BEPA-NESP
Research type
Research Study
Full title
Identifying the Barriers to Exercise and engagement with Physical Activity among Non-English Speaking patients with osteoarthritis or chronic musculoskeletal Pain
IRAS ID
286486
Contact name
Nasimah Maricar
Contact email
Sponsor organisation
Salford Royal NHS Foundation Trust
Clinicaltrials.gov Identifier
N/A, N/A
Duration of Study in the UK
0 years, 10 months, 29 days
Research summary
Research Summary
Prevention of long-term and debilitating diseases and addressing the inequalities in health in our population are priorities of the National Health Service (NHS). Ensuring equal access to healthcare and treatment and positive outcomes for Black, Asian and minority ethnic (BAME) patients forms part of this. One of the most common conditions within the general population is chronic musculoskeletal pain (such as chronic back pain and fibromyalgia) and arthritis and it is recognised that regular physical activity or exercise is beneficial in these conditions. Indeed, the health benefits of exercise can go beyond treatment of chronic pain and also include prevention of disease and improving mental health.
The City of Manchester has the highest proportion of non-white people of any district in Greater Manchester, including many non-English speakers; however, the provision of care in NHS has been largely geared towards the English speaking population. Resources for patients and health professionals are predominantly in English and many group-based health treatment programmes and exercise classes are also conducted primarily in the English language; this may exclude patients from the BAME groups and limit their access to relevant treatments. Simply offering these opportunities in different languages, however, may in itself not be enough, as it is equally important to understand the barriers to exercise acceptance among people from different cultures and/or among those who are non-English speaking and their readiness to be more active. This project seeks to gain a better understanding of this in order to personalize treatment and deliver the best support to non-English speaking patients living with chronic musculoskeletal pain.Summary of Results
The mean age was 52 (range: 40-68; SD: 9.5). 9 participants identified as female. Three themes were identified: ‘Promotors to physical activity’; ‘Barriers to physical activity’; and ‘Exercise beliefs’, with several associated sub-themes.
Promotors to physical activity:
Some participants had not been made aware of physical activity and exercise and the benefits of undertaking them. Helping participants to become more informed about physical activity could therefore help to facilitate their engagement in it. Some participants had acknowledged that they had been given resources to support their engagement in physical activity, such as booklets or information sheets. However, what seemed to be important was that the resources that they were provided with were in a language that they understood. Having supportive environment also appeared to be helpful in promoting better engagement with exercise and physical activity. For those who could not undertake physical activity in the house or saw barriers to outdoor activities, having access to other facilities such as a community hall could facilitate them to be active.
Barriers to physical activity:
Group activities were not the preference for everyone. Lack of time to engage in this way could provide a barrier to the undertaking of physical activity. Additionally, attending the community activities could be challenging unless they had transportation to get them there. Participants' physical condition was perceived to influence their ability to undertake any physical activity. Pain and tiredness seemed to be the main symptoms that provided a barrier to this. Some participants also feared falling if they exercised. However, for some, it seemed to be a lack of understanding of what they should do and how they could undertake the activity that deterred them from engaging with it.
This resonated with participants who perceived that the lack of engagement in physical activity was because many had not been educated about physical activity and therefore knew about the positive effects on their health. It was also highlighted that language differences affected the ability to understand what they were being told and also the ability to clarify their situation.
Exercise beliefs:
Participants' beliefs about physical activity and exercises influenced whether they were undertaken or not. Those participants who were more motivated to undertake physical activity believed that exercises were essential to help them with their physical symptoms and their mental health. However, some participants were deterred from undertaking physical activity as they believed doing so would increase their symptoms. This view seemed to have been reinforced for some who had attempted to undertake physical activity and felt no relief from engaging with them or in some cases their symptoms had increased. Whereas others seemed resigned to the situation that they were in. There was a perception from participants that their culture shaped their compatriots’ beliefs about physical activity. It was their view that many were discouraged from undertaking physical activity as it was not normal practice for people from their country of birth to engage in it. There also appeared to be a lack of understanding as to what they believed exercise and physical activity to be. There was confusion, particularly about whether activities of daily living counted towards their daily exercise and physical activity. This would seem an important consideration as some participants felt they did not benefit from formalized exercise yet saw the advantage in participating in other types of physical activity such as walking.REC name
West Midlands - Edgbaston Research Ethics Committee
REC reference
20/WM/0305
Date of REC Opinion
24 Nov 2020
REC opinion
Favourable Opinion