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High-risk individuals’ perspective on risk of Type 2 Diabetes and physical activity in the prevention of diabetes. A qualitative study
S178
Thursday 1 November Posters / Journal of Science and Medicine in Sport 15 (2012) S127–S187
429
430
High-risk individuals’ perspective on risk of Type 2 Diabetes and physical activity in the prevention of diabetes. A qualitative study
The design and feasability of a web-based physical activity program for patients with osteoarthritis of hip or knee
K. Vähäsarja 1,∗ , K. Kasila 1 , T. Kettunen 1,2 , P. Rintala 3 , S. Salmela 1 , M. Poskiparta 1 1
Department of Health Sciences, University of Jyväskylä, Finland Central Finland Health Care District, Jyväskylä, Finland 3 Department of Physical Activity, University of Jyväskylä, Finland 2
Introduction: Screening of type 2 diabetes provides a valuable opportunity for people at risk of diabetes to re-evaluate their current lifestyle and conduct modifications to prevent diabetes. It has been suggested that risk perception predicts protective behaviour. However, the evidence with regard to risk perceptions of type 2 diabetes and behaviour change is limited. The awareness of the actual risk status is often poorly reported, although it’s relevance to the risk perceptions. This qualitative study was conducted to understand the risk perceptions and perspectives on physical activity behaviour change of individuals aware of having a high risk for type 2 diabetes. Methods: We recruited participants of a community-based lifestyle intervention within a large diabetes prevention programme in primary health care (FIN-D2D) to participate in semi-structured individual interviews. Fourteen participants with a wide age-range (37–64 years) completed an interview in the beginning (2006) and after (2008) the intervention. The risk status of the participants was verified with the oral glucose tolerance test within the intervention. A total of 28 interviews were analysed using inductive content analysis. Results: Two major themes of risk experience were drawn from the data; the risk was perceived as a serious threat or the risk was rejected by the person. Perceiving the risk as a serious threat was based on unexpectedness of the identified risk factors and belonging to the risk-group. It was also described by the increased awareness. The risk caused these people anxiety and disappointment. Nevertheless, hope was strongly present among those who perceived the risk as a serious threat. Rejecting was based on scepticism toward the existing risk. In addition, these individuals were not touched by the risk for various reasons, nor did they perceive the risk as an urgent issue. Furthermore, their descriptions revealed the importance of defending one’s current identity. Participants in general viewed physical activity positively. However, the ‘rejecters’ failed with their attempts to increase their physical activity, and expressed the need for external prompts whereas the others often described successful behaviour change, emphasising the role of everyday physical activities. Maintenance was achieved through incremental progression. Discussion: Present findings indicate that without realising the seriousness of the risk of diabetes, increased physical activity levels among the high risk population seem unlikely. Understanding the factors that individuals’ risk perceptions are based on is ethically important. Furthermore, it helps the development of future interventions and guides health professionals in their counselling practices. http://dx.doi.org/10.1016/j.jsams.2012.11.432
D. Bossen 1 , C. Veenhof 1,∗ , J. Dekker 2 , D. De Bakker 1 1
Netherlands Institute of Health Services Research (NIVEL), Utrecht, The Netherlands 2 Department of Rehabilitation Medicine and Department of Psychiatry, EMGO Institute, VU University Medical Center Amsterdam, The Netherlands Introduction: A large proportion of patients with osteoarthritis (OA) do not meet the recommended levels of physical activity (PA). Although inactivity may enhance in short-term pain reduction, prolonged inactivity may augment functional decline. Therefore, we developed a web-based intervention that provides a highly individualized behaviourally based PA program for patients with knee and/or hip OA. The aim of this study is to describe the systematic development process, preliminary effectiveness and usability of a 9-week web-based intervention on PA behaviour change in individuals with hip and/or knee OA. Methods: An iterative design approach was used to develop, test and enhance various prototypes. End-users (i.e. patients with knee and/hip OA) were involved continuously throughout the development process. The intervention incorporates core principles of the behaviour graded activity theory. A pilot study prototype was tested through a non-randomized pilot study among 20 patients with hip and/or knee OA. PA levels, pain scores and physical function were measured through online questionnaires (week 0, 6 and 12). Subsequently, the usability of the intervention was tested. Results: After several iterations of testing and revising, we developed the final version of the intervention. Based on 16 the interviews after the pilot study, we adjusted the rigid character of the intervention into a more flexible format. The PA program includes an introduction module (module 1) and 8 text based week assignments (module 2). OA patients, between 50 and 80 years of age, participated in the pilot study and received the intervention. After 12 weeks, there was a non-significant increase in PA (1697 to 2044 minutes per week). After six weeks, pain scores increased from 5.3 to 6.6 (p = 0.04). After 12 weeks, however, this significant increase disappeared. The usability of the final version was tested by four experts and five OA patients. Conclusion: This paper outlines the preliminary effectiveness, development and usability of a web-based PA intervention. The results suggest that the intervention is feasible in promotion of PA among patients with hip and/or knee OA. The intervention was easy to use and the satisfaction with the program was high. Preliminary results from the pilot study revealed that PA scores increased, although differences were not statistical significant. Pain scores increased significantly after six week and decreased to baseline values after twelve weeks. Findings require validation in other studies. Therefore, the intervention will be further tested in a one year randomized controlled trial. http://dx.doi.org/10.1016/j.jsams.2012.11.433
