
- In the results, under “Rec-time motivators”, some quotes are cited. It is unclear where these
quotes come from. Please indicate in your methods section, where you describe the variables,
which if any questions were open-ended, so it is clear where the quotes come from.
- Please rephrase “Switzerland prisons”: It is either “Switzerland’s prisons”, “Swiss prisons” or
“prisons in Switzerland”.
- Please review and restructure this sentence for clarity: “However, many environmental
conditions were noted as barriers to physical activity including activities such as volleyball were
more appropriate for younger women incarcerated.”
- It was unclear to me as a reviewer where you would like to place your figures and tables within
the text. It was not indicated anywhere.