Barriers and Facilitators to Physical Activity in People With Young-Onset (Aged 18-40 Years) Type 2 Diabetes: A Qualitative Study.

Objective: To explore the barriers and facilitators to physical activity engagement among people with young-onset type 2 diabetes.

Methods: A qualitative research design using individual semi-structured interviews. Methods: A purposive sampling technique was used to recruit individuals with young-onset type 2 diabetes through social media, based on: age, gender, diabetes duration, diabetes complication and physical activity level. Interviews were audio recorded, transcribed verbatim and analysed using Framework analysis integrating the Capability, Opportunity, Motivation and Behaviour model.

Results: Twenty-three individuals with type 2 diabetes (median age 29 years; 13 women; median diabetes duration 1 year) were interviewed. Nineteen subthemes were identified across all domains of the Capability, Opportunity, Motivation and Behaviour model. The most common domains and the related subthemes were psychological capability (physical activity knowledge, self-monitoring); social opportunity (stigma, family commitments, guidance from professionals, interactive physical activity, emotional support); and reflective motivation (perceived physical impact of physical activity, perceived mental impact of physical activity, social role & responsibility, perceived self-efficacy). Interactions were also observed between the different domains of the Capability, Opportunity, Motivation and Behaviour model.

Conclusions: This study revealed in-depth and novel information on the barriers and facilitators to physical activity in people with young-onset type 2 diabetes. Future interventions would require multimodal approaches to enhance physical activity motivation in this population by addressing these underpinning psychological and social barriers. This study highlighted the need for a multimodal strategy that addresses psychological capability, social opportunity and reflective motivation for increasing physical activity in people with young-onset type 2 diabetes. This study was reported using the Consolidated Criteria for Reporting Qualitative Research checklist. An advisory group including six individuals with young-onset type 2 diabetes contributed to the design of the interview topic guide.