title: Exercise facilitators and barriers from adoption to maintenance in the diabetes aerobic and resistance exercise trial.
abstract: OBJECTIVE
  We conducted a qualitative investigation of patients with type 2 diabetes to determine their perceived facilitators and barriers to exercise at multiple time points while enrolled in a randomized exercise trial including aerobic, resistance or combined exercise. We explored differences in these themes over time, between intervention groups and by adherence level after intervention.
  
  
  METHODS
  Interviews were conducted by telephone at 3 weeks (run-in period), and at 3 (midintervention), 6 (end of intervention) and 9 months (maintenance) after enrollment to assess factors that facilitated and hampered adherence to the exercise program. Audiotapes were transcribed verbatim and subjected to content analysis.
  
  
  RESULTS
  Participants (n=28) with type 2 diabetes engaged in the interviews. Social support from family and the trainer, future health benefits, a sense of well-being and perceived fitness improvements were exercise facilitators. Experiencing illness or injury, work commitments and inclement weather were highlighted barriers. A sense of well-being, fitness improvements and enjoyment frequently were expressed by participants assigned to the combined and resistance exercise conditions. Participants who maintained prescribed exercise levels tended to be engaged in resistance exercise, and spoke of support from their personal trainers, the importance of strategies and enjoyment more frequently than those who did not maintain their exercise level. Exercise maintainers also cited more facilitators; no differences were found for barriers.
  
  
  CONCLUSIONS
  Patients with type 2 diabetes require social support, including continued contact with exercise specialists. Patients need assistance with motivational enhancement and strategies to increase facilitators to maintain exercise behaviour. Incorporating resistance exercise improves well-being and enjoyment-2 important factors linked to exercise maintenance.
authors: University of Ottawa Heart Institute, Prevention and Rehabilitation Centre, Ottawa, Ontario, Canada. Electronic address: hetulloch@ottawaheart.ca.
authors: Heather
authors: H
authors: Tulloch
authors: Shane N
authors: SN
authors: Sweet
authors: Michelle
authors: M
authors: Fortier
authors: Gary
authors: G
authors: Capstick
authors: Glen P
authors: GP
authors: Kenny
authors: Ronald J
authors: RJ
authors: Sigal
authors: Ronal J
authors: RJ
authors: Sigal
mesh_terms: D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D015444:Exercise / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055070:Resistance Training; D012932:Social Facilitation
keywords: barriers; diabetes; diabète; exercice; exercise; facilitateurs; facilitators; maintenance; maintien; obstacles