Objective The purpose of the study was to determine the impact of COVID-19 restrictions on community-based exercise classes for people with Parkinson disease (PD) and their instructors. Methods Data were collected via custom-designed electronic surveys for people with PD and class instructors who reported attending or teaching PD-specific exercise class ≥1/week for ≥3 months prior to pandemic restrictions (March 2020). The PD group also completed the Godin Leisure-Time Questionnaire (GLT-Q), Self-Efficacy for Exercise (SEE) scale, Schwab-England scale, and Parkinson’s Disease Questionnaire 8 (PDQ-8). Results Eighty-seven people with PD (mean = 70 [7.3] years old) and 43 instructors (51 [12.1] years old) from the United States completed surveys (October 2020 to February 2021). Mean Schwab-England (84 [16]) and PDQ-8 (21 [15]) scores indicated low-to-moderate disability in the PD group. Ninety-five percent of the PD group had COVID-19 exposure concerns and 54% reported leaving home ≤1/week. While 77% of the PD group scored “active” on the GLTQ, the mean SEE score (55 [24]) indicated only moderate exercise self-efficacy, and > 50% reported decreased exercise quantity/intensity compared to pre-COVID. There was decreased in-person and increased virtual class participation for both groups. The top in-person class barrier for the PD (63%) and instructor (51%) groups was fear of participant COVID-19 exposure. The top virtual class barriers were lack of socialization (20% of PD group) and technology problems (74% of instructor group). Conclusions During COVID-19 there has been less in-person and more virtual exercise class participation in people with PD, and decreased exercise quantity and intensity. Virtual classes may not fully meet the needs of people with PD, and primary barriers include technology and lack of socialization. Impact As COVID-19 restrictions wane, it is imperative to help people with PD increase exercise and activity. The barriers, needs, and facilitators identified in this study might help inform approaches to increase participation in exercise and activity for people with PD. Lay Summary During COVID-19, there has been less in-person and more virtual exercise class participation in people with PD—and a decrease in exercise quantity and intensity. If you have PD, virtual classes might not fully meet your needs. Primary barriers may include technology problems and lack of social interaction.

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Introduction Integrating type 2 diabetes (T2DM) self-care behaviors into daily life is complex and poorly understood. Occupational therapists, as experts in life context, habits, roles, and routines, can foster new ways of understanding and promoting daily engagement in T2DM self-care. The Model of Human Occupation (MOHO), a conceptual practice model, may have applicability to better understanding the experience of living with T2DM and engaging in necessary self-care behaviors. Methods We conducted focus group interviews with individuals with T2DM ( n = 10). We applied the MOHO to understand the experience of living with T2DM and engaging in related self-care behaviors. Findings Participants discussed each element of MOHO and how it related to living with and managing type 2 diabetes. Participants identified obtaining skills for self-advocacy with family, individualized/adapted exercise, stable health-promoting environments and routines, and problem-solving skills for disruptions to routine as critical needs for managing T2DM. These intervention strategies are well-aligned with MOHO and occupational therapy practice. Conclusion We found that MOHO was a useful tool for exploring the experience and daily management of T2DM.