Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada.
Centre for Family Medicine Family Health Team, Kitchener, ON, Canada.
Osteoporos Int. 2018 May;29(5):1081-1091. doi: 10.1007/s00198-018-4390-3. Epub 2018 Feb 13.
Knowledge exchange with community-dwelling individuals across Ontario revealed barriers to implementation of physical activity recommendations that reflected capability, opportunity, and motivation; barriers unique to individuals with osteoporosis include fear of fracturing, trust in providers, and knowledge of exercise terminology. Using the Behaviour Change Wheel, we identified interventions (training, education, modeling) and policy categories (communication/marketing, guidelines, service provision).
Physical activity recommendations exist for individuals with osteoporosis; however, to change behavior, we must address barriers and facilitators to their implementation. The purposes of this project are (1) to identify barriers to and facilitators of uptake of disease-specific physical activity recommendations (2) to use the findings to identify behavior change strategies using the Behaviour Change Wheel (BCW).
Focus groups and semi-structured interviews were conducted with community-dwelling individuals attending osteoporosis-related programs or education sessions in Ontario. They were stratified by geographic area, urban/rural, and gender, and transcribed verbatim. Two researchers coded data and identified emerging themes. Using the Behaviour Change Wheel framework, themes were categorized into capability, opportunity, and motivation, and interventions were identified.
Two hundred forty community-dwelling individuals across Ontario participated (mean ± SD age = 72 ± 8.28). Barriers were as follows: capability: disease-related symptoms hinder exercise and physical activity participation, lack of exercise-related knowledge, low exercise self-efficacy; opportunity: access to exercise programs that meet needs and preferences, limited resources and time, physical activity norms and preferences; motivation: incentives to exercise, fear of fracturing, trust in exercise providers. Interventions selected were training, education, and modeling. Policy categories selected were communication/marketing, guidelines, and service provision.
Barriers unique to individuals with osteoporosis included the following: lack of knowledge on key exercise concepts, fear of fracturing, and trust in providers. Behavior change techniques may need tailoring to gender, age, or presence of comorbid conditions.
目的：本研究旨在（1）确定骨质疏松症患者接受特定疾病的体力活动建议的障碍和促进因素；（2）利用研究结果，使用行为改变轮（BCW）确定行为改变策略。
方法：对安大略省参加骨质疏松症相关项目或教育课程的社区居民进行了焦点小组和半结构化访谈。根据地理位置、城乡和性别对参与者进行分层，并逐字转录。两名研究人员对数据进行编码并确定了新出现的主题。使用行为改变轮框架，将主题分为能力、机会和动机，并确定了干预措施。
结果：共有 240 名安大略省的社区居民参与了研究（平均年龄±标准差为 72±8.28 岁）。障碍如下：能力方面：疾病相关症状妨碍锻炼和体力活动参与，缺乏锻炼相关知识，锻炼自我效能感低；机会方面：获得满足需求和偏好的锻炼计划，资源和时间有限，体力活动规范和偏好；动机方面：锻炼的激励因素，害怕骨折，对锻炼提供者的信任。选择的干预措施包括培训、教育和示范。选择的政策类别包括沟通/营销、指南和服务提供。
结论：骨质疏松症患者特有的障碍包括缺乏关键运动概念的知识、害怕骨折和对提供者的信任。行为改变技术可能需要根据性别、年龄或合并症的存在进行调整。
