Factors Influencing Exercise Among Adults With Visual Impairments in Brazil and the United States: A Cross-Cultural Qualitative Study Using the Capability, Opportunity, Motivation-Behavior Model.

This study compared exercise factors among 14 adults with visual impairments in Brazil and the United States. Using inductive reflexive thematic analysis mapped onto the capability, opportunity, motivation-behavior model, findings revealed shared initial health motivations but divergent maintenance drivers. Brazilian participants were motivated by social identity and community, whereas Americans prioritized autonomy. Due to inaccessible community fitness spaces, participants adopted distinct coping strategies: American participants typically exercised at home to ensure consistency (often sacrificing technical progression), while Brazilian participants relied on specialized public institutions to achieve higher exercise intensity (despite facing systemic program fragility). These results highlight that the drivers of sustained exercise manifest differently across distinct sociopolitical contexts. Consequently, interventions cannot be universal. We propose culturally situated strategies based on the Behavior Change Wheel, specifically environmental restructuring and enablement, to move beyond generic advice and foster sustainable participation.