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“A gift from heaven” or “This was not for me”. A mixed methods approach to describe experiences of participation in an outsourced physical activity program for persons with rheumatoid arthritis

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Abstract

Most persons with rheumatoid arthritis (RA) do not perform health-enhancing physical activity (HEPA). Evaluations of innovative HEPA programs need to be complemented with descriptive and qualitative data from the users. The aim of this mixed methods study was to explore and describe how a subgroup of the RA population perceives participation during the first year of an outsourced 2-year HEPA program. Data were collected by a study-specific postal survey to 220 program participants (response rate 87 %, n = 191) and by interviews with a purposefully selected subsample of 35, including completers and dropouts. The survey data were analyzed by descriptive statistics and the interviews by qualitative content analysis.

The survey demonstrated increased self-reported physical activity in 165 participants (86 %). After the first year of the program, participants reported having performed “regular” or “periodical” circuit training (78 %) and physical activity in daily life (92 %). The most valued program components were circuit training and physical activity in daily life, both rated median 5/5. Coach support, prompts by text messages, and expert lectures were rated median 4/5. Five categories emerged from the interviews describing expectations, facilitators, gains, maintenance, and obstacles/suggestions for improvement of the program. The results demonstrate that HEPA outside health care is highly appreciated by a subgroup of the RA population. Professional coaching and prompts by text messages seem to be particularly useful facilitators. Individual preferences emphasize the need to tailor settings, exercise formats, and behavioral support for HEPA even in a narrow, self-selected group with RA.

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Acknowledgments

The authors wish to thank all the participants in the study, the physical therapists in the PARA 2010 study group and the Swedish Rheumatology Quality Registries.

Disclosures

None.

Source of funding

Funding was received from the Swedish Research Council, Combine Sweden, the Swedish Rheumatism Foundation, the National Postgraduate School of Health Care Sciences at Karolinska Institutet, and the Strategic Research Program in Health Care Sciences at Karolinska Institutet.

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Authors and Affiliations

  1. Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden

    Ingrid Demmelmaier, Birgitta Nordgren & Christina H. Opava

  2. Nacka Rehabilitation Center, Stockholm, Sweden

    Åsa Lindkvist

  3. Department of Rheumatology, Karolinska University Hospital, Stockholm, Sweden

    Christina H. Opava

Authors
  1. Ingrid Demmelmaier
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  2. Åsa Lindkvist
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  3. Birgitta Nordgren
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  4. Christina H. Opava
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Corresponding author

Correspondence to Ingrid Demmelmaier.

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Demmelmaier, I., Lindkvist, Å., Nordgren, B. et al. “A gift from heaven” or “This was not for me”. A mixed methods approach to describe experiences of participation in an outsourced physical activity program for persons with rheumatoid arthritis. Clin Rheumatol 34, 429–439 (2015). https://doi.org/10.1007/s10067-014-2723-y

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