Facilitators and Barriers for Community Dwellers at Risk of Diabetes Mellitus to Attend Community-based Physical Activity Programme

Abstract

Introduction: In 2015, our research team offered free 10-week structured physical-activity (PA) programmes to 56 community dwellers aged ≥50 years at high risk of DM. Each programme comprised twenty 90-minutes classes of combined muscle-strengthening and aerobic exercises instructed by a certified fitness trainer at a conveniently located community gym. Unexpectedly, significant dropout (77%) was observed towards the end of each programme. This study investigated the facilitators and barriers of the attendees to enrol and adhere to the PA programme. Method: A qualitative study using focus group interviews to explore the attendees’ expectations, experiences, facilitators and barriers encountered in the PA programmes was conducted in 2018. Suggestions to improve the programme were also invited. All 56 PA programme attendees were recruited to participate in one of the 8 focus group interviews, which lasted for 30-60 minutes with 3-5 subjects per group. Results: Thirty-four attendees (60.7%) participated in the focus group interviews. Four main themes emerged, including perceived benefits of the PA programme, interpersonal relationship, convenience, and programme design. Free course, motivation to develop exercise habit and improve health facilitated enrolment in the PA programmes. Positive attributes (active and enthusiastic) of instructors, social connectedness and support were regarded as the most important enablers for participants to be continually involved. Yet, lack of improvement in health, long travel distance, and issues with programme design including unclear objectives, and content being too simple and repetitive were reported as barriers for some participants to continue. Some participants suggested more personalised training with additional supports like online videos and free health assessment to improve adherence. Conclusions: Our results demonstrated that perceived health benefits, engaging instructors and peer support facilitated enrolment and adherence to PA programme, while programme inefficiency and inconvenience contributed to non-adherence. Future PA programme should pay particular attention to its design, and selections of instructor, venue and schedule.