Insight from health professionals on physical activity promotion within routine diabetes care

Exploring the Use of Fitbit Consumer Activity Trackers to Support Active Lifestyles in Adults with Type 2 Diabetes: A Mixed-Methods Study

Background: People with type 2 diabetes are less active than those without the condition. Physical activity promotion within diabetes health care is limited. This project explored the use of Fitbit activity trackers (Fitbit, San Francisco, CA, USA) to support active lifestyles in adults with type 2 diabetes through a mixed-methods study. Methods: Two stages were conducted. In stage 1, adults with type 2 diabetes used a Fitbit Charge 4 (Fitbit, San Francisco, CA, USA) for 4 weeks. Fitbit and self-reported physical activity data was examined through quantitative analysis. Qualitative analysis was conducted to explore the experiences of participants. In stage 2, health professionals were interviewed to examine their views on using Fitbit activity trackers within type 2 diabetes care. Results: Adults with type 2 diabetes were recruited for stage 1 and adult health care and fitness professionals were recruited for stage 2. Stage 1 participants’ self-reported increases in physical activity (mean weekly minutes of walking increased from 358.75 to 507.50 min, p = 0.046) and a decrease in sedentary behaviour (mean daily hours of sedentary behaviour decreased from 10.65 to 10.05 h, p = 0.575). Fitbit activity data ranges identified individuals who led inactive and sedentary lifestyles below levels recommended and in need of physical activity support to reduce the risk to their health. During interviews, participants stated that the Fitbit activity tracker motivated them to be more active. Stage 2 participants intimated that Fitbit activity trackers could improve the promotion of physical activity within type 2 diabetes care. Interventions involving the Fitbit premium service, community prescription and combined use of Fitbits with physical activity behaviour change models were recommended by stage 2 participants. Conclusions: This study found that there is future scope for using Fitbit activity trackers to support active lifestyles in adults diagnosed with type 2 diabetes.

Physical activity guidelines and promotion: An online survey of United Kingdom's prosthetic rehabilitation healthcare professionals

BACKGROUND

Healthcare professionals play a key role in supporting physical activity participation for people with lower limb absence.

OBJECTIVES

The objectives of this study were to survey healthcare professionals' views of people with lower limb absence in the United Kingdom, explore their awareness and knowledge of physical activity recommendations and investigate their current and desirable practice towards physical activity promotion.

STUDY DESIGN

Cross-sectional study.

METHODS

Potential participants were identified from open-access health-related databases, educational institution databases, and the authors' professional networks. An online 40-item questionnaire was distributed electronically and by post. Survey items were multiple choice, Likert-type scale or open-ended questions to explore the characteristics of healthcare professionals, awareness/knowledge of physical activity guidelines, current and desired practice and views on physical activity promotion.

RESULTS

In total, 106 people responded. Physiotherapists had greater awareness/knowledge of physical activity guidelines compared to prosthetists/orthotists and other respondents. Awareness/knowledge of guidelines decreased as age, experience and time since qualification increased. The most common source of knowledge was self-directed learning.

CONCLUSION

Continuing and improving education on the content of physical activity guidelines may be helpful for healthcare professionals in promoting physical activity to those with lower limb absence.

CLINICAL RELEVANCE

This research aims to inform prosthetic rehabilitation professionals and academics about an under-researched area within physical activity for health. This knowledge could help develop interventions with the aim of improving physical activity promotion and participation, and ultimately the health and well-being of people with limb absence.

Physical activity and exercise in adults with type 1 diabetes: understanding their needs using a person-centered approach

Physical activity is a key component in the management of diabetes, but most people do not engage in recommended levels of physical activity. A recent consensus statement on exercise management in type 1 diabetes (T1D) fails to mention behavioral change and the specific determinants impacting on exercise management. The aim of this study is to investigate the needs of adults with T1D around physical activity and the challenges they face. Using a person-centered approach, focus groups and individual semi-structured interviews recorded the perspectives of 67 adults aged ≥18 with diabetes. Four global themes were identified: (i) it's a balancing act, (ii) winging it, (iii) engagement and (iv) encouraging uptake. These findings suggest that adults with T1D find it difficult to manage their diabetes and physical activity and decision-making is based on trial and error with minimal input from healthcare professionals. Participants want more information to enable them to manage their diabetes and physical activity effectively. Adults with T1D face unique challenges in relation to physical activity. Participants reported key determinants for being active. Research is needed to understand how physical activity promotion is best developed for those with T1D and the preparedness of healthcare professionals for delivering guidance to adults with T1D.

The connection between the primary care and the physical activity sector: professionals' perceptions

BACKGROUND

To stimulate physical activity (PA) and guide primary care patients towards local PA facilities, Care Sport Connectors (CSC), to whom a broker role has been ascribed, were introduced in 2012 in the Netherlands. The aim of this study is to assess perceptions of primary care, welfare, and sport professionals towards the CSC role and the connection between the primary care and the PA sector.

METHODS

Nine focus groups were held with primary care, welfare and sport professionals within the CSC network. In these focus groups the CSC role and the connection between the sectors were discussed. Both top-down and bottom-up codes were used to analyse the focus groups.

RESULTS

Professionals ascribed three roles to the CSC: 1) broker role, 2) referral, 3) facilitator. Professionals were enthusiastic about how the current connection was established. However, barriers relating to their own sector were currently hindering the connection: primary care professionals' lack of time, money and knowledge, and the lack of suitable PA activities and instructors for the target group.

CONCLUSIONS

This study provides further insight into the CSC role and the connection between the sectors from the point of view of primary care, welfare, and sport professionals. Professionals found the CSC role promising, but barriers are currently hindering the collaboration between both sectors. More time for the CSC and changes in the way the primary care and PA sector are organized seem to be necessary to overcome the identified barriers and to make a success of the connection.

TRIAL REGISTRATION

Dutch Trial register NTR4986 . Registered 14 December 2014.