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Hale L.1, Smith C.1, Adhia D.1, Mulligan H.1, Siew B.1, Treharne G.2
1University of Otago, School of Physiotherapy, Dunedin, New Zealand, 2University of Otago, Department of Psychology, Dunedin, New Zealand
Background: Participating in physical activity is important for health and wellbeing of people living with long-term conditions and disabilities. Past research has identified that: Choice of activity, control over level of engagement, support in choice of programme and, advice and encouragement from a physiotherapist are factors that enable people living with disability to engage in long-term physical activity. These components build intrinsic motivation and self-efficacy that underpins a physiotherapy approach we developed called Blue Prescription. Our research has demonstrated the acceptability and potential benefit of Blue Prescription for people with multiple sclerosis. Research in a more diverse population of adults with long-term conditions/disabilities, with longer follow-up, is warranted.
Purpose: To explore feasibility and acceptability of Blue Prescription to promote and sustain physical activity engagement for people with long-term conditions/disabilities.
Methods: In this qualitative study we used in-depth interviews at the completion of a phase II feasibility randomised controlled trial of Blue Prescription to explore the perceptions of participants and physiotherapists to this approach. We recruited adults living with long-term conditions/disabilities of a predominantly physical nature (self-reported) and of slight- to moderately-severe level of severity (grade 2-4 on the modified Rankin Scale). All participants were recruited from one urban area of Aotearoa New Zealand. We randomly assigned them to six months of either Blue Prescription or a control group intervention (general physical activity advice and suggestions of local community-based physical activity opportunities). All participants and two Blue Prescription physiotherapists were interviewed post-intervention. The interview data were analysed with the General Inductive Approach.
Results: Of 24 participants recruited, ten withdrew (4 from the Blue Prescription group, 6 from the control group). The completing 14 participants had a range of complex conditions/disabilities of long duration (mean 21; 1.5-64 years); most had found previous health professional interventions unsuccessful in addressing their needs. All participants (irrespective of level of disability) were able to find a physical activity to engage in. Three themes articulated the perceptions of participants and physiotherapists of Blue Prescription - expectations, a solitary approach and a subtle intervention. Participants reported volunteering for the study because they had exhausted all other options for help with physical activity and they had an expectation that Blue Prescription would benefit them. Blue Prescription was seen as a solitary intervention because it did not require participants to join a group physical activity. And it was seen as a subtle intervention through reassurance that the participant was on the right track with their physical activity.
Conclusion(s): Blue Prescription was acceptable and beneficial to people with complex long-term conditions/disabilities. Due to the complexity of their condition, participants had previously been unable to find suitable, usable and meaningful help, and Blue Prescription presented another option. Participants liked that the physiotherapists actively listened, understood and supported them within their context of being.
Implications: Physiotherapists need more skills and knowledge to help support and build self-efficacy skills for long-term physical activity engagement for individuals with complex long-term conditions/disabilities.
Funding acknowledgements: Physiotherapy New Zealand Scholarship Trust Fund and the Division of Health Sciences, University of Otago Dunedin‐based Summer Research Scholarship Programme.
Topic: Health promotion & wellbeing/healthy ageing
Ethics approval: University of Otago (Dunedin, New Zealand) Human Research Ethics Committee (H14/036)
All authors, affiliations and abstracts have been published as submitted.
