Understanding physical activity facilitators and barriers during and following a supervised exercise programme in Type 2 diabetes: a qualitative study

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Abstract
To assess barriers and facilitators of participation in a supervised exercise programme, and adherence to exercise after programme completion. Focus group discussions addressed factors which could facilitate attendance, current engagement in exercise, reasons for continuing or discontinuing regular exercise and ways to integrate exercise into daily life. Three focus groups, with a total of 16 participants, were led by a trained moderator; audiotapes were transcribed verbatim; transcripts were coded and themes were identified. Themes that recurred across all three focus groups were considered to have achieved saturation. Motivation was the most critical factor in exercising both during and following the programme. Participants appreciated the monitoring, encouragement and accountability provided by programme staff. They voiced a need for better transition to post-programme realities of less support and supervision. Co-morbid conditions were apt to derail them from a regular exercise routine. They viewed the optimal programme as having even greater scheduling flexibility and being closer to them geographically. Post-programme, walking emerged as the most frequent form of physical activity. Adults with Type 2 diabetes require long-term monitoring and support for physical activity and exercise.