Understanding Physical Activity Behavior in Ghanaian Adults with Type 2 Diabetes: A Qualitative Descriptive Study

Abstract

Despite a relatively low prevalence rate, sub-Saharan Africa bears a substantial diabetes burden. Physical activity (PA) plays a crucial role in managing type 2 diabetes mellitus (T2DM). However, PA levels among this population remain suboptimal. This study aimed to explore patients’ perspectives on the barriers and facilitators to PA participation among Ghanaian adults with T2DM. Thirteen adults with T2DM were recruited from Korle-Bu Teaching Hospital, Ghana, for this qualitative descriptive study. Semi-structured interviews were conducted, and the data were analyzed using thematic analysis. Two overarching themes (personal factors and socio-structural factors) and 10 sub-themes relating to PA barriers and facilitators were identified. Participants had limited awareness of the recommended PA guidelines for T2DM management. Chronic illness-related factors hindered exercise participation. Difficulty differentiating between PA and exercise impeded the achievement of PA targets. Socio-structural barriers include concerns about social ridicule or embarrassment, safety during outdoor activities, a lack of culturally appropriate exercise facilities, and high social and work demands. Despite these barriers, participants were motivated by their understanding of the health benefits of PA. They emphasized integrating PA into daily routines through walking, work-related tasks, and household chores. Motivation and PA education from healthcare professionals are valued supports in achieving PA targets. Our findings showed that PA behaviour in Ghanaian adults with T2DM is influenced by both personal and external factors. Tailored PA interventions for this population should address identified barriers while leveraging facilitators to implement successful PA programs.

Prevalence of diabetes and associated risk factors in Ga Mashie, Accra, Ghana – the CARE Diabetes community-based survey

“…Insufficient physical activity in this context was found to be highly prevalent, with women presenting with a significantly higher burden, i.e., 82% of women do not engage in sufficient physical activity, compared to 57% of men. Evidence of this gender gap can be explained by gender norms affecting physical activity, as shown by the work of Amin et al (35), where reported socio-structural barriers for physical activity included concerns about social ridicule or embarrassment, safety during outdoor activities, a lack of culturally appropriate exercise facilities, and high social and work demands. For people living with diabetes, chronic illness-related factors also hindered their exercise participation.…”

“…Nonetheless, evidence suggests that physical activity interventions in this context might be feasible, and could lead to significant improvement of glycaemic control and reduction of NCD risk factors like waist circumference (35,36).…”

Effect of a home‐based physical activity program on metabolic syndrome in Ghanaian adults with type 2 diabetes: Protocol for a feasibility randomized controlled trial

“…This underscores the need for the development and testing of a PA programme to improve MetS markers in people with T2DM. The culturally appropriate home-based PA programme to be evaluated in the current study is informed by the findings of two of our previous studies (Amin et al, 2023a(Amin et al, , 2023b. Testing such programme before full implementation in a larger population provides evidence about its efficacy, possible participation rate and safety.…”