Perceptions of physical activity and technology enabled exercise interventions among people with advanced chronic kidney disease: a qualitative study

Abstract

Background Exercise improves health outcomes and quality of life in persons with chronic kidney disease (CKD). The numbers of persons with advanced CKD meeting physical activity guidelines however is low. We undertook a qualitative study of men and women aged 36–74 from various race/ethnic populations with advanced CKD not requiring dialysis to describe their experiences and opinions around prior physical activity, motivating factors for and barriers to exercise, and perceptions of exercise-promoting technology and group-based programming designed to improve physical activity levels. Methods Nineteen persons with advanced CKD not requiring dialysis were interviewed at two high volume nephrology clinics enriched with racial/ethnic minority patients (Emory University and Santa Clara Valley Medical Center). We used thematic analysis to identify dominant themes (n = 4) and subthemes (n = 19) around exercise experience, barriers, motivators, views, and preferences. Results Four dominant themes and 19 subthemes were identified. The most common motivators to exercise included physical and mental health benefits, appearance, improvement in energy levels, and potential social interaction in group-based programs. Common barriers included health concerns, particularly complications related to other co-morbidities, as well as time and transportation constraints. Participants were skeptical of exercise programs solely reliant on technology. Conclusions The use of group-based exercise programs may motivate persons with CKD to increase exercise levels, while programs entirely based on technology may be less effective.

Technology-assisted behavioral intervention to encourage prehabilitation in frail older adults undergoing surgery: Development and design of the BeFitMe™ Apple Watch app

“… 24 Consistent with prior studies that utilized wearable devices, 6 , 7 , 10 we found positive engagement between the participants and the watch devices. While prior work shows there remain certain barriers with technology-assisted prehab programs, such as patient confusion with mobile devices, disinterest in technology, or that mobile applications were not responsive to older patients’ needs, 12 we found that most enrolled patients liked using the Apple Watch and that BeFitMe™ Watch app was helpful for their exercise needs. Perhaps this is because it may be easier to engage in physical activity by wearing a watch rather than holding a smartphone.…”

“… 6 , 7 While various health interventions utilizing technology have successfully demonstrated feasibility and acceptability, 6 – 11 including among the older adult population, 7 , 9 , 10 there remain challenges with technology-assisted prehab programs unique to older adults, such as patient confusion with mobile devices, disinterest or lack of confidence in using technology, or lack of designs addressing older patients’ needs. 12 …”

Avoiding God’s Waiting Room: Lessons from the Lived Experiences of Older People who Use Digital Technology to Support Physical Activity

“…Evidence for this can be seen in other studies in which older people 'seemed to want to disregard their limitations even while speaking about them' (Torres & Hammarström, 2006) and reported simultaneous feelings of enthusiasm and apprehension about technology (Vaportzis et al, 2017). Perceptions that technology is designed for and by young healthy people may exacerbate this apprehension (Weber et al, 2021), as may 'stereotype threat' where fear of conforming to a negative stereotype can undermine competency (Lamont et al, 2015). Some argue that technology is itself inherently paradoxical, for example, functioning as both a mitigator and exacerbator of vulnerability (Yap et al, 2021).…”

Preferences of people with chronic kidney disease regarding digital health interventions that promote healthy lifestyle: qualitative systematic review with meta-ethnography

“… 71 Furthermore, three papers explored consumers’ preferences on more than one type of technology, including telephone call and mobile application 70 ; information communication technologies and website 68 ; and activity trackers and mobile applications. 72 A description of the function of each type of DHI was included in online supplemental table S5 .…”