Determinants and strategies for physical activity maintenance in chronic health conditions: a qualitative study

Background: Physical activity is promoted to help adults manage chronic health conditions, but evidence suggests that individuals relapse after intervention cessation. The objective of this study was to explore the determinants and strategies for successful and unsuccessful physical activity maintenance. Methods: A qualitative study using semi-structured interviews was conducted with 32 participants. Purposive sampling was used to recruit 20 successful and 12 unsuccessful maintainers. Adults with chronic health conditions were recruited having completed a physical activity referral scheme six months before study commencement. The IPAQ and SPAQ were used to categorize participants according to physical activity status. Data were analyzed using framework analysis. Results: Eleven main themes emerged: 1) outcome expectations, 2) experiences, 3) core values, 4) trial and error, 5) social and practical support, 6) attitudes towards physical activity, 7) environmental barriers, 8) psychological barriers, 9) physical barriers, 10) Cognitive-behavioral strategies for physical activity self-management (e.g., self-monitoring), and, 11) condition management (e.g., pacing). Conclusions: The findings identified determinants and strategies for successful maintenance and highlighted the processes involved in physical activity disengagement. Such findings can guide the development of physical activity maintenance interventions and increase activity engagement over the long-term in adults with chronic health conditions.