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Erschienen in: Osteoporosis International 5/2018

13.02.2018 | Original Article

“Left to my own devices, I don’t know”: using theory and patient-reported barriers to move from physical activity recommendations to practice

verfasst von: C. Ziebart, C. McArthur, L. Lee, A. Papaioannou, J. Laprade, A. M. Cheung, R. Jain, L. Giangregorio

Erschienen in: Osteoporosis International | Ausgabe 5/2018

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Abstract

Summary

Knowledge exchange with community-dwelling individuals across Ontario revealed barriers to implementation of physical activity recommendations that reflected capability, opportunity, and motivation; barriers unique to individuals with osteoporosis include fear of fracturing, trust in providers, and knowledge of exercise terminology. Using the Behaviour Change Wheel, we identified interventions (training, education, modeling) and policy categories (communication/marketing, guidelines, service provision).

Introduction

Physical activity recommendations exist for individuals with osteoporosis; however, to change behavior, we must address barriers and facilitators to their implementation. The purposes of this project are (1) to identify barriers to and facilitators of uptake of disease-specific physical activity recommendations (2) to use the findings to identify behavior change strategies using the Behaviour Change Wheel (BCW).

Methods

Focus groups and semi-structured interviews were conducted with community-dwelling individuals attending osteoporosis-related programs or education sessions in Ontario. They were stratified by geographic area, urban/rural, and gender, and transcribed verbatim. Two researchers coded data and identified emerging themes. Using the Behaviour Change Wheel framework, themes were categorized into capability, opportunity, and motivation, and interventions were identified.

Results

Two hundred forty community-dwelling individuals across Ontario participated (mean ± SD age = 72 ± 8.28). Barriers were as follows: capability: disease-related symptoms hinder exercise and physical activity participation, lack of exercise-related knowledge, low exercise self-efficacy; opportunity: access to exercise programs that meet needs and preferences, limited resources and time, physical activity norms and preferences; motivation: incentives to exercise, fear of fracturing, trust in exercise providers. Interventions selected were training, education, and modeling. Policy categories selected were communication/marketing, guidelines, and service provision.

