Perceived Facilitators and Barriers in Response to a Walking Intervention in Rural Cancer Survivors: A Qualitative Exploration
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Procedure
2.3. Coding and Analysis
3. Results
3.1. Participants’ Characteristics
3.2. Qualitative Findings
3.2.1. Perceived Motivators
(1) Physical/Psychological Factors
I’m not getting out of breath as much now. I feel better in myself, my skin is quite clear … I feel better in myself.(Female, 78, breast cancer)
I’m fitter, I’d lost weight with the steps and walking up the hills, I plateaued out now a little bit, but I haven’t put on weight.(Female, 60, breast cancer)
I have noticed that by being more active I can actually do more with my knees. So, I can now squat for a little bit of time, and I can now kneel, where I used to never be able to.(Female, 62, breast cancer)
(I) don’t seem to get so tired now like I used to before because before I started on this, I’d be really tired by the end of the day and have no motivation and so it’s really helped me that way.(Male, 70, prostate cancer)
… it’s (boot camp) probably something I wouldn’t have tackled before, but now I’m tackling it and crawling on my knees and doing all sorts of things that I don’t think I would’ve done if I hadn’t increased my walking. It helped me, the walking helped me, to start and walk up hills so then I started to feel fitter and things like that. And then I was looking for another challenge so Boot Camp’s a challenge.(Female, 60, breast cancer)
(2) Social Support
Somebody’s looking over your shoulder, making sure you’re walking, and because you (researchers) are monitoring it there’s a tendency to have the guilty conscience if you’re not doing it. Therefore, you tend to meet that (step) goal.(Male, 70, prostate cancer)
Well I think you’re all; you just gave us that extra enthusiasm to stick with it ... I personally feel I got to know you well… and I think that’s generally a feeling that you were all a great help to us. So that’s … having somebody there that you can relate to I think.(Female, 78, breast cancer)
I think you’ve brought it to the forefront about your health and that there are actually people that are trying to help people look after themselves, and so you feel as though well, they’re putting in their time, you’ve got to do your time. There’s no good just dragging yourself and saying oh yes, I can’t be bothered, you know. So, if everybody else is willing to do their part, I think you’ve got to do yours.(Female, 78, breast cancer)
I probably wouldn’t be disciplined enough to faithfully follow it through, I think I need that outside input, in my case.(Male, 65, prostate cancer)
No that would make people too lazy. I think when someone sets you something to do no matter how many steps, you do it, otherwise you just say oh right and you do five today when you’ve been setting a person 12 so I think having the STRIDE people set the goal is very good.(Male, 70, prostate cancer)
It’s a challenge, if I did it myself I might set too low a goal, whereas you’re creating it from facts, from figures and if I can’t achieve it that’s okay but I think it’s based better, based more scientifically if you do it rather than me just thinking oh well only feel like doing so many steps today so that’s all I’ll do.(Female, 60, breast cancer)
I don’t need to count the steps, because I know the, the amount of time that I’m walking. I think before the step program I was probably walking about 40 min, whereas now our minimum walk is an hour up to even close to two hours.(Female, 60, breast cancer)
Joan (pseudonym) and I doing it together was great because when we started, we were off, and we’d go for an hours walk or whatever and, and it was good to get away and talk and, and do that part of it, I thought it was great.(Male, 67, face cancer)
… it was good in the fact that we were both talking to one another about what we’re eating and how we’re walking and being part of the program together was good.(Female, 62, breast cancer)
(3) Website Factors
I enjoy going on and typing in my steps and seeing the graph—that’s a physical motivator for me ... And I’ve done it on a graph on my fridge and stuck it on things like that … that does motivate me … that does actually help me stay on track.(Female, 62, breast cancer)
3.2.2. Perceived Barriers
(1) Physical Limitations
My joints are just so sore and so all I want to do is sit down and put my feet up. …I really like to try and get out before lunchtime if I can, any later than that, I’ve done it, but it’s a real struggle and quite uncomfortable.(Female, 60, breast cancer)
I had my legs packed-up, that sort of hinders me a bit.(Female, 78, breast cancer)
(3) Environmental Barriers
