From Roller Coaster to Confidence: A Qualitative Study of a Hybrid Exercise Program for Individuals With Type 1...

This study aimed to explore the experiences and reflections of adults with type 1 diabetes (T1D) 3-24 months after completing a 15-week hybrid exercise program combining in-person and virtual components. Particular attention was given to how participants translated program knowledge into daily self-management and perceived the hybrid delivery format. The program was delivered as part of a clinic-based quality improvement initiative between May 2021 and February 2024.

This qualitative study used the practice-oriented interpretive description methodology. Nine former participants were recruited from a parent sample of 87. Semistructured interviews lasting 45-60 min were conducted. Interview transcripts were coded and analyzed thematically using NVivo.

Three themes emerged. The first was one-on-one consultations made knowledge usable in everyday life, where participants gained theoretical and practical understanding of physical activity (PA) and T1D but required individualized support to interpret complex material. Second was gaining confidence in managing blood glucose, where participants described a shift from fear and frustration toward greater confidence in managing blood glucose during PA, including strategies such as insulin adjustment and timing carbohydrate intake. Third was the necessity and challenges of a hybrid format, where the virtual option enhanced accessibility while posing challenges related to digital skills and hesitation to ask questions.

A hybrid, knowledge-based exercise intervention provided a flexible and accessible approach to deliver PA support to adults with T1D, strengthening participants' confidence and perceived capability to engage safely in PA. Implementation requires individualized support and attention to challenges related to digital delivery and interaction in virtual settings.