Descriptives
Seventeen participants finished the interview (64.71% female, mean age 31.94, range 19–57). The participants had the following diagnosis: Depression (in any form except for a major depressive disorder), specific anxiety disorder, general anxiety disorder, attention deficit hyperactivity disorder, insomnia, post-traumatic stress disorder, panic disorder, obsessive-compulsive disorder and somatic symptom disorder. Participants’ definitions of physical activity can be interpreted on a continuum, ranging from ‘physical activity is everything that is not sitting or sleeping’ to ‘more moderate/vigorous exercises in combination with feelings of being satisfied’. See Appendix
4 for all given definitions of physical activity. The weekly physical activity levels of participants were divergent. The least active participant only conducted some household tasks. The most active participant did some light exercises after waking up, walked every day for at least 30 minutes and performed moderate to vigorous physical activity approximately three times a week. Participants can be distinguished into four groups: not active at all (1), active during only daily physical activities (1), active during only moderate/vigorous physical activity (3) and active during both (4). Almost all participants expressed the intention to increase their physical activity level, except for the four people that were in the ‘active during both’ group.
No consistent pattern was found in satisfaction level and actual physical activity level. The mental/physical circumstances of the person, negative thoughts, high demands on themselves and self-compassion seemed to play a crucial role in the satisfaction level. All participants, except for one, found physical activity important. The most important reason for participants to perform physical activity were physical reasons such as increasing aerobic fitness, increasing posture, healing past injuries, improving strength, losing weight and increasing physical appearance. The second important reason was to improve their mental health (e.g. increasing mood, feeling better about themselves, clearing the mind and increasing well-being).
Determinants of physical activity
Attitudes
The majority of the participants expressed a positive attitude towards physical activity. However, some of them experienced a negative attitude, especially against more moderate/vigorous physical activity. Often a threshold to start with physical activity is described, but when they started/overcame this threshold, they enjoyed it. One participant explained that she experiences a threshold, but sometimes she comes into a flow of performing physical activities. ‘Sometimes I have periods when I am in such a flow of doing a lot of physical activities, eh, yes then I really do feel better. Kind of an addictive feeling’ (P6). Explanations given for the positive attitude are: putting your energy into something, stress relief, taking your mind off it, giving your daily life meaning, feeling proud of yourself, and feeling happier afterwards. Most explanations are related to their mental health such as this participant explains: ‘Physical activity is progress on all aspects of life, you stay clear, fresh, it has a positive influence on your body and your mind, it helps to be more present’ (P2).
Self-efficacy
More than half of the participants talked about difficulties to start with physical activities. Different given reasons are ‘Because I am lazy’ (P5, P10), ‘I lack self-discipline’ (P3, P5, P7, P17), and ‘I am not motivated enough’ (P3, P7, P8, P9, P10, P13, P15), ‘I am not a sporty type’ (P8, P9, P15), or a lack of confidence if they can perform the actual movement. Participants in the active during both groups showed more confidence than people that are not active at all or performed more daily movements. Participants who performed only moderate/vigorous physical activity experienced a low self-efficacy before they became more active.
Social support and norm
Almost all participants experienced enough social support to perform the physical activity. Their social network did not counteract their intention to become (more) physical active. Two participants did not experience enough social support. These participants showed the lowest physical activity level. In general, participants enjoyed physical activity more when done with other people. Good guidance from a personal trainer or someone who is experienced is beneficial for the participants. Compliments from their surrounding are perceived as motivating. So is described: ‘Even if it is a compliment or a “Hey you look good” or whatever, that is motivating, it shows that you are doing well’ (P4). Other people can function as a foot-in-the-door to commit to their intention to perform physical activity. An example is, ‘Then umh, there is someone, yes, a kind of social control. Someone is waiting for you, so it is easier once you have said “I am in to go.” Then you have to go. So that makes it easier for me’ (P9). A strong social norm in combination with having great demands on themselves seemed to be counterproductive for their physical activity level. So mentioned one participant: ‘Umh, but then I sometimes have the thought: “my mother is 60 and she can run 10 kilometres in an hour, so why can I not do it?” Because I basically have the same posture. So, I should be able to do so let’s say’ (P9). In general, a higher social norm resulted in performing more physical activity.
Facilitators and barriers to physical activity
In most interviews, the weather is discussed as a facilitator/barrier. More than half of the participants said their physical activity depended on the weather. However, other facilitators or barriers were more prominent. Appendix
5 shows a full overview of facilitators, barriers and tricks that helped participants to become more physically active. The most frequently mentioned facilitators were social support; having fun during physical activity; noticing progress; performing physical activity in a daily routine; self-compassion; and being in a nice environment. The most frequently mentioned barriers were being busy with other appointments; mental complaints; lack of energy; negative thoughts; not having fun during physical activity; procrastinating; and physical complaints/(fear of) injuries.
