Facilitators and Barriers of Physical Activity in Prevention and Control of NCD – A Qualitative Study in North India

Abstract

Abstract Background: There is an escalating burden of Non-communicable diseases (NCDs) in India. World Health Organisation (WHO) and the government of India aim to reduce the physical inactivity relatively by 10%, as it is a modifiable risk factor for NCDs. Patients and the general population are generally advised to do the physical activity by doctors and other health personnel through individual counselling and group health talks in the community. But whether they can follow the given advice or the knowledge provided alone was sufficient to translate it into practice was not studied. This study was done to explore the facilitators and barriers to physical activity in an urban resettlement colony in New Delhi (India). Methods: It was a qualitative study, where participants were interviewed face to face until theory saturation. Some interviews were conducted at the outpatient department and some participants in the community. Then a random visit was made to one of the residential colonies and a park to check the facilities present for physical activity at the community level. Interview contained open-ended questions and followed an interview guide. The audio was transcribed and the text was read multiple times for familiarisation. Quotations depicting facilitators and barriers for physical activity were identified. Following this, coding was done and meaningful themes were identified as thematic analysis. Results: Knowledge regarding the benefits of physical activity was present in all the participants. Five participants (36%) were regularly doing physical activity in the form of exercise/yoga/gym/brisk walking. The facilitators identified were motivation/will power, time management skills, knowledge and perceived benefits of physical activity, presence of disease and its management, a facility like a park/garden equipped with physical exercise equipment, convenient school timings. The barriers identified were lack of time, lack of indoor and outdoor spaces, lack of maintenance of parks/infrastructure, inadequate equipment for physical activity, unfavourable season/weather, physical restriction, unhealthy lifestyle and laziness. Conclusions: We conclude that simply having knowledge about the benefits of physical activity is not sufficient to translate it to practice. There should be an enabling environment and well-maintained facilities in the community, schools. Timings of school/work and motivation also play a major role. At a personal level, motivation needs to come from within and needs to be persistent. Keywords: Barriers; Control; Exercise; Facilitators; India; Non-Communicable Disease; Physical Activity; Prevention