Sustaining physical activity in chronic obstructive pulmonary disease: a qualitative study of perspectives on a...

Sustaining pulmonary rehabilitation (PR) benefits in community-dwelling individuals with chronic obstructive pulmonary disease (COPD) is challenging.

The objective of this study was to explore the experiences of individuals with COPD participating in a PersonalIzed CommUnity-based Physical Activities program (PICk UP) and to identify which behavioral change techniques (BCTs) supported sustained physical activity (PA).

This was a qualitative pre-post intervention study (NCT04223362|NCT04711057).

The study was conducted in a community setting.

This study recruited individuals with COPD assigned to the PICk UP intervention.

Participants enrolled in a 6-month, post-PR, community-based program comprising gym, senior exercise classes, pool exercise classes, or Chi Kung.

Participants' perspectives on impacts of the PICk UP program, motivators, facilitators, and barriers to adherence were collected through pre-post focus groups. Data were analyzed using deductive and inductive reflexive thematic analysis. The "capability, opportunity, motivation, behavior" framework was used to identify BCTs.

Fifteen individuals with COPD participated (14 male, 70 [8] years, FEV1 57.1% [18.1%] predicted). Five main themes emerged, focusing on PA choice, barriers, facilitators, effects, and suggestions: (1) one size doesn't fit all; (2) organizational factors and system-level support enabling adherence; (3) it doesn't come easy; (4) a positive feedback cycle sustained physical, psychological, and social benefits; and (5) the more, the merrier. The PICk UP intervention supported PA through 13 BCTs, across 5 intervention types (education, persuasion, training, environmental restructuring, and enablement), collectively addressing all 6 components influencing behavior.

Individuals with COPD reported lasting PR benefits after the PICk UP and were willing to remain physically active. Participants emphasized the importance of diverse PA options and support from peers, health, and fitness professionals.

To sustain PA beyond PR, interventions should prioritize intersectoral partnerships and embed ongoing social support. These findings underscore PICk UP's effectiveness, positioning it as a promising and replicable model for promoting long-term PA in individuals with COPD.