Abstract
Background: Physical activity (PA) is a key component in the management of type 2 diabetes. However, this population have low rates of PA engagement. Electrically assisted cycling has been identified as a means through which to increase PA by incorporating activity into daily life, while overcoming some of the barriers to conventional cycling. The determinants of e-cycling among people living with chronic disease are largely unknown. The aim of this research was to explore the determinants of e-cycling among individuals with type 2 diabetes using the Theoretical Domains Framework (TDF) and the Capability, Opportunity and Motivation for Behaviour change model (COM-B). This information is important for determining the suitability of future e-cycling initiatives and, if appropriate, inform future e-cycling interventions.
Method: One-to-one semi structured interviews were conducted with 16 participants from the e-cycling arm of a pilot randomised controlled trial between September 2019 and April 2020. The TDF was used to develop the interview guide. The framework method of analysis was used, incorporating both deductive and inductive reasoning. A conceptual model of the factors that influence e-cycling in this population was created.
Results: The most commonly reported TDF domains were skills, knowledge, belief about capabilities, belief about consequences and environmental context and resources. Specifically, e-bike training facilitated e-cycling engagement by providing participants with the skills, knowledge, and confidence needed to ride the e-bike and ride on the road. In addition, the enjoyment of e-cycling was a key facilitator to engagement. Participants engaged in e-cycling to improve their health rather than for environmental reasons. Most barriers to e-cycling related to the natural or physical environment.
Conclusion: This study provides insight into the personal, social, and environmental factors associated with e-cycling in this population. The findings of this study can be used to develop a more refined e-cycling intervention targeting the factors identified as influencing e-cycling engagement. In addition, this information will help in the selection of mechanistic outcome measures for evaluation.
Method: One-to-one semi structured interviews were conducted with 16 participants from the e-cycling arm of a pilot randomised controlled trial between September 2019 and April 2020. The TDF was used to develop the interview guide. The framework method of analysis was used, incorporating both deductive and inductive reasoning. A conceptual model of the factors that influence e-cycling in this population was created.
Results: The most commonly reported TDF domains were skills, knowledge, belief about capabilities, belief about consequences and environmental context and resources. Specifically, e-bike training facilitated e-cycling engagement by providing participants with the skills, knowledge, and confidence needed to ride the e-bike and ride on the road. In addition, the enjoyment of e-cycling was a key facilitator to engagement. Participants engaged in e-cycling to improve their health rather than for environmental reasons. Most barriers to e-cycling related to the natural or physical environment.
Conclusion: This study provides insight into the personal, social, and environmental factors associated with e-cycling in this population. The findings of this study can be used to develop a more refined e-cycling intervention targeting the factors identified as influencing e-cycling engagement. In addition, this information will help in the selection of mechanistic outcome measures for evaluation.
| Original language | English |
|---|---|
| Article number | 1150724 |
| Number of pages | 16 |
| Journal | Frontiers in Sports and Active Living |
| Volume | 5 |
| DOIs | |
| Publication status | Published - 29 Sept 2023 |
Bibliographical note
Funding Information:One-to-one semi-structured interviews were conducted with individuals who were randomised to the intervention arm of a parallel two-arm pilot randomised controlled trial. The trial compared an e-cycling intervention against a standard-care waitlist control in adults with type 2 diabetes (). Eligibility for the study included having a clinical diagnosis of type 2 diabetes and being between 30 and 70-years of age. Individuals were ineligible if they self-reported engagement in ≥150-min of MVPA per week (); took exogenous insulin; had a myocardial infarction or stroke in the past six months or had evidence of end-stage renal failure or liver disease; had uncontrolled hypertension; had any other contraindications to exercise; were not cleared to engage in PA by their GP and/or were unable to read and communicate in English. This single centre study was conducted in the city of Bristol, England. Individuals in the intervention arm received e-bike training consisting of two one-to-one training sessions followed by a 12-week e-bike loan in which they were instructed to use the e-bike as they desired (i.e., no riding goals stipulated). During the e-bike loan participants were offered two further training sessions. Twenty individuals were allocated to the intervention arm. Four participants discontinued with the intervention (reasons included: personal situation [n = 2], purchased an e-bike [n = 1], undisclosed [n = 1]). Seventeen individuals were invited to take part in the interviews of which 16 participated. Interviews were conducted by JEB over the telephone between September 2019 and April 2020, within two weeks of finishing the e-bike trial. The interviews were digitally recorded using encrypted recording devices. The recordings were transcribed verbatim by Transcription UK and stored using NVivo data management software (NVivo10, QSR International, 2012). The transcripts were checked against the original recordings to ensure reliability. Interviews ranged between 33mins and 50mins in length. Ethical approval was obtained from the NHS Health Research Authority Southwest/Central Bristol Research Ethics Committee (Ref: 18/SW/0164) and was sponsored by the University of Bristol.
Funding Information:
This study was funded by the NIHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.
Publisher Copyright:
2023 Bourne, Leary, England and Searle.