Conclusions

Barriers unique to individuals with osteoporosis included the following: lack of knowledge on key exercise concepts, fear of fracturing, and trust in providers. Behavior change techniques may need tailoring to gender, age, or presence of comorbid conditions.
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Literatur
1.
Zurück zum Zitat Giangregorio LM, Papaioannou A, MacIntyre NJ, Ashe MC, Heinonen A, Shipp K et al (2014) Too Fit to Fracture: exercise recommendations for individuals with osteoporosis or osteoporotic vertebral fracture. Osteoporos Int 25(3):821–835CrossRefPubMedPubMedCentral Giangregorio LM, Papaioannou A, MacIntyre NJ, Ashe MC, Heinonen A, Shipp K et al (2014) Too Fit to Fracture: exercise recommendations for individuals with osteoporosis or osteoporotic vertebral fracture. Osteoporos Int 25(3):821–835CrossRefPubMedPubMedCentral
2.
Zurück zum Zitat Giangregorio LM, McGill S, Wark JD, Laprade J, Heinonen A, Ashe MC, MacIntyre NJ, Cheung AM, Shipp K, Keller H, Jain R, Papaioannou A (2015) Too Fit To Fracture: outcomes of a Delphi consensus process on physical activity and exercise recommendations for adults with osteoporosis with or without vertebral fractures. Osteoporos Int 26(3):891–910CrossRefPubMed Giangregorio LM, McGill S, Wark JD, Laprade J, Heinonen A, Ashe MC, MacIntyre NJ, Cheung AM, Shipp K, Keller H, Jain R, Papaioannou A (2015) Too Fit To Fracture: outcomes of a Delphi consensus process on physical activity and exercise recommendations for adults with osteoporosis with or without vertebral fractures. Osteoporos Int 26(3):891–910CrossRefPubMed
3.
Zurück zum Zitat Graham ID, Logan J, Harrison MB, Straus SE, Tetroe J, Caswell W, Robinson N (2006) Lost in knowledge translation: time for a map? J Contin Educ Heal Prof 26(1):13–24CrossRef Graham ID, Logan J, Harrison MB, Straus SE, Tetroe J, Caswell W, Robinson N (2006) Lost in knowledge translation: time for a map? J Contin Educ Heal Prof 26(1):13–24CrossRef
4.
Zurück zum Zitat Tulloch H, Sweet SN, Fortier M, Capstick G, Kenny GP, Sigal RJ (2013) Exercise facilitators and barriers from adoption to maintenance in the diabetes aerobic and resistance exercise trial. Can J Diabetes 37(6):367–374CrossRefPubMed Tulloch H, Sweet SN, Fortier M, Capstick G, Kenny GP, Sigal RJ (2013) Exercise facilitators and barriers from adoption to maintenance in the diabetes aerobic and resistance exercise trial. Can J Diabetes 37(6):367–374CrossRefPubMed
5.
Zurück zum Zitat Petursdottir U, Arnadottir SA, Halldorsdottir S (2010) Facilitators and barriers to exercising among people with osteoarthritis: a phenomenological study. Phys Ther 90(7):1014–1025CrossRefPubMed Petursdottir U, Arnadottir SA, Halldorsdottir S (2010) Facilitators and barriers to exercising among people with osteoarthritis: a phenomenological study. Phys Ther 90(7):1014–1025CrossRefPubMed
6.
Zurück zum Zitat Rogerson MC, Murphy BM, Bird S, Morris T (2012) “I don’t have the heart”: a qualitative study of barriers to and facilitators of physical activity for people with coronary heart disease and depressive symptoms. Int J Behav Nutr Phys Act 9:140CrossRefPubMedPubMedCentral Rogerson MC, Murphy BM, Bird S, Morris T (2012) “I don’t have the heart”: a qualitative study of barriers to and facilitators of physical activity for people with coronary heart disease and depressive symptoms. Int J Behav Nutr Phys Act 9:140CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Baert V, Gorus E, Mets T, Bautmans I (2015) Motivators and barriers for physical activity in older adults with osteoporosis. J Geriatr Phys Ther Baert V, Gorus E, Mets T, Bautmans I (2015) Motivators and barriers for physical activity in older adults with osteoporosis. J Geriatr Phys Ther
8.
Zurück zum Zitat Michie S, Atkins L, West R (2014) The behaviour change wheel: a guide to designing interventions, 2nd edn. Silverback Publishing, Sutton Michie S, Atkins L, West R (2014) The behaviour change wheel: a guide to designing interventions, 2nd edn. Silverback Publishing, Sutton
9.
Zurück zum Zitat Michie S, van Stralen MM, West R (2011) The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci 6(1) Michie S, van Stralen MM, West R (2011) The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci 6(1)
