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. 2022 Aug 1;17(8):e0272355.
doi: 10.1371/journal.pone.0272355. eCollection 2022.

Developing an ecological approach to physical activity promotion in adults with Cystic fibrosis

James Shelley  1   2 , Ellen A Dawson  1 , Lynne M Boddy  1 , Claire E Stewart  1 , Freddy Frost  2   3 , Dilip Nazareth  2   3 , Martin J Walshaw  2   3 , Zoe R Knowles  1
Affiliations

Developing an ecological approach to physical activity promotion in adults with Cystic fibrosis

James Shelley et al. PLoS One. .

Abstract

Background: There are few examples of interventions designed to promote physical activity (PA) in adults with Cystic fibrosis (CF). Increasing levels of habitual PA may be more feasible and result in greater compliance than conventional exercise training inventions which give little or no attention to long-term PA behaviour. Despite this there is limited research exploring perceptions of PA among adults with CF. The study aimed to understand the ecological correlates of PA in adults with CF and to involve individuals with CF, their families (where applicable) and clinicians in a formative process to inform the development of an ecological approach to PA promotion in this population.

Methods: An iterative approach was utilised, whereby findings from earlier phases of the research informed subsequent phases. Semi-structured interviews were conducted to explore patients' perceptions of PA, devised using the PRECEDE component of the PRECEDE-PROCEED model. Followed by, focus groups to discuss the perceived barriers, facilitators and opportunities for PA participation and how this information could inform the development and delivery of a PA intervention. Separate focus groups were conducted with individuals with CF (n = 11) and their families and CF MDT members. Thematic analysis was used to construct themes.

Results: Physical and mental wellbeing manifested as both barriers and facilitators of PA. CF is characterised by a progressive decline in physical function, which presents as a number of challenging symptoms and set-backs for an individual with CF. PA represents an opportunity for participants to slow the rate of this decline and manage the symptoms associated with the condition. Enjoyment was an important facilitator of PA. Exercise professionals and family reinforce PA behaviour, particularly during adolescence.

Conclusions: PA promotion should form part of routine CF care with additional exercise professional support during adolescence.

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Conflict of interest statement

The authors have declared that no competing interests exist

Figures

Fig 1
Fig 1. Illustrating the iterative process from participant screening and recruitment to data collection and analysis.
Fig 2
Fig 2. The PRECEDE-PROCEED model for health promotion, planning and evaluation [17].
Fig 3
Fig 3. Pen profile displaying predisposing factors (n = 11) with illustrative quotes, associated participant number and frequency count provided in square brackets.
Fig 4
Fig 4. Pen profile displaying enabling factors (n = 11) with illustrative quotes, associated participant number and frequency count provided in square brackets.
Fig 5
Fig 5. Pen profile displaying reinforcing factors (n = 11) with illustrative quotes, associated participant number and frequency count provided in square brackets.
Fig 6
Fig 6. Pen profile displaying ‘other’ factors (n = 11) with illustrative quotes, associated participant number and frequency count provided in square brackets.
Fig 7
Fig 7. Pen profile displaying participant (patients (n = 9) & clinicians (n = 3) selected intervention outcome measures with illustrative quotes, associated participant number and frequency count provided in square brackets.
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