Gendered and Contextual Barriers to Physical Activity Among Indonesian Adolescents: Implications for Physical, Psychosocial, and Emotional Development in a Cross-Cultural Context

Background: Adolescent physical inactivity contributes to rising non-communicable disease (NCD) risks and poorer mental wellbeing, particularly in low- and middle-income countries (LMICs). This study examined how gender and environmental context jointly shape physical activity (PA) levels and perceived barriers among Indonesian junior high school students. Methods: A cross-sectional school-based survey was conducted in 2025 among 1,977 students (aged 12–15 years) from urban, transitional, and rural areas in Bali, Indonesia. PA was measured using the validated Physical Activity Questionnaire for Adolescents (PAQ-A; Cronbach’s α = 0.69). Perceived barriers were collected via open-ended responses and coded using directed content analysis (inter-rater kappa = 0.82). Group differences were analyzed with nonparametric tests and effect sizes. Predictors of PA level and barriers were modeled using ordinal logistic regression and generalized estimating equations (GEE) to account for school clustering, with sensitivity analyses performed. Results: Boys reported significantly higher PAQ-A scores than girls (small-to-moderate effect size), while area differences were more pronounced among girls. Barrier patterns were structured: time-related and motivational barriers predominated among girls and urban students, whereas facility barriers were more common among boys and rural students. Higher PA scores were independently associated with lower odds of time- and facility-related barriers. GEE models confirmed these associations after adjusting for clustering. Conclusions: Perceived barriers to physical activity exhibit gendered and contextual patterns rather than random variation. These findings support the development of constraint-matched, school-based interventions that are gender-responsive and context-sensitive. By addressing sociocultural and environmental barriers, such strategies can enhance not only physical activity levels but also contribute to physical, psychosocial, and emotional development among adolescents in diverse cultural contexts.