In the middle of summer it’s bloody hot and there’s no shade.(Male, 67, face cancer)
Really bad weather … really strong winds is a barrier; I mean that danger would be a barrier.(Female, 60 years, breast cancer)
It was a winter thing and you’d look out and it was just pouring, you couldn’t go out in that weather. So those days you were only doing 4 or 500 steps you know, which just wasn’t enough because it was too cold to go anywhere.(Female, 78, breast cancer)
… the only place we can walk is, is along an unmade, a dirt road and with crops on both sides … and there’s always potential for snakes.(Male, 67, face cancer)
Well actually the only thing I really disliked was the flies on the walks, the bush flies. You don’t get them like we do out in the bush. So that was the most annoying thing of the whole exercise … it’s a rural barrier to it. It kind of puts you off unless you’re wearing a fly veil.(Male, 70, prostate cancer)
I can only walk … down a road … And the only thing that keeps you on a program is having the goals and the commitment to doing them and I guess somewhere to walk and if it’s more exciting than down a (road) paddocks on either side, which have been ploughed. So, my setting, my environment I don’t think was conducive to actually encouraging walking.(Male, 70, prostate cancer)
We’ve got a veranda around our house, and when I couldn’t get out because it was pouring with rain, I would just walk walk, and walk, and walk, around, and around, and around the veranda.(Female, 62, breast cancer)
I really don’t mind if I get a bit wet, if it’s, if it’s hot, get up a bit earlier go or do the walk that’s got more shade, there’s some areas that are shadier than others, take water.(Female, 60, breast cancer)
Organizational Barriers
I’d walk, I’d made myself an hour in the morning and an hour at night, either before or after work … and I thought, well I can’t just keep walking and not get anything else done in my life, there’s more to it.(Female, 62, breast cancer)
There were a couple of days, where we drove to Adelaide and back, well there’s six hours out of the day to start with, because we went down for medical appointments. So, there’s just no time for walking, if you’re going to spend six hours in a car.(Male, 65, prostate cancer)
Probably priorities, if I had things I needed to do, they took priority, rather than trying to think about—am I doing my steps.(Male, 65, prostate cancer)
I prefer to walk in the morning, my joints aren’t very good later in the day, so if I was busy all day—for instance during the school holidays when I’m working all day at Vacation Care, if I don’t get home till 5:30 pm, 6:00 pm I’m too tired to go for a walk.(Female, 60, breast cancer)
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Characteristics | |
---|---|
Age (y) | |
Mean | 74.0 |
SD | 5.5 |
Range | 60–78 |
Sex (n) | |
Male | 5 |
Female | 5 |
Ethnicity (n) | |
Caucasian | 10 |
Cancer type (n) | |
Breast | 5 |
Prostate | 4 |
Face | 1 |
Theme | Sub-Theme | |
---|---|---|
Motivators | Physical/psychological benefits | Increased fitness |
Weight loss | ||
Feeling better | ||
Improved body image | ||
Social support | Obligation to research team | |
Appreciated support and encouragement from research team | ||
Enjoyed connecting with others | ||
Website factors | Tailored step goals | |
Graphic visualization of progress on website | ||
Barriers | Physical limitations | Fatigue |
Pain | ||
Chronic illness | ||
Psychosocial barriers | Social isolation | |
Lack of motivation/encouragement | ||
Environmental barriers | Poor weather conditions | |
Poor walking environment | ||
Safety issues | ||
Geographical isolation | ||
Organizational barriers | Time constraints | |
Competing priorities |
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Share and Cite
Frensham, L.J.; Parfitt, G.; Stanley, R.; Dollman, J. Perceived Facilitators and Barriers in Response to a Walking Intervention in Rural Cancer Survivors: A Qualitative Exploration. Int. J. Environ. Res. Public Health 2018, 15, 2824. https://doi.org/10.3390/ijerph15122824
Frensham LJ, Parfitt G, Stanley R, Dollman J. Perceived Facilitators and Barriers in Response to a Walking Intervention in Rural Cancer Survivors: A Qualitative Exploration. International Journal of Environmental Research and Public Health. 2018; 15(12):2824. https://doi.org/10.3390/ijerph15122824
Chicago/Turabian StyleFrensham, Lauren J., Gaynor Parfitt, Rebecca Stanley, and James Dollman. 2018. "Perceived Facilitators and Barriers in Response to a Walking Intervention in Rural Cancer Survivors: A Qualitative Exploration" International Journal of Environmental Research and Public Health 15, no. 12: 2824. https://doi.org/10.3390/ijerph15122824