Opportunities for physical activity research in Puerto Rico: a review of the literature

Puerto Rico (PR) is the most physically inactive jurisdiction in the United States, with half of its population being inactive. Understanding the evidence on physical activity (PA) research in PR is crucial to advancing the field. This narrative review aimed to examine existing literature on PA in PR and evaluate the current research capacity in this area. This type of review was necessary due to the limited studies on PA in PR and the broad scope of the research question. Each study was assigned a phase (1 through 5) based on the Behavioral Epidemiology Framework (BEF) and the socio-ecological model for determinants/correlates. Following PRISMA guidelines, seven databases were systematically searched for English and Spanish articles, resulting in 26 eligible studies out of 797 records screened. The included studies focused on the following BEF phases, with the majority (16, 61.6%) concentrating on Phase 3, which involved identifying correlates, determinants, mediators, or moderators. Followed by Phase 4 (intervention evaluation), with seven studies (26.9%). Two studies (7.7%) were addressed in Phase 2 (developing/validating methods), and only one study (3.8%) focused on Phase 1 (establishing links between PA and health). No studies explored Phase 5 (translation into policy/practice). Overall, these patterns highlight a field that has identified who is inactive but has yet to develop mature measurement systems, strong causal evidence, or scalable solutions. We recommend forming transdisciplinary, diverse, and inclusive teams comprising researchers, policymakers, practitioners, and community members to enhance the evidence base and translate it into effective PA policies and practices.

The online version contains supplementary material available at 10.1186/s12982-025-01041-3.