“…Given that 31% of people invited to PR do not attend the initial assessment (Steiner et al, 2016 ), there are a large number of people with COPD for whom an intervention may be beneficial. PR is effective at improving health outcomes (McCarthy et al, 2015 ) and is also cost-effective (Chakravorty, Fasakin, Paine, Narasimhaiah, & Austin, 2011 ; Griffiths, Phillips, Davies, Burr, & Campbell, 2001 ); therefore, any intervention that is successful in improving PR attendance, is likely to have significant benefits for those with COPD. Thus, by highlighting the different elements that combine to motivate an individual with moderate-to-severe COPD to self-manage their condition, this study provides a useful first-step in informing future research, interventions, and healthcare practice.…”