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Physical activity in patients with type 2 diabetes and hypertension--insights into motivations and barriers from the MOBILE study.

Duclos M, Dejager S, Postel-Vinay N, di Nicola S, Quéré S, Fiquet B - Vasc Health Risk Manag (2015)

Bottom Line: The physician's role emerged in the motivations (reassurance on health issues, training on hypoglycemia risk, and prescription/monitoring of the PA by the physician).A negative self-image was the highest ranked barrier for the inactive patients, followed by lack of support and medical concerns.Physicians should consider PA prescription as seriously as any drug prescription, and take into account motivations and barriers to PA to tailor advice to patients' specific needs and reduce their perceived constraints.

View Article: PubMed Central - PubMed

Affiliation: Department of Sport Medicine and Functional Explorations, University-Hospital (CHU), G Montpied Hospital; INRA, UNH, CRNH Auvergne, France ; Nutrition Department, University of Auvergne, Clermont-Ferrand, Auvergne, France.

ABSTRACT

Background: Although physical activity (PA) is key in the management of type 2 diabetes (T2DM) and hypertension, it is difficult to implement in practice.

Methods: Cross-sectional, observational study. Participating physicians were asked to recruit two active and four inactive patients, screened with the Ricci-Gagnon (RG) self-questionnaire (active if score ≥16). Patients subsequently completed the International Physical Activity Questionnaire. The objective was to assess the achievement of individualized glycated hemoglobin and blood pressure goals (<140/90 mmHg) in the active vs inactive cohort, to explore the correlates for meeting both targets by multivariate analysis, and to examine the barriers and motivations to engage in PA.

Results: About 1,766 patients were analyzed. Active (n=628) vs. inactive (n=1,138) patients were more often male, younger, less obese, had shorter durations of diabetes, fewer complications and other health issues, such as osteoarticular disorders (P<0.001 for all). Their diabetes and hypertension control was better and obtained despite a lower treatment burden. The biggest difference in PA between the active vs inactive patients was the percentage who declared engaging in regular leisure-type PA (97.9% vs. 9.6%), also reflected in the percentage with vigorous activities in International Physical Activity Questionnaire (59.5% vs. 9.6%). Target control was achieved by 33% of active and 19% of inactive patients (P<0.001). Active patients, those with fewer barriers to PA, with lower treatment burden, and with an active physician, were more likely to reach targets. The physician's role emerged in the motivations (reassurance on health issues, training on hypoglycemia risk, and prescription/monitoring of the PA by the physician). A negative self-image was the highest ranked barrier for the inactive patients, followed by lack of support and medical concerns.

Conclusion: Physicians should consider PA prescription as seriously as any drug prescription, and take into account motivations and barriers to PA to tailor advice to patients' specific needs and reduce their perceived constraints.

No MeSH data available.


