title: Barriers and enablers of physical activity engagement for patients with COPD in primary care.
abstract: BACKGROUND
  Given that physical activity (PA) has a positive impact on COPD symptoms and prognosis, this study examined the factors that both encourage and limit participation in PA for individuals with COPD in a primary care setting from the perspective of social cognitive theory.
  
  
  METHODS
  A purposive sample of 26 individuals with a range of COPD severity (age range: 50-89 years; males =15) were recruited from primary care to participate in one of four focus groups. Thematic analysis was undertaken to identify key concepts related to their self-efficacy beliefs.
  
  
  RESULTS
  Several barriers and enablers closely related to self-efficacy beliefs and symptom severity were identified. The main barriers were health related (fatigue, mobility problems, breathing issues caused by the weather), psychological (embarrassment, fear, frustration/disappointment), attitudinal (feeling in control of their condition, PA perception, older age perception), and motivational. The main enabling factors were related to motivation (autonomous or controlled), attitudes, self-regulation, and performance accomplishments.
  
  
  CONCLUSIONS
  When designing interventions for individuals with COPD, it is important to understand the patient-specific social cognitive influences on PA participation. This information can then inform individually tailored management planning.
authors.affiliation: School of Sport, Exercise and Rehabilitation Sciences.
authors.forename: Maria-Christina
authors.initials: MC
authors.lastname: Kosteli
authors.affiliation: School of Sport, Exercise and Rehabilitation Sciences.
authors.forename: Nicola R
authors.initials: NR
authors.lastname: Heneghan
authors.affiliation: School of Sport, Exercise and Rehabilitation Sciences.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Roskell
authors.affiliation: School of Sport, Exercise and Rehabilitation Sciences.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Williams
authors.affiliation: Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK.
authors.forename: Peymane
authors.initials: P
authors.lastname: Adab
authors.affiliation: Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK.
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Dickens
authors.affiliation: Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Enocson
authors.affiliation: Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK.
authors.forename: David A
authors.initials: DA
authors.lastname: Fitzmaurice
authors.affiliation: Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK.
authors.forename: Kate
authors.initials: K
authors.lastname: Jolly
authors.affiliation: Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK.
authors.forename: Rachel
authors.initials: R
authors.lastname: Jordan
authors.affiliation: Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK.
authors.forename: Sheila
authors.initials: S
authors.lastname: Greenfield
authors.affiliation: School of Sport, Exercise and Rehabilitation Sciences.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Cumming
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition; D015444:Exercise; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D009042:Motivation; D010349:Patient Compliance; D010465:Perception; D011320:Primary Health Care; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D020127:Recovery of Function; D040242:Risk Reduction Behavior; D012648:Self Care; D020377:Self Efficacy; D012919:Social Behavior; D016896:Treatment Outcome
keywords: COPD; barriers; enablers; primary care; self-efficacy; social cognitive theory