Social support/buddy/commitment
All participants found it easier to become more active when they experienced enough social support (such as having a physical activity buddy) or when they felt committed to something. One participant described: ‘So for myself, I can leave it very easily, but if I let someone else down, I will find it more difficult’ (P15). Another participant said: ‘But if I have an appointment with Umh, a friend, then I force myself to go outside, to honour the deal’ (P3). Only a few participants did not experience enough social support. Some of the participants mentioned some reasons why they felt empowered to perform more physical activity after they encountered social support. One participant described that she felt upset when she saw her partner doing it better. However, she came out stronger after they talked about it and felt more supported. ‘But we do learn to talk about it. Umh, we explained to each other our struggles. And because of that, you can also embrace better what you already have’ (P2).
(Not) Having fun during physical activity
Having fun during physical activity was mentioned, across all groups of physical activity levels. Some participants explored different physical activities before they found what they really liked. One participant explained: ‘If you want to become active, find something that you like. Umh, because when you do not like it, your motivation is hard to find. And if you have something you really like, yes then you are also more motivated. You can keep doing it, otherwise, you will be tired of it after a week or a month’ (P12).
Being in a nice environment and noticing progress
To become more active, it helped people to be outside or in a nice environment. Some physical activity helped them to explore their neighbourhood/new places. For example, this participant explained: ‘Because it helps me to see and do all kinds of fun things of course. Umh, yes, it helps me to be able to go somewhere else’ (P11). After people started a physical activity, they became more motivated to continue when they noticed some progress. ‘That you get better at something, because then, of course, it becomes more and more fun to do’ (P14).
Physical activity is part of daily routine/busy with other appointments
One of the most frequently mentioned barriers to performing physical activity was being busy with other appointments followed by procrastination. On the other hand, participants found it easier to perform physical activity when it was part of their daily life. An example of how procrastinating resulted in not doing any physical activity anymore is as followed: ‘And then, I do it at the end of the day, I keep procrastinating... procrastinating... procrastinating...and eventually, at some point, the day is over and then I think yes… I will do it tomorrow’ (P1). One way to get physical activity in your daily routine is to have reminders. One participant had a smart solution to remind himself to perform some physical activity: ‘I also have a pull-up bar in my hall, so when I go to the toilet, I always see it. So that is a kind of a reminder of Oh yes, I still have to do something’ (P3). Reminders were an often-mentioned trick for participants to perform physical activity.
Self-compassion
Self-compassion is more mentioned among participants that were in ‘the active during both’ group. In addition, it was often mentioned as a wish, that it would help them to become more active in the other groups. An example of how self-compassion can work is described as followed: ‘By writing a positive diary. So, you can write down: I have not put any pressure on myself by obsessively exercising or umh, by having to do that workout, no I have at least moved and that’s fine. And I took care of myself, I listened to my body’ (P16).
Mental complaints/lack of energy/negative thoughts
Mental complaints (e.g. low mood, mental fatigue, anxiety) and a lack of energy were the most frequently mentioned barriers next to the weather. One participant explained when ‘a mental breakdown’ (P7) is experienced, it is more difficult to do something active. When people are tired, low in energy, or did not sleep well it was also difficult to perform some active activities. Another frequently mentioned barrier was having negative thoughts. One of the participants describes: ‘I also get negative thoughts like “Oh I cannot do this at all” and “Oh this is not going well” or “I am not in shape” and “I will never get better at this”’ (P9). Another participant described how her thoughts are holding her back to perform physical activities ‘For me, it is mainly the way I approach it myself. Because I gave it such a negative connotation. Somewhere down the road, I made it an obligation for myself. So let me just say the mindset about it, that I would like to change for myself’ (P17).
Physical complaints/(fear of) injury
Physical complaints or injuries often caused inactivity among the participants. Some physical conditions experienced were cardiac infarction, vertigo (dizziness) and hypermobility of the joints. Other people had an injury (in the past) or were discouraged to perform a physical activity because of their low aerobic fitness. People that (had) experienced an injury, expressed a fear of a new injury. This was another reason to be hesitant in performing physical activity. An example of how a participant described the fear of an injury: ‘But, yes, I would like to do some exercises, but on the other hand, I am like, I do not want to do something wrong that can cause pain in my leg again’ (P5).
Goals as a method to overcome barriers
About half of the participants set goals for their daily and/or moderate/vigorous physical activities. Some of the participants had a general idea of what they wanted to achieve but did not set clear goals for themselves. Across all groups, it was mentioned that when they wanted to achieve their goal, it was helpful to become more active. In general, people with clear goals, perform more physical activity. Five participants recommended setting goals for other people that want to become more physically active. An overview of mentioned goals can be found in Appendix
6. All manuscripts and available data can be found on
https://osf.io/3puer/.