10.
Zurück zum Zitat Clark R, McArthur C, Papaioannou A, Cheung A, Laprade J, Lee L, et al (2017) “I do not have time. Is there a handout I can use?”: combining physicians’ needs and behavior change theory to put physical activity evidence into practice. Osteoporos Int 1–11 Clark R, McArthur C, Papaioannou A, Cheung A, Laprade J, Lee L, et al (2017) “I do not have time. Is there a handout I can use?”: combining physicians’ needs and behavior change theory to put physical activity evidence into practice. Osteoporos Int 1–11
14.
Zurück zum Zitat [Internet]. Available from: bonefit.ca [Internet]. Available from: bonefit.ca
15.
Zurück zum Zitat Corbin JM, Strauss A (1990) Grounded theory research: procedures, canons, and evaluative criteria. Qual Sociol 13(1):3–21CrossRef Corbin JM, Strauss A (1990) Grounded theory research: procedures, canons, and evaluative criteria. Qual Sociol 13(1):3–21CrossRef
17.
Zurück zum Zitat Rodrigues I, Armstrong J, Adachi J, MacDermid J (2016) Facilitators and barriers to exercise adherence in patients with osteopenia and osteoporosis: a systematic review. Osteoporos Int:1–11 Rodrigues I, Armstrong J, Adachi J, MacDermid J (2016) Facilitators and barriers to exercise adherence in patients with osteopenia and osteoporosis: a systematic review. Osteoporos Int:1–11
18.
Zurück zum Zitat Baert V, Gorus E, Mets T, Bautmans I (2015) Motivators and barriers for physical activity in older adults with osteoporosis. J Geriatr Phys Ther 38(3):105–114CrossRefPubMed Baert V, Gorus E, Mets T, Bautmans I (2015) Motivators and barriers for physical activity in older adults with osteoporosis. J Geriatr Phys Ther 38(3):105–114CrossRefPubMed
19.
Zurück zum Zitat Simmonds B, Hannam K, Fox K, Tobias J (2015) An exploration of barriers and facilitators to older adults’ participation in higher impact physical activity and bone health: a qualitative study. Osteoporos Int:1–9 Simmonds B, Hannam K, Fox K, Tobias J (2015) An exploration of barriers and facilitators to older adults’ participation in higher impact physical activity and bone health: a qualitative study. Osteoporos Int:1–9
20.
Zurück zum Zitat Jepson RG, Harris FM, Platt S, Tannahill C (2010) The effectiveness of interventions to change six health behaviours: a review of reviews. BMC Public Health 10(1):538CrossRefPubMedPubMedCentral Jepson RG, Harris FM, Platt S, Tannahill C (2010) The effectiveness of interventions to change six health behaviours: a review of reviews. BMC Public Health 10(1):538CrossRefPubMedPubMedCentral
21.
Zurück zum Zitat Van Der Bij AK, Laurant MG, Wensing M (2002) Effectiveness of physical activity interventions for older adults: a review. The full text of this article is available via AJPM Online at www.elsevier.com/locate/ajpmonline. Am J Prev Med 22(2):120–133CrossRefPubMed Van Der Bij AK, Laurant MG, Wensing M (2002) Effectiveness of physical activity interventions for older adults: a review. The full text of this article is available via AJPM Online at www.elsevier.com/locate/ajpmonline. Am J Prev Med 22(2):120–133CrossRefPubMed
22.
Zurück zum Zitat Conn VS, Minor MA, Burks KJ, Rantz MJ, Pomeroy SH (2003) Integrative review of physical activity intervention research with aging adults. J Am Geriatr Soc 51(8):1159–1168CrossRefPubMed Conn VS, Minor MA, Burks KJ, Rantz MJ, Pomeroy SH (2003) Integrative review of physical activity intervention research with aging adults. J Am Geriatr Soc 51(8):1159–1168CrossRefPubMed
23.
Zurück zum Zitat Blalock SJ, DeVellis BM, Patterson CC, Campbell MK, Orenstein DR, Dooley MA (2002) Effects of an osteoporosis prevention program incorporating tailored educational materials. Am J Health Promot 16(3):146–156CrossRefPubMed Blalock SJ, DeVellis BM, Patterson CC, Campbell MK, Orenstein DR, Dooley MA (2002) Effects of an osteoporosis prevention program incorporating tailored educational materials. Am J Health Promot 16(3):146–156CrossRefPubMed
24.