Thursday 1 November Posters / Journal of Science and Medicine in Sport 15 (2012) S127–S187
429
430
High-risk individuals’ perspective on risk of Type 2 Diabetes and physical activity in the prevention of diabetes. A qualitative study
The design and feasability of a web-based physical activity program for patients with osteoarthritis of hip or knee
K. Vähäsarja 1,∗ , K. Kasila 1 , T. Kettunen 1,2 , P. Rintala 3 , S. Salmela 1 , M. Poskiparta 1 1
Department of Health Sciences, University of Jyväskylä, Finland Central Finland Health Care District, Jyväskylä, Finland 3 Department of Physical Activity, University of Jyväskylä, Finland 2
Introduction: Screening of type 2 diabetes provides a valuable opportunity for people at risk of diabetes to re-evaluate their current lifestyle and conduct modifications to prevent diabetes. It has been suggested that risk perception predicts protective behaviour. However, the evidence with regard to risk perceptions of type 2 diabetes and behaviour change is limited. The awareness of the actual risk status is often poorly reported, although it’s relevance to the risk perceptions. This qualitative study was conducted to understand the risk perceptions and perspectives on physical activity behaviour change of individuals aware of having a high risk for type 2 diabetes. Methods: We recruited participants of a community-based lifestyle intervention within a large diabetes prevention programme in primary health care (FIN-D2D) to participate in semi-structured individual interviews. Fourteen participants with a wide age-range (37–64 years) completed an interview in the beginning (2006) and after (2008) the intervention. The risk status of the participants was verified with the oral glucose tolerance test within the intervention. A total of 28 interviews were analysed using inductive content analysis. Results: Two major themes of risk experience were drawn from the data; the risk was perceived as a serious threat or the risk was rejected by the person. Perceiving the risk as a serious threat was based on unexpectedness of the identified risk factors and belonging to the risk-group. It was also described by the increased awareness. The risk caused these people anxiety and disappointment. Nevertheless, hope was strongly present among those who perceived the risk as a serious threat. Rejecting was based on scepticism toward the existing risk. In addition, these individuals were not touched by the risk for various reasons, nor did they perceive the risk as an urgent issue. Furthermore, their descriptions revealed the importance of defending one’s current identity. Participants in general viewed physical activity positively. However, the ‘rejecters’ failed with their attempts to increase their physical activity, and expressed the need for external prompts whereas the others often described successful behaviour change, emphasising the role of everyday physical activities. Maintenance was achieved through incremental progression. Discussion: Present findings indicate that without realising the seriousness of the risk of diabetes, increased physical activity levels among the high risk population seem unlikely. Understanding the factors that individuals’ risk perceptions are based on is ethically important. Furthermore, it helps the development of future interventions and guides health professionals in their counselling practices. http://dx.doi.org/10.1016/j.jsams.2012.11.432
D. Bossen 1 , C. Veenhof 1,∗ , J. Dekker 2 , D. De Bakker 1 1
Netherlands Institute of Health Services Research (NIVEL), Utrecht, The Netherlands 2 Department of Rehabilitation Medicine and Department of Psychiatry, EMGO Institute, VU University Medical Center Amsterdam, The Netherlands Introduction: A large proportion of patients with osteoarthritis (OA) do not meet the recommended levels of physical activity (PA). Although inactivity may enhance in short-term pain reduction, prolonged inactivity may augment functional decline. Therefore, we developed a web-based intervention that provides a highly individualized behaviourally based PA program for patients with knee and/or hip OA. The aim of this study is to describe the systematic development process, preliminary effectiveness and usability of a 9-week web-based intervention on PA behaviour change in individuals with hip and/or knee OA. Methods: An iterative design approach was used to develop, test and enhance various prototypes. End-users (i.e. patients with knee and/hip OA) were involved continuously throughout the development process. The intervention incorporates core principles of the behaviour graded activity theory. A pilot study prototype was tested through a non-randomized pilot study among 20 patients with hip and/or knee OA. PA levels, pain scores and physical function were measured through online questionnaires (week 0, 6 and 12). Subsequently, the usability of the intervention was tested. Results: After several iterations of testing and revising, we developed the final version of the intervention. Based on 16 the interviews after the pilot study, we adjusted the rigid character of the intervention into a more flexible format. The PA program includes an introduction module (module 1) and 8 text based week assignments (module 2). OA patients, between 50 and 80 years of age, participated in the pilot study and received the intervention. After 12 weeks, there was a non-significant increase in PA (1697 to 2044 minutes per week). After six weeks, pain scores increased from 5.3 to 6.6 (p = 0.04). After 12 weeks, however, this significant increase disappeared. The usability of the final version was tested by four experts and five OA patients. Conclusion: This paper outlines the preliminary effectiveness, development and usability of a web-based PA intervention. The results suggest that the intervention is feasible in promotion of PA among patients with hip and/or knee OA. The intervention was easy to use and the satisfaction with the program was high. Preliminary results from the pilot study revealed that PA scores increased, although differences were not statistical significant. Pain scores increased significantly after six week and decreased to baseline values after twelve weeks. Findings require validation in other studies. Therefore, the intervention will be further tested in a one year randomized controlled trial. http://dx.doi.org/10.1016/j.jsams.2012.11.433