A behaviour change intervention to reduce sedentary behaviour in chronic obstructive pulmonary disease: a qualitative study

Abstract

Objectives

To document the experiences of people with chronic obstructive pulmonary disease (COPD) who underwent a behaviour change intervention to reduce sedentary behaviour (SB) in a clinical trial.

Design and participants

Qualitative study using semi-structured interviews to explore perspectives of the behaviour change intervention and specific intervention components in people with stable COPD on the waitlist for pulmonary rehabilitation.

Setting

Three outpatient pulmonary rehabilitation programmes in Sydney, Australia.

Interventions

The six-week behaviour change intervention with once weekly contact with a physiotherapist aimed to reduce SB by replacing it with light-intensity physical activity (PA) and by breaking up prolonged SB.

Main outcome measures

Of 30 participants who completed the behaviour change intervention, interviews were conducted with 13 participants and analysed using the ‘capability, opportunity, motivation, behaviour (COM-B)’ framework of behaviour change.

Results

Intervention components regarded as most helpful by participants were verbal education on health consequences on SB, goal setting, and self-monitoring of, and feedback on, step count using activity trackers. There was a clear preference during goal setting to increase PA rather than to reduce SB. Physical limitations and enjoyment of SB were the most reported barriers to reducing SB.

Conclusions

Goal setting, verbal education, and self-monitoring of, and feedback on step count, were viewed positively by people with COPD and may show promise for reducing SB and increasing PA based on individual preference.

Contribution of the paper

  • When given the choice, most people with stable COPD undergoing a behaviour change intervention preferred to increase their physical activity levels rather than reduce sedentary behaviour, which challenges previous assumptions that reducing sedentary behaviour is more feasible for people with COPD than increasing physical activity.
  • The behaviour change intervention improved the confidence and motivation of people with stable COPD to reduce their sedentary behaviour but did not alter their physical limitations or enjoyment of sedentary behaviour, which were perceived as barriers to change.
  • Goal setting, verbal education, and self-monitoring of, and feedback on, step count using activity trackers were identified as the most helpful strategies for changing sedentary behaviour and physical activity in people with stable COPD.