More than one million individuals, mostly women, work for low wages in the childcare industry. These individuals experience health disparities, including high rates of obesity and low levels of physical activity (PA). Understanding their specific barriers to PA could improve intervention strategies to increase PA, reduce obesity, and eliminate a wide array of chronic disease disparities.


Complete data were available for 562 African American (AA) and Caucasian women participating in the Caring and Reaching for Health (CARE) worksite-based PA intervention. Analyses used baseline data, including surveys of demographics and barriers to PA (yes/no); accelerometer-measured moderate-to-vigorous PA (MVPA; min/d); and BMI. Separate multivariable linear regressions assessed associations between 14 perceived barriers and MVPA adjusted for age, BMI, income, marital status, insurance status, and employee role.


Participants were primarily AA (58%), without a college degree (75%), and earning <$20k (55%). Health risk were evident, with 66% having obesity and average MVPA of 17.1 min/d. Most commonly perceived barriers to PA were past efforts being too hard to keep up (44%) and lack of time (35%). In the multivariable analysis, significantly lower levels of MVPA were associated with not enjoying PA (-5.6±1.7 min/d), PA ruining hair (-6.0±2.0), no PA partner (-2.7±1.4), and PA making them tired/sweaty (-2.8±1.5).. When stratified by race, among Caucasian women, only not enjoying PA was significant. Among AA women, significant barriers were not enjoying PA, hair, being tired/sweaty, and lack of time.


The high prevalence of obesity and physical inactivity observed among low-income women working in childcare are cause for concern. Interventions should address enjoyment of PA, and given the number of AA women employed, also address physical concerns such as hair and being tired/sweaty. Finding fun activities could improve affect and moderate feelings of exertion.