Patients’ experiences with a behaviour change intervention to enhance physical activity in primary care: A mixed methods study

Abstract

Objective To explore the experiences of patients at risk for cardiovascular disease in primary care with the Activate intervention in relation to their success in increasing their physical activity. Methods A convergent mixed methods study was conducted, parallel to a cluster-randomised controlled trial in primary care, using a questionnaire and semi-structured interviews. Questionnaires from 67 patients were analysed, and semi-structured interviews of 22 patients were thematically analysed. Experiences of patients who had objectively increased their physical activity (responders) were compared to those who had not (non-responders). Objective success was analysed in relation to self-perceived success. Results The questionnaire and interview data corresponded, and no substantial differences among responders and non-responders emerged. Participating in the intervention increased patients’ awareness of their physical activity and their physical activity level. Key components of the intervention were the subsequent support of nurses with whom patients’ have a trustful relationship and the use of self-monitoring tools. Patients highly valued jointly setting goals, planning actions, receiving feedback and review on their goal attainment and jointly solving problems. Nurses’ support, the use of self-monitoring tools, and involving others incentivised patients to increase their physical activity. Internal circumstances and external circumstances challenged patients’ engagement in increasing and maintaining their physical activity. Conclusion Patients experienced the Activate intervention as valuable to increase and maintain their physical activity, irrespective of their objective change in physical activity. The findings enable the understanding of the effectiveness of the intervention and implementation in primary care. Trial registration ClinicalTrials.gov NCT02725203 .

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“…Research has examined patients' willingness to receive behaviour change interventions within specific health contexts, such as during cancer screening appointments [19] or in the context of managing or preventing long-term health conditions including psoriasis [20] and cardiovascular disease [21], but have not considered consultations for conditions that may have little to do (at least from the perspective of the patient) with the target health behaviour. Consequently, more research is needed on the patient perspective of receiving opportunistic behaviour change interventions from GPs, during routine primary care consultations.…”

Association between behavioral phenotypes and response to a physical activity intervention using gamification and social incentives: Secondary analysis of the STEP UP randomized clinical trial

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