title: Physical activity in patients with type 2 diabetes and hypertension--insights into motivations and barriers from the MOBILE study.
abstract: BACKGROUND
  Although physical activity (PA) is key in the management of type 2 diabetes (T2DM) and hypertension, it is difficult to implement in practice.
  
  
  METHODS
  Cross-sectional, observational study. Participating physicians were asked to recruit two active and four inactive patients, screened with the Ricci-Gagnon (RG) self-questionnaire (active if score ≥16). Patients subsequently completed the International Physical Activity Questionnaire. The objective was to assess the achievement of individualized glycated hemoglobin and blood pressure goals (<140/90 mmHg) in the active vs inactive cohort, to explore the correlates for meeting both targets by multivariate analysis, and to examine the barriers and motivations to engage in PA.
  
  
  RESULTS
  About 1,766 patients were analyzed. Active (n=628) vs. inactive (n=1,138) patients were more often male, younger, less obese, had shorter durations of diabetes, fewer complications and other health issues, such as osteoarticular disorders (P<0.001 for all). Their diabetes and hypertension control was better and obtained despite a lower treatment burden. The biggest difference in PA between the active vs inactive patients was the percentage who declared engaging in regular leisure-type PA (97.9% vs. 9.6%), also reflected in the percentage with vigorous activities in International Physical Activity Questionnaire (59.5% vs. 9.6%). Target control was achieved by 33% of active and 19% of inactive patients (P<0.001). Active patients, those with fewer barriers to PA, with lower treatment burden, and with an active physician, were more likely to reach targets. The physician's role emerged in the motivations (reassurance on health issues, training on hypoglycemia risk, and prescription/monitoring of the PA by the physician). A negative self-image was the highest ranked barrier for the inactive patients, followed by lack of support and medical concerns.
  
  
  CONCLUSIONS
  Physicians should consider PA prescription as seriously as any drug prescription, and take into account motivations and barriers to PA to tailor advice to patients' specific needs and reduce their perceived constraints.
authors.affiliation: Department of Sport Medicine and Functional Explorations, University-Hospital (CHU), G Montpied Hospital; INRA, UNH, CRNH Auvergne, France ; Nutrition Department, University of Auvergne, Clermont-Ferrand, Auvergne, France.
authors.forename: Martine
authors.initials: M
authors.lastname: Duclos
authors.affiliation: Department of Endocrinology and Metabolism, La Pitié-Salpétrière Hospital, Paris, France ; Clinical and Scientific Affairs, Novartis Pharma SAS, Rueil-Malmaison, France.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Dejager
authors.affiliation: Department of Hypertension, Georges Pompidou European Hospital, Paris, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Postel-Vinay
authors.affiliation: Biostatistics, Inferential, Paris, France.
authors.forename: Sylvie
authors.initials: S
authors.lastname: di Nicola
authors.affiliation: Biostatistics, Novartis Pharma SAS, Rueil-Malmaison, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Quéré
authors.affiliation: Clinical and Scientific Affairs, Novartis Pharma SAS, Rueil-Malmaison, France ; Department of Hypertension, Georges Pompidou European Hospital, Paris, France.
authors.forename: Béatrice
authors.initials: B
authors.lastname: Fiquet
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D005602:France / Q000453:epidemiology; D015438:Health Behavior; D006454:Hemoglobins; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000453:epidemiology* / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009043:Motor Activity; D015999:Multivariate Analysis; D010342:Patient Acceptance of Health Care; D010817:Physician-Patient Relations; D011795:Surveys and Questionnaires
chemical_list: D006454:Hemoglobins
keywords: MOBILE; barriers; hypertension; motivations; physical activity; type 2 diabetes