Abstract
BackgroundExercise is an important component of a healthy lifestyle, the development of which is a relapse prevention strategy for those with alcohol use disorder. However, it is a challenge to create exercise interventions with a persistent behavioural change. The aim of this qualitative study was to investigate perceived barriers to participation in an exercise intervention among alcohol use disorder patients, who dropped out of the intervention program. Furthermore, this study aims to propose possibilities for a better practice of future intervention studies based on the participants’ experiences and suggestions.MethodsQualitative interviews with 17 patients who dropped out from an exercise intervention in an outpatient treatment centre about their experiences and reasons for dropping out. Social cognitive theory informed the development of the interview guides and systematic text condensation was used for analysis.ResultsAnalysis revealed three central themes: 1) Structural barriers described as the type of exercise and the timing of the intervention, 2) Social barriers described as need for accountability and unsupportive relations, and 3) Emotional barriers described as fear, guilt and shame, and negative affect of the intervention on long term.ConclusionsFuture exercise interventions should include socio-psychological support during the first weeks, begin shortly after treatment initiation instead of concurrently, and focus on garnering social support for participants in both the intervention context and among their existing network in order to best reduce barriers to participation.Trial registrationThis study was retrospectively registered at Current Controlled Trials ISRCTN74889852 on 11 July 2013.
Highlights
Exercise is an important component of a healthy lifestyle, the development of which is a relapse prevention strategy for those with alcohol use disorder
As health care providers are well aware, maintaining an exercise program is the hurdle after beginning, because persistent behavioral change - i.e., continued activity after the course of the program - cannot be incited if participation is not maintained
Social cognitive theory directed the design of the semi-structured interview guide used in this study which aimed at answering our research question: What were the reasons for dropping out of the exercise intervention, and how should an exercise intervention be like for Alcohol Use Disorder (AUD)-patients to participate in a persistent way?
Summary
Exercise is an important component of a healthy lifestyle, the development of which is a relapse prevention strategy for those with alcohol use disorder. It is a challenge to create exercise interventions with a persistent behavioural change. The aim of this qualitative study was to investigate perceived barriers to participation in an exercise intervention among alcohol use disorder patients, who dropped out of the intervention program. Exercise is an important public health recommendation to the general public, clinical groups, and across the lifespan, as physical inactivity is the fourth leading risk factor for global mortality [1]. High drop-out rates are of concern, and barriers to participation have been investigated in numerous qualitative and quantitative studies, only few recent studies reported suggestions to better physical exercise interventions for AUD and other substance use disorder patients [6,7,8,9,10]. Read et al [8], Stoutenberg et al [9] and Abrantes et al [10] suggest that the alcohol treatment field could benefit from existing knowledge of intervention designs and motivational techniques from the larger exercise science field to improve adherence to interventions targeted individuals with AUD
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