Related in: MedlinePlus

Barriers and motivations to physical activity ranked by the patients.Notes: (A) Barriers: Barriers were ranked on a scale of 1 (fully disagree) to 5 (fully agree). Mean (and SD) responses from active patients are shown in light grey and that of inactive patients in dark grey. Items were: 1) fitness and self-image (feeling too tired, too fat, not feeling like it, feeling unfit, feeling self-conscious about one’s look); 2) lack of support from a nonphysician (nobody to exercise with, nobody encouraging); 3) health concerns (fear of hypoglycemia, fear of BP rise, musculoskeletal disorders, fear of heart attack, fear of injury); 4) environmental factors (lack of infrastructures close by, lack of parks close by, lack of time, too costly). (B) Motivations: Motivations were ranked on a scale of 1 (fully disagree) to 5 (fully agree). Mean (and SD) responses from active patients are shown in light grey and that of inactive patients in dark grey. Items were: 1) lack of health concerns (no fear of any medical risk being trained on how to prevent hypoglycemia); 2) medical support (direct request from the physician, regular monitoring of patients’ PA from the physician); 3) support from a nonphysician (someone to exercise with, someone encouraging); 4) self-image (having sufficiently lost weight); 5) environmental factors (sufficient infrastructures/parks available close by, pedometer to use, internet or smartphone advices, advice from a coach, having sufficient time).Abbreviations: SD, standard deviation; BP, blood pressure; PA, physical activity.
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f2-vhrm-11-361: Barriers and motivations to physical activity ranked by the patients.Notes: (A) Barriers: Barriers were ranked on a scale of 1 (fully disagree) to 5 (fully agree). Mean (and SD) responses from active patients are shown in light grey and that of inactive patients in dark grey. Items were: 1) fitness and self-image (feeling too tired, too fat, not feeling like it, feeling unfit, feeling self-conscious about one’s look); 2) lack of support from a nonphysician (nobody to exercise with, nobody encouraging); 3) health concerns (fear of hypoglycemia, fear of BP rise, musculoskeletal disorders, fear of heart attack, fear of injury); 4) environmental factors (lack of infrastructures close by, lack of parks close by, lack of time, too costly). (B) Motivations: Motivations were ranked on a scale of 1 (fully disagree) to 5 (fully agree). Mean (and SD) responses from active patients are shown in light grey and that of inactive patients in dark grey. Items were: 1) lack of health concerns (no fear of any medical risk being trained on how to prevent hypoglycemia); 2) medical support (direct request from the physician, regular monitoring of patients’ PA from the physician); 3) support from a nonphysician (someone to exercise with, someone encouraging); 4) self-image (having sufficiently lost weight); 5) environmental factors (sufficient infrastructures/parks available close by, pedometer to use, internet or smartphone advices, advice from a coach, having sufficient time).Abbreviations: SD, standard deviation; BP, blood pressure; PA, physical activity.

Mentions: The role of the physician also emerged in the motivations (reassurance on potential health issues and training on potential risks such as hypoglycemia, as well as the importance of a specific request from the physician and his monitoring of the PA), while a negative self-image was the highest ranked barrier for the inactive patients, followed by the lack of support and encouragement, and by medical concerns and fear of injury (Figure 2A and B).


Physical activity in patients with type 2 diabetes and hypertension--insights into motivations and barriers from the MOBILE study.

Duclos M, Dejager S, Postel-Vinay N, di Nicola S, Quéré S, Fiquet B - Vasc Health Risk Manag (2015)

Barriers and motivations to physical activity ranked by the patients.Notes: (A) Barriers: Barriers were ranked on a scale of 1 (fully disagree) to 5 (fully agree). Mean (and SD) responses from active patients are shown in light grey and that of inactive patients in dark grey. Items were: 1) fitness and self-image (feeling too tired, too fat, not feeling like it, feeling unfit, feeling self-conscious about one’s look); 2) lack of support from a nonphysician (nobody to exercise with, nobody encouraging); 3) health concerns (fear of hypoglycemia, fear of BP rise, musculoskeletal disorders, fear of heart attack, fear of injury); 4) environmental factors (lack of infrastructures close by, lack of parks close by, lack of time, too costly). (B) Motivations: Motivations were ranked on a scale of 1 (fully disagree) to 5 (fully agree). Mean (and SD) responses from active patients are shown in light grey and that of inactive patients in dark grey. Items were: 1) lack of health concerns (no fear of any medical risk being trained on how to prevent hypoglycemia); 2) medical support (direct request from the physician, regular monitoring of patients’ PA from the physician); 3) support from a nonphysician (someone to exercise with, someone encouraging); 4) self-image (having sufficiently lost weight); 5) environmental factors (sufficient infrastructures/parks available close by, pedometer to use, internet or smartphone advices, advice from a coach, having sufficient time).Abbreviations: SD, standard deviation; BP, blood pressure; PA, physical activity.
© Copyright Policy
Related In: Results  -  Collection

