Motivators, Barriers, and Opportunity for E-Health to Encourage Physical Activity in Axial Spondyloarthritis: A Qualitative Descriptive Study

Abstract

Objective: Physical activity is fundamental in the management of axial spondyloarthritis (SpA); however, evidence suggests that patients with axial SpA are not adhering to physical activity recommendations. E-health technology (e.g., telephone reminders and mobile text messaging) can increase participation in physical activity. The aims of this study were as follows: 1) to understand perspectives of the importance of physical activity in the management of axial SpA; 2) to describe factors associated with physical activity adherence; and 3) to explore the role of e-health technology to facilitate physical activity in patients with axial SpA.

Methods: Semistructured interviews were conducted with axial SpA patients attending an urban academic rheumatology clinic. Interviews were audio recorded and transcribed verbatim. Data were analyzed using thematic principles. Systematic labeling of the data set was completed using an inductive approach until saturation of emergent themes.

Results: Twelve patient interviews were completed. Most respondents were male (83.3%) with a mean ± SD age of 45.5 ± 12.5 years and a mean ± SD disease duration of 21.5 ± 14.9 years. Participants defined physical as any activity involving physical exertion. The role of physical activity in axial SpA management was well recognized and included symptom relief, pharmacologic synergy, and impact on general health. Motivators included a growth mindset, social support networks, and facility access. Barriers included fear of disease progression, life demands, and environmental restrictions. Feedback, electronic reminders, and virtual support networks were key components of e-health technology to facilitate engagement in physical activity.

Conclusion: The results of this study provide a foundation to guide development of patient-centered e-health technology interventions to increase physical activity uptake in patients with axial SpA.