Perceived barriers to physical activity behaviour among patients with diabetes and hypertension in Kosovo: a qualitative study

Ariana Bytyci Katanolli; Nicole Probst-Hensch; Katrina Ann Obas; Jana Gerold; Manfred Zahorka; Naim Jerliu; Qamile Ramadani; Nicu Fota; Sonja Merten

doi:10.1186/s12875-022-01866-w

Perceived barriers to physical activity behaviour among patients with diabetes and hypertension in Kosovo: a qualitative study

BMC Prim Care. 2022 Sep 30;23(1):257. doi: 10.1186/s12875-022-01866-w.

Authors

Ariana Bytyci Katanolli^{1

2}, Nicole Probst-Hensch^{1

2}, Katrina Ann Obas^{1

2}, Jana Gerold^{2

3}, Manfred Zahorka^{2

3}, Naim Jerliu^{4

5}, Qamile Ramadani⁶, Nicu Fota⁶, Sonja Merten^{7

8}

Affiliations

¹ Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland.
² University of Basel, Basel, Switzerland.
³ Swiss Centre for International Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland.
⁴ National Institute of Public Health Kosovo, Prishtina, Kosovo.
⁵ Medical Faculty, University of Prishtina, Prishtina, Kosovo.
⁶ Accessible Quality Healthcare Project, Prishtina, Kosovo.
⁷ Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland. sonja.merten@swisstph.ch.
⁸ University of Basel, Basel, Switzerland. sonja.merten@swisstph.ch.

Abstract

Background: In a cohort of primary health care users across Kosovo (KOSCO cohort), high rates and poor control of diabetes and hypertension were observed. These conditions can be prevented and better controlled by adapting to a healthy lifestyle. Physical activity is an important target, as inactivity and related obesity were very prevalent in the KOSCO cohort. This qualitative study aims to identify individual and structural barriers to physical activity perceived by patients with diabetes and/or hypertension so as to inform health care providers and policy-makers in Kosovo on strategies for promoting physical activity.

Methods: Interviews were conducted from July to October 2020 with 26 public primary health care users from five municipalities of Kosovo (Mitrovica, Vushtrri, Fushe Kosova, Gjakova, and Malisheva). The qualitative study was nested into the KOSCO cohort. KOSCO was implemented in 2019 and recruited consecutive patients visiting the public primary health care centres in these municipalities. Participants of this qualitative sub-study were selected if they had a doctor's diagnosis of diabetes and/or hypertension. The interview guide consisted of questions related to physical activity barriers these patients are facing, despite having received motivational counselling sessions in primary healthcare centres. Data were analysed using a framework methodology.

Results: Three main themes moderating physical activity behaviour were identified: 1) neighbourhood built environment, 2) health-related problems, and 3) social support. The barriers to physical activity related to the first theme were structural features of the neighbourhoods such as: crowded sidewalks, lack of green spaces, lack of proper lighting in public spaces, as well as dense traffic. In regards to the second theme, the main health reasons for study participants to delay physical activity were related to: physical discomfort as well as stress, worry, and lack of energy. An additional barrier to exercise was lack of social support specifically from friends.

Conclusion: The study identifies structural and individual targets for integrated and inter-sectoral physical activity promotion efforts.

Keywords: Barriers; Diabetes; Hypertension; Kosovo; Physical activity.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Built Environment
Diabetes Mellitus* / epidemiology
Exercise*
Health Status
Humans
Hypertension* / epidemiology
Kosovo / epidemiology
Neighborhood Characteristics
Qualitative Research
Social Support