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Show All Figures
getmorefigures.php?uid=PMC4492639&req=5

f2-vhrm-11-361: Barriers and motivations to physical activity ranked by the patients.Notes: (A) Barriers: Barriers were ranked on a scale of 1 (fully disagree) to 5 (fully agree). Mean (and SD) responses from active patients are shown in light grey and that of inactive patients in dark grey. Items were: 1) fitness and self-image (feeling too tired, too fat, not feeling like it, feeling unfit, feeling self-conscious about one’s look); 2) lack of support from a nonphysician (nobody to exercise with, nobody encouraging); 3) health concerns (fear of hypoglycemia, fear of BP rise, musculoskeletal disorders, fear of heart attack, fear of injury); 4) environmental factors (lack of infrastructures close by, lack of parks close by, lack of time, too costly). (B) Motivations: Motivations were ranked on a scale of 1 (fully disagree) to 5 (fully agree). Mean (and SD) responses from active patients are shown in light grey and that of inactive patients in dark grey. Items were: 1) lack of health concerns (no fear of any medical risk being trained on how to prevent hypoglycemia); 2) medical support (direct request from the physician, regular monitoring of patients’ PA from the physician); 3) support from a nonphysician (someone to exercise with, someone encouraging); 4) self-image (having sufficiently lost weight); 5) environmental factors (sufficient infrastructures/parks available close by, pedometer to use, internet or smartphone advices, advice from a coach, having sufficient time).Abbreviations: SD, standard deviation; BP, blood pressure; PA, physical activity.
Mentions: The role of the physician also emerged in the motivations (reassurance on potential health issues and training on potential risks such as hypoglycemia, as well as the importance of a specific request from the physician and his monitoring of the PA), while a negative self-image was the highest ranked barrier for the inactive patients, followed by the lack of support and encouragement, and by medical concerns and fear of injury (Figure 2A and B).

Bottom Line: The physician's role emerged in the motivations (reassurance on health issues, training on hypoglycemia risk, and prescription/monitoring of the PA by the physician).A negative self-image was the highest ranked barrier for the inactive patients, followed by lack of support and medical concerns.Physicians should consider PA prescription as seriously as any drug prescription, and take into account motivations and barriers to PA to tailor advice to patients' specific needs and reduce their perceived constraints.

View Article: PubMed Central - PubMed

Affiliation: Department of Sport Medicine and Functional Explorations, University-Hospital (CHU), G Montpied Hospital; INRA, UNH, CRNH Auvergne, France ; Nutrition Department, University of Auvergne, Clermont-Ferrand, Auvergne, France.

ABSTRACT

Background: Although physical activity (PA) is key in the management of type 2 diabetes (T2DM) and hypertension, it is difficult to implement in practice.

Methods: Cross-sectional, observational study. Participating physicians were asked to recruit two active and four inactive patients, screened with the Ricci-Gagnon (RG) self-questionnaire (active if score ≥16). Patients subsequently completed the International Physical Activity Questionnaire. The objective was to assess the achievement of individualized glycated hemoglobin and blood pressure goals (<140/90 mmHg) in the active vs inactive cohort, to explore the correlates for meeting both targets by multivariate analysis, and to examine the barriers and motivations to engage in PA.

Results: About 1,766 patients were analyzed. Active (n=628) vs. inactive (n=1,138) patients were more often male, younger, less obese, had shorter durations of diabetes, fewer complications and other health issues, such as osteoarticular disorders (P<0.001 for all). Their diabetes and hypertension control was better and obtained despite a lower treatment burden. The biggest difference in PA between the active vs inactive patients was the percentage who declared engaging in regular leisure-type PA (97.9% vs. 9.6%), also reflected in the percentage with vigorous activities in International Physical Activity Questionnaire (59.5% vs. 9.6%). Target control was achieved by 33% of active and 19% of inactive patients (P<0.001). Active patients, those with fewer barriers to PA, with lower treatment burden, and with an active physician, were more likely to reach targets. The physician's role emerged in the motivations (reassurance on health issues, training on hypoglycemia risk, and prescription/monitoring of the PA by the physician). A negative self-image was the highest ranked barrier for the inactive patients, followed by lack of support and medical concerns.

Conclusion: Physicians should consider PA prescription as seriously as any drug prescription, and take into account motivations and barriers to PA to tailor advice to patients' specific needs and reduce their perceived constraints.

No MeSH data available.


Related in: MedlinePlus