Abstract

Background: As insufficient physical activity is a widespread public health problem, the patients' perspective and experiences during their efforts to increase levels of physical activity need to be explored and elucidated. Objectives: The purpose of our study was to qualitatively analyze the patient-written email messages in order to explore patients' experiences during a 12-week pedometer-based physical activity intervention in a primary care setting that was paired with email counseling. Methods: The content of 31 email messages from 10 participants was extracted, coded, and analyzed using thematic analysis. Results: We identified 22 themes that were grouped into 3 categories: reflections on the pedometer-based intervention, use of behavior change techniques, and barriers that affected participants' engagement in physical activity. We have also anecdotally described several interesting aspects of behavior change techniques: negative attitudes elicited by the goal setting process, learning from their own data, and enjoyment associated with self-monitoring. Conclusion: Qualitatively analyzing email messages written as part of the physical activity counseling process is useful in documenting patients' perceptions and use of different behavior change techniques and their reported barriers that get in the way of increasing their physical activity.

Highlights

  • Sedentary lifestyles and physical inactivity are major health problems that increase the incidence of numerous chronic diseases and premature death (Pedersen & Saltin, 2015; Reiner, Niermann, Jekauc, & Woll, 2013; Warburton, Nicol, & Bredin, 2006; Woodcock, Franco, Orsini, & Roberts, 2011)

  • Perceived benefits of PA Participants were aware of health benefits of PA and considered walking to be an appropriate and enjoyable form of PA: “I know that physical activity is very beneficial.” (Male, 34)

  • Using thematic analysis of the email messages written by participants in the course of physical activity counseling intervention, the study extends previous findings on the use of behavior change techniques (BCTs) by intervention participants, documenting their perceptions and experiences with various BCTs

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Summary

Introduction

Sedentary lifestyles and physical inactivity are major health problems that increase the incidence of numerous chronic diseases and premature death (Pedersen & Saltin, 2015; Reiner, Niermann, Jekauc, & Woll, 2013; Warburton, Nicol, & Bredin, 2006; Woodcock, Franco, Orsini, & Roberts, 2011). Several groups have studied the beliefs, attitudes, behaviors, and experiences of patients participating in PA interventions delivered in a primary care setting (Casey et al, 2014; Wahlich et al, 2017) as well as barriers and facilitators that play a role in changing PA levels (Normansell et al, 2014; Patel, Schofield, Kolt, & Keogh, 2013). Conclusion: Qualitatively analyzing email messages written as part of the physical activity counseling process is useful in documenting patients’ perceptions and use of different behavior change techniques and their reported barriers that get in the way of increasing their physical activity

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