Understanding physical activity facilitators and barriers during and following a supervised exercise programme in Type 2 diabetes: a qualitative study

Background: Self-management has become a key strategy for caring chronic patients in community. However, little is known about peoples’ self-management experiences and their perceived cues and barriers to engagement in self-management. Objective: To explore issues patients with type 2 diabetes experienced in their self-management practices,to understand cues and barriers to engagement in self-management. Design: Qualitative study (Semi-structured interviews) Setting: 11 communities in Beijing, China Participants: Type 2 diabetes patients in community, aged >18, no admission in past 90 days. Methods: 40 critical incident interviews were run during Apr to Sep in 2011 using purposive sampling (20 interviews with patients whose HbA1c well-controlled (<6.5%), while 20 badly-controlled (≥8%)).Themes from interviews were identified using content analysis, which revealed cues and barriers to self-modification for diabetes management. Results: Implications for self- management practice included objectively understanding on the severity and complications of diabetes. In addition to family support such as supervision in family and fully-use of family resource, desires/duties to be responsible for whole family life as a breadwinner was emerged as a key cue to engagement in self-control. Barriers to engagement in self-management stemmed from financial burden to monitor blood glucose daily, dissatisfaction of HbA1c level after efforts, and malignant life events. It is worth mentioning that starving experience of difficult time with natural disasters in1960s- 1970s in China was identified also as a key barrier to engagement in diet management. Discussion and Conclusion: There was a strong desire for Chinese patients to comply with Chinese cultural norms; particularly those relating to family value. It was the patients’ power to be involved in self-management that they could devote their healthy life to family duty. Everyone had his/her own history so experiences in past shaped patients’ behaviors now. The findings highlighted the importance of understanding the family value and the personal experiences as facilitators and barriers to self-management of Chinese patients with type 2 diabetes living in community.

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The The Barriers and Facilitators of Physical Activity Participation Among People Living with Type 2 Diabetes

Social Science Protocols ◽

10.7565/ssp.v3.4497 ◽

2020 ◽

Vol 3 ◽

pp. 1-16

Author(s):

Ozge Olbeci ◽

Aycan Celik ◽

Russell Jone

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Science Studies ◽

Meta Analysis ◽

Barriers And Facilitators ◽

Primary Data ◽

Future Research ◽

Quantitative Studies ◽

Facilitators And Barriers

Background: Type 2 diabetes mellitus (T2DM) is among the leading causes of serious mortality and health burden globally. Exercise is one of the commonly suggested preventions/ interventions for T2DM. However, many adults with T2DM are not achieving the recommended levels of physical activity. The objective of this systematic review is to investigate the barriers and facilitators to physical activity among people living with type 2 diabetes. Methods/Design: This review will be undertaken using the Preferred Reporting Items and Meta-analysis (PRISMA). The database search will be performed in MEDLINE, CINAHL, PubMed, and Web of Science. Studies included will report primary data (qualitative and quantitative) on people with T2DM (18 and over years of age). The review will be limited in English published between 2009 and 2020. A study design describing reasons for barriers, facilitators or both of physical activity among people with T2DM will be included. The risk of bias will be evaluated with Mixed-Methods Appraisal Tool (MMAT). Data synthesis will be conducted with narrative synthesis for quantitative studies, and thematic synthesis for qualitative studies followed by a mix-method synthesis to combine the previous synthesis. Discussion: This review will provide evidence for better understanding the facilitators and barriers to physical activity among people with T2DM. This information will also guide future research and support the development of the intervention to expand and increase facilitator factors determined by people with T2DM.

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Lack of infrastructure, social and cultural factors limit physical activity among patients with type 2 diabetes in rural Sri Lanka, a qualitative study

PLoS ONE ◽

10.1371/journal.pone.0192679 ◽

2018 ◽

Vol 13 (2) ◽

pp. e0192679 ◽

Cited By ~ 4

Author(s):

Arjuna Medagama ◽

Manoj Galgomuwa

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Sri Lanka ◽

Qualitative Study ◽

Cultural Factors ◽

Social And Cultural Factors

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How do we support walking prescriptions for type 2 diabetes management? Facilitators and barriers following a 3-month prescription

Journal of Primary Health Care ◽

10.1071/hc20023 ◽

2020 ◽

Vol 12 (2) ◽

pp. 173 ◽

Cited By ~ 1

Author(s):

Andrew N. Reynolds ◽

Ian Moodie ◽

Bernard Venn ◽

Jim Mann

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Lived Experience ◽

Health Care Professionals ◽

Diabetes Management ◽

Post Intervention ◽

Physical Activity Guidelines ◽

Self Rated Health ◽

Facilitators And Barriers

ABSTRACT INTRODUCTIONPrescribing physical activity is an inexpensive method to promote patients’ long-term health, but determinants of adherence with physical activity prescriptions are seldom considered. AIMTo identify facilitators and barriers experienced by adults with type 2 diabetes when prescribed regular walking. METHODSParticipants were prescribed a regular walking routine that met current physical activity guidelines for type 2 diabetes management for a period of 3 months. Pre- and post-intervention questions considered participants’ self-rated health and physical activity amount. Thematic analysis of recorded interviews held after the 3-month prescription identified barriers and facilitators to adherence for participants. RESULTSTwenty-eight adults (aged 60±9 years, body mass index 32.3±4.0kg/m2, HbA1c 59±16mmol/mol) participated in the 3-month intervention, providing 7 years of lived experience. Self-rated health (14%; 95% confidence interval (CI) 7–22%) and time spent walking (+11 min/day; 95% CI 4–18 min/day) increased following the prescription. Major themes motivating participants were: establishing a walking routine; the support of their family members; observing health benefits; and being monitored by a health professional. The greatest barriers were associated with walking in the evening and included feelings of insecurity in the dark or a preference for sedentary behaviour. DISCUSSIONA prescription to walk increased time spent in physical activity and self-rated health in adults with type 2 diabetes. Health-care professionals can support walking prescriptions by promoting facilitators and reducing barriers to prescription adherence. Practical solutions to barriers include identifying alternative physical activity opportunities within the house or advice to develop support networks to provide company while walking.

