Barriers and enablers to ongoing exercise for people with chronic health conditions: Participants' perspectives following a randomized controlled trial of two interventions

Background: At present there is no clear evidence to support any one particular intervention for engaging adults with chronic health issues in ongoing exercise. An understanding of consumer perceptions and preferences is important, because low rates of exercise adherence are likely to limit any benefits obtained. Objective: To identify and compare participants' perceptions about their own motivation, capacity and opportunity to adhere to an allocated exercise program during either a gym-based or a home-based exercise program with telephone follow-up. Method/design: This qualitative study used convenience sampling to recruit participants (adults with chronic health issues) immediately after a randomised controlled trial comparing gym-and home-based exercise programs conducted for 12 months. Ten people, five from each intervention group, attended face-to-face semi-structured interviews at a local Community Health Service. Thematic analysis methods were used to analyse the dataset. Results: Improved social interaction in the gym-based program was seen to contribute to adherence, however home-based programs were perceived as more convenient and easily integrated into daily routines. Individualized exercise prescription by a health professional with regular follow up (in person or by telephone) promoted an active practitioner-participant relationship. Health coaching combined with exercise was perceived to improve self-efficacy and assisted with the removal of intrinsic and extrinsic exercise barriers. Conclusion: This research presented many common and different themes in participant's motivation, capacity and opportunity in sustained adherence to a gym or home-based exercise program. However, this study found no superior intervention or individual preference to improve ongoing exercise adherence.