I want to get better; I don't want to just stay at home: a theory-driven qualitative exploration of participation in a home-based lung cancer exercise clinical trial.
We conducted a multi-site randomised controlled trial (RCT) of home-based exercise and self-management for patients after lung cancer surgery, which improved the intervention group's exercise capacity and self-efficacy and objectively measured physical function. We conducted this qualitative evaluation of the RCT to explore participants' experiences of the program and understand factors influencing participation, behaviour change, and acceptability.
A qualitative study nested within an RCT (ACTRN12617001283369), informed by the Theoretical Domains Framework (TDF) and Theoretical Framework of Acceptability (TFA). The intervention group participated in a 12-week postoperative remotely delivered exercise and self-management program. Following intervention maturation, consecutive intervention participants participated in individual, semi-structured telephone interviews at program discharge. Interviews were audio recorded, transcribed verbatim, cross-checked, and analysed using directed content analysis.
Twenty-one participants took part in interviews (88% of those approached). Thirty-three themes were developed from the qualitative data and mapped to TDF and TFA domains. Key TDF domains driving behaviour change included reinforcement, skills, and social influences. Examples of exercise enablers included regular physiotherapy phone consultations and activity tracking tools. Barriers to exercise included symptoms, poor weather, and competing priorities. Perceived effectiveness was a key TFA domain driving intervention acceptability. Most participants felt the program improved their physical health, exercise self-efficacy and capacity, and physical activity levels. Minor areas for improving acceptability included increased flexibility/tailoring and exercise supervision/demonstration.
The program was acceptable to participants and facilitated meaningful behaviour change. Qualitative findings aligned with quantitative RCT findings, particularly regarding improvements to exercise self-efficacy and capacity at program discharge.
Australian New Zealand Clinical Trials Registry ( http://anzctr.org.au ). Registered on 06/09/2017. Identifier: ACTRN12617001283369.
A qualitative study nested within an RCT (ACTRN12617001283369), informed by the Theoretical Domains Framework (TDF) and Theoretical Framework of Acceptability (TFA). The intervention group participated in a 12-week postoperative remotely delivered exercise and self-management program. Following intervention maturation, consecutive intervention participants participated in individual, semi-structured telephone interviews at program discharge. Interviews were audio recorded, transcribed verbatim, cross-checked, and analysed using directed content analysis.
Twenty-one participants took part in interviews (88% of those approached). Thirty-three themes were developed from the qualitative data and mapped to TDF and TFA domains. Key TDF domains driving behaviour change included reinforcement, skills, and social influences. Examples of exercise enablers included regular physiotherapy phone consultations and activity tracking tools. Barriers to exercise included symptoms, poor weather, and competing priorities. Perceived effectiveness was a key TFA domain driving intervention acceptability. Most participants felt the program improved their physical health, exercise self-efficacy and capacity, and physical activity levels. Minor areas for improving acceptability included increased flexibility/tailoring and exercise supervision/demonstration.
The program was acceptable to participants and facilitated meaningful behaviour change. Qualitative findings aligned with quantitative RCT findings, particularly regarding improvements to exercise self-efficacy and capacity at program discharge.
Australian New Zealand Clinical Trials Registry ( http://anzctr.org.au ). Registered on 06/09/2017. Identifier: ACTRN12617001283369.
Authors
Whish-Wilson Whish-Wilson, Edbrooke Edbrooke, Krishnasamy Krishnasamy, Visentin Visentin, Kinnersly Kinnersly, Mitchell Mitchell, Granger Granger, Parry Parry
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