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Mobile Health Biometrics to Enhance Exercise and Physical Activity Adherence in Type 2 Diabetes (MOTIVATE-T2D): protocol for a feasibility randomised controlled trial

BMJ Open ◽

10.1136/bmjopen-2021-052563 ◽

2021 ◽

Vol 11 (11) ◽

pp. e052563

Author(s):

Katie Hesketh ◽

Jonathan Low ◽

Robert Andrews ◽

Charlotte A Jones ◽

Helen Jones ◽

...

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Controlled Trial ◽

Routine Practice ◽

Supervised Exercise ◽

Feasibility Randomised Controlled Trial ◽

Exercise Specialist ◽

Randomised Controlled ◽

The Uk

IntroductionExercise and physical activity (PA) are fundamental to the treatment of type 2 diabetes. Current exercise and PA strategies for newly diagnosed individuals with type 2 diabetes are either clinically effective but unsuitable in routine practice (supervised exercise) or suitable in routine practice but clinically ineffective (PA advice). Mobile health (mHealth) technologies, offering biometric data to patients and healthcare professionals, may bridge the gap between supervised exercise and PA advice, enabling patients to engage in regular long-term physically active lifestyles. This feasibility randomised controlled trial (RCT) will evaluate the use of mHealth technology when incorporated into a structured home-based exercise and PA intervention, in those recently diagnosed with type 2 diabetes.Methods and analysisThis feasibility multicentre, parallel group RCT will recruit 120 individuals with type 2 diabetes (diagnosis within 5–24 months, aged 40–75 years) in the UK (n=60) and Canada (n=60). Participants will undertake a 6-month structured exercise and PA intervention and be supported by an exercise specialist (active control). The intervention group will receive additional support from a smartwatch and phone app, providing real-time feedback and enabling improved communication between the exercise specialist and participant. Primary outcomes are recruitment rate, adherence to exercise and loss to follow-up. Secondary outcomes include a qualitative process evaluation and piloting of potential clinical outcome measures for a future RCT.Ethics and disseminationThe trial was approved in the UK by the South East Scotland Research Ethics Committee 01 (20/SS/0101) and in Canada by the Clinical Research Ethics Board of the University of British Columbia (H20-01936), and is being conducted in accordance with the Declaration of Helsinki and Good Clinical Practice. Results will be published in peer-reviewed journals and presented at national and international scientific meetings.Trial registration numbersISRCTN14335124; ClinicalTrials.gov: NCT04653532.

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BARRIERS TO PHYSICAL ACTIVITY IN RECENTLY DIAGNOSED TYPE 2 DIABETES MELLITUS PATIENTS: A QUALITATIVE STUDY

Nurse and Health: Jurnal Keperawatan ◽

10.36720/nhjk.v9i2.176 ◽

2020 ◽

Vol 9 (2) ◽

pp. 87-94

Author(s):

Yulia Kurniawati ◽

Ninuk Dian Kurniawati ◽

Ririn Probowati

Keyword(s):

Physical Activity ◽

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Health Literacy ◽

Qualitative Study ◽

Diabetes Management ◽

Phenomenological Approach ◽

Media Technology

Background: Physical activity as one of diabetes management plays important role in maintaining glycemic control. Not all diabetics are doing adequate physical activity. Especially for recently diagnosed type 2 Diabetes Mellitus patients with the characteristic haven’t adopt diabetes management properly.Objectives: The aim of this study to reveal the barriers in physical activity that faced by recently diagnosed type 2 Diabetes Mellitus patients.Methods: Qualitative study with phenomenological approach was conducted in 10 recently diagnosed type 2 Diabetes Mellitus patients in Primary Health Care Kedungdoro and Asemrowo, Surabaya. The participants were selected based on inclusion criteria, namely patients aged 25-45 years old, under 6 months diagnosed, spoke in Indonesian or Javanese well. The exclusion criteria were patients with complication. Semi-structured in-depth interviews guided by interview guideline was conducted to obtain the information about barrier in physical activity. There were six questions in interview guideline. Then data from interview was analyzed by Colaizzi method.Results: Two themes were emerged as barriers in physical activity namely time expenditure and health literacy. Participants’ time expenditure refers to the limited time in doing physical activity, namely obligation to others and lack of spare time. Health literacy refers to the ability in searching and using health information. The barrier in health literacy aspect namely physical activity substitute and different information that got from others.Conclusion: The barriers of physical activity were problem in time flexibility, activity substitute, and need for straightening various information. Using media technology and involving family to promote and remind the physical activity can be suggested. Keywords: Barriers, Diabetes Mellitus Type 2, Recently Diagnosed, Physical Activity

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