Zurück zum Zitat Sedlak CA, Doheny MO, Jones SL (2000) Osteoporosis education programs: changing knowledge and behaviors. Public Health Nurs 17(5):398–402CrossRefPubMed Sedlak CA, Doheny MO, Jones SL (2000) Osteoporosis education programs: changing knowledge and behaviors. Public Health Nurs 17(5):398–402CrossRefPubMed
25.
Zurück zum Zitat Larson E, George A, Morgan R, Poteat T (2016) 10 Best resources on... intersectionality with an emphasis on low- and middle-income countries. Health Policy Plan 31(8):964–969CrossRefPubMed Larson E, George A, Morgan R, Poteat T (2016) 10 Best resources on... intersectionality with an emphasis on low- and middle-income countries. Health Policy Plan 31(8):964–969CrossRefPubMed
27.
Zurück zum Zitat Bušljeta Banks I, Dens N, De Pelsmacker P (2016) The influence of gender on the effectiveness of probability markers in advertising. Int J Advert 35(4):682–705CrossRef Bušljeta Banks I, Dens N, De Pelsmacker P (2016) The influence of gender on the effectiveness of probability markers in advertising. Int J Advert 35(4):682–705CrossRef
28.
Zurück zum Zitat Stolee P, Zaza C, Schuehlein S (2012) Evaluation of a volunteer-led in-home exercise program for home-bound older adults. Work 41(3):339–354PubMed Stolee P, Zaza C, Schuehlein S (2012) Evaluation of a volunteer-led in-home exercise program for home-bound older adults. Work 41(3):339–354PubMed
29.
Zurück zum Zitat Riva S, Camerini A, Allam A, Schulz PJ (2014) Interactive sections of an Internet-based intervention increase empowerment of chronic back pain patients: randomized controlled trial. J Med Internet Res 16(8):e180CrossRefPubMedPubMedCentral Riva S, Camerini A, Allam A, Schulz PJ (2014) Interactive sections of an Internet-based intervention increase empowerment of chronic back pain patients: randomized controlled trial. J Med Internet Res 16(8):e180CrossRefPubMedPubMedCentral
30.
Zurück zum Zitat Brosseau L, Wells G, Brooks-Lineker S, Bennell K, Sherrington C, Briggs A, Sturnieks D, King J, Thomas R, Egan M, Loew L, de Angelis G, Casimiro L, Toupin April K, Cavallo S, Bell M, Ahmed R, Coyle D, Poitras S, Smith C, Pugh A, Rahman P (2015) Internet-based implementation of non-pharmacological interventions of the “people getting a grip on arthritis” educational program: an international online knowledge translation randomized controlled trial design protocol. JMIR Res Protoc 4(1):e19CrossRefPubMedPubMedCentral Brosseau L, Wells G, Brooks-Lineker S, Bennell K, Sherrington C, Briggs A, Sturnieks D, King J, Thomas R, Egan M, Loew L, de Angelis G, Casimiro L, Toupin April K, Cavallo S, Bell M, Ahmed R, Coyle D, Poitras S, Smith C, Pugh A, Rahman P (2015) Internet-based implementation of non-pharmacological interventions of the “people getting a grip on arthritis” educational program: an international online knowledge translation randomized controlled trial design protocol. JMIR Res Protoc 4(1):e19CrossRefPubMedPubMedCentral
31.
Zurück zum Zitat Vandelanotte C, Mummery WK (2011) Qualitative and quantitative research into the development and feasibility of a video-tailored physical activity intervention. Int J Behav Nutr Phys Act 8:70CrossRefPubMedPubMedCentral Vandelanotte C, Mummery WK (2011) Qualitative and quantitative research into the development and feasibility of a video-tailored physical activity intervention. Int J Behav Nutr Phys Act 8:70CrossRefPubMedPubMedCentral
32.
Zurück zum Zitat Vestergaard S, Kronborg C, Puggaard L (2008) Home-based video exercise intervention for community-dwelling frail older women: a randomized controlled trial. Aging Clin Exp Res 20(5):479–486CrossRefPubMed Vestergaard S, Kronborg C, Puggaard L (2008) Home-based video exercise intervention for community-dwelling frail older women: a randomized controlled trial. Aging Clin Exp Res 20(5):479–486CrossRefPubMed
Metadaten
Titel
“Left to my own devices, I don’t know”: using theory and patient-reported barriers to move from physical activity recommendations to practice
verfasst von
C. Ziebart
C. McArthur
L. Lee
A. Papaioannou
J. Laprade
A. M. Cheung
R. Jain
L. Giangregorio
Publikationsdatum
13.02.2018
Verlag
Springer London
Erschienen in
Osteoporosis International / Ausgabe 5/2018
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-018-4390-3

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