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Reasons for non-participation in a primary care-based physical activity trial: a qualitative study.

ABSTRACT: To explore reasons for non-participation in a primary care-based physical activity trial and understand how these may contribute to recruitment of non-representative research samples. We also aimed to elicit non-participants' own recommendations for enhancing trial uptake in primary care.Semistructured telephone interviews with non-participants to a randomised controlled trial of a very brief intervention for promoting physical activity conducted in primary care (the Very Brief Interventions trial), with thematic analysis of interview transcripts.5 general practice (GP) surgeries in the East of England, UK.Interviews were completed with 10 female and 6 male non-participants of white ethnicity and aged between 40 and 71 years. 13 of the 16 interviewees were either active or moderately active according to the GP Physical Activity Questionnaire (GPPAQ).Interviewees discussed a range of reasons for non-participation. These included beliefs surrounding the personal relevance of the trial based on preconceptions of intervention content. Many interviewees considered themselves either sufficiently active or too functionally limited to increase activity levels further, so rendering participation pointless in their view. Other identified barriers included a lack of free time, for trial participation and for increasing physical activity, and dissatisfaction with appointment scheduling systems in place at GP surgeries. Interviewees questioned the appropriateness of primary care as a context for delivering interventions to promote physical activity. In general, interviewees were positively disposed towards the idea of trial participation, especially if personal benefits are made salient, but suggested that interventions could be delivered in a different setting such as the internet.To increase participation in physical activity promotion trials conducted in primary care, the content of invitation materials and procedures for contacting potential participants require reconsideration. Specific recommendations include streamlining intervention materials and enhancing their relevance to the health concerns of invitees.ISRCTN72691150; Pre-results.

SUBMITTER: Attwood S

PROVIDER: S-EPMC4885436 | biostudies-other | 2016 May

REPOSITORIES: biostudies-other

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Project description:BackgroundA sufficient amount of regular moderate physical activity (PA), at least 2.5 h of moderate to vigorous PA per week as recommended by the WHO, is one of the most important lifestyle factors for maintaining good health in old age. However, less than one in four older adults (65 years or older) in Germany meets this recommendation for PA. Although previous research has found several factors related to participation in PA programmes, little is known about how these factors simultaneously affect participation decisions of older adults and how PA programmes can accommodate these dynamics. Taking an everyday life perspective, this study aimed to identify multidimensional types of PA behaviour among older adults.MethodsIn this qualitative study, 25 episodic interviews were conducted with participants and non-participants (ratio 1:3) of a structured PA intervention for older adults (65 years or older). Direct and indirect recruitment methods (e.g. pick up, gatekeeper) were used in different municipalities in Northwest Germany. The interviews were analysed according to the Grounded Theory methodology and a typology of PA participation behaviour was derived from the responses of the interviewees.ResultsFour types of PA participation behaviour were identified based on different activity goals and time management preferences: 'Health designer', 'Flexible function-oriented type', 'Comparison and competition type' and 'Fun and wellness-oriented type'. The results indicate that the structured PA intervention was better able to reach the health designer and the competitive type but was less successful in accommodating the function- or wellness-oriented type.ConclusionsIn order to improve older adults' participation in PA, preventive offers should take various activity goals and the desire for flexible time management in everyday life into account. The typology of PA participation behaviour contributes to a better understanding of the target group and can thus help to improve the development, communication and implementation of tailored PA interventions.

Project description:Adolescents who are overweight or obese are reported to be less active than their peers. Motivation is a critical factor in sustaining physical activity and thereby positive health outcomes. This qualitative study explores how participation in a 12-week Internet-based intervention study, Young & Active, influenced the participants' short-term and long-term motivation to increase and sustain physical activity. The overall purpose of Young & Active was to design, test, and evaluate a health-promoting Internet-based program for use in the school health services in Norway. The program was informed by self-determination theory and motivational interviewing. Two postintervention qualitative research interviews were conducted with 21 adolescents, aged 13 to 14 years, with a 9- to 12-month interval. The adolescents were recruited from a total of 84 participants from the Young & Active study intervention group. Data were analyzed using qualitative content analysis. Self-determination theory was used as a theoretical and explanatory framework. Following the motivational continuum from self-determination theory, all adolescents showed changes in motivation, from extrinsic toward more intrinsic motivation, and for some, a reversal after completing the program. Analysis of the adolescents' utterances formed patterns that could be divided into four main categories: (a) reinforcement of a habit, (b) promotion of competence and enjoyment, (c) boost of temporary change, and (d) reinforcement of adverse habits. An Internet-based intervention may help adolescents increase and sustain physical activity if participation is based on self-choice and if they have sufficient support in their social environments. The intervention alone is not enough to support adolescents who are less motivated or have other challenges in life and may even provoke resistance and reinforce negative health behavior. Such a program may be used together with face-to-face counseling in school health services, provided that it is further refined on a larger scale and that the counseling is performed by qualified health service professionals.

Project description:ObjectivesTo examine the recruitment, retention, and preliminary effects of a Christmas themed physical activity intervention designed to increase participation in physical activity and decrease sedentary behaviour in inactive adults.DesignPilot randomised controlled trial.SettingRecruitment from social medial platforms, workplaces, and community groups in the UK.Participants107 inactive adults (who did not meet the UK guidelines for physical activity) aged 18-75 years.InterventionsThe intervention consisted of an email sent to participants each day of Advent (1-24 December 2021), which contained a Christmas themed physical activity idea to be completed that day. Each physical activity idea was presented in three intensity formats, including Easy Elf (light intensity), Moderate Mrs Claus (moderate intensity), and Strenuous Santa (vigorous intensity). The comparator group received a leaflet about healthy living on the 1 December.Main outcome measuresParticipants were randomly assigned (2:1) to either the intervention or control and were masked to group allocation before randomisation. Primary outcomes were recruitment rate, retention, and weekly minutes of participation in self-reported moderate-to-vigorous intensity physical activity by use of the exercise vital signs questionnaire. Primary analysis compared change in minutes of moderate-to-vigorous intensity physical activity from baseline to weeks one, two, and three during the Active Advent intervention. Secondary outcomes were participation in muscle strengthening based physical activity (days per week), accelerometer measured moderate-to-vigorous intensity physical activity, light intensity physical activity, total physical activity, and sedentary time (minutes per day), and enjoyment of and adherence to the intervention.Results323 individuals expressed interest in participating in the trial and 107 were randomly assigned to the intervention (n=71) or the comparator (n=36) group. The recruitment target (n=105) was reached within 19 days of starting recruitment. 23 (21%) of 107 participants were lost to follow-up. On average, the groups reported participation in similar minutes of moderate-to-vigorous intensity physical activity in weeks one and two. At week three, the adjusted mean difference between groups was 20.6 minutes of participation in moderate-to-vigorous intensity physical activity per week (95% confidence interval -29.7 to 70.9) in favour of the intervention group. Accelerometer data showed that the intervention group spent fewer minutes sedentary per day than comparators (mean difference -58.6 (-113.5 to -3.8)). Overall, 42 (70%) of 60 participants in the intervention group reported that they liked the intervention and 41 (69%) of 59 reported that they completed the Active Advent intervention ideas each day.ConclusionsThe public were interested to participate in a Christmas themed physical activity intervention during Advent, which might increase physical activity and reduce time sedentary. Enjoyment of, and adherence to the intervention shows the potential benefit that Christmas themed physical activity campaigns/initiatives might have for improving public health.Trial registrationISRCTN12415556.

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Reasons for non-participation in a primary care-based physical activity trial: a qualitative study.

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