Exercising alcohol patients don't lack motivation but struggle with structures, emotions and social context - a qualitative dropout study.
BACKGROUND
Exercise is an important component of a healthy lifestyle, the development of which is a relapse prevention strategy for those with alcohol use disorder. However, it is a challenge to create exercise interventions with a persistent behavioural change. The aim of this qualitative study was to investigate perceived barriers to participation in an exercise intervention among alcohol use disorder patients, who dropped out of the intervention program. Furthermore, this study aims to propose possibilities for a better practice of future intervention studies based on the participants' experiences and suggestions.


METHODS
Qualitative interviews with 17 patients who dropped out from an exercise intervention in an outpatient treatment centre about their experiences and reasons for dropping out. Social cognitive theory informed the development of the interview guides and systematic text condensation was used for analysis.


RESULTS
Analysis revealed three central themes: 1) Structural barriers described as the type of exercise and the timing of the intervention, 2) Social barriers described as need for accountability and unsupportive relations, and 3) Emotional barriers described as fear, guilt and shame, and negative affect of the intervention on long term.


CONCLUSIONS
Future exercise interventions should include socio-psychological support during the first weeks, begin shortly after treatment initiation instead of concurrently, and focus on garnering social support for participants in both the intervention context and among their existing network in order to best reduce barriers to participation.


BACKGROUND
This study was retrospectively registered at Current Controlled Trials ISRCTN74889852 on 11 July 2013.
Department of Psychology, University of Southern Denmark, Campusvej 55, 5230, Odense, Denmark.|Unit of Clinical Alcohol Research (UCAR), Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
Sengül
S
Sari
Norwegian Centre for Addiction Research (SERAF), Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Ashley Elizabeth
AE
Muller
Department of Psychology, University of Southern Denmark, Campusvej 55, 5230, Odense, Denmark. kroessler@health.sdu.dk.
Kirsten K
KK
Roessler
D000328:Adult; D019973:Alcohol-Related Disorders / Q000523:psychology / Q000534:rehabilitation*; D003718:Denmark; D004644:Emotions; D015444:Exercise; D005081:Exercise Therapy / Q000458:organization & administration* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009042:Motivation; D020380:Needs Assessment; D010352:Patient Dropouts / Q000523:psychology / Q000706:statistics & numerical data*; D011322:Primary Prevention / Q000379:methods; D036301:Qualitative Research; D012008:Recurrence; D018570:Risk Assessment; D055502:Secondary Prevention / Q000379:methods*; D012931:Social Environment; D012944:Social Support; D016896:Treatment Outcome
Alcohol use disorder; Best practice; Dropout; Outpatient treatment; Participation; Physical exercise; Relapse prevention