Determinants of study completion and response to a 12-month behavioral physical activity intervention in chronic obstructive pulmonary disease: A cohort study

PLoS One. 2019 May 20;14(5):e0217157. doi: 10.1371/journal.pone.0217157. eCollection 2019.

Abstract

Objectives: Physical activity is key to improve the prognosis of chronic obstructive pulmonary disease (COPD). To help to tailor future interventions we aimed to identify the baseline characteristics of COPD patients which predict 12-month completion and response to a behavioral physical activity intervention.

Methods: This is a 12-month cohort study of the intervention arm of the Urban Training randomized controlled trial (NCT01897298), an intervention proven to be efficacious to increase physical activity. We considered baseline sociodemographic, interpersonal, environmental, clinical and psychological characteristics as potential determinants of completion and response. We defined completion as attending the 12-month study visit. Among completers, we defined response as increasing physical activity ≥1100 steps/day from baseline to 12 months, measured by accelerometer. We estimated the factors independently for completion and response using multivariable logistic regression models.

Results: Of a total of 202 patients (m (SD) 69 (9) years, 84% male), 132 (65%) completed the study. Among those, 37 (28%) qualified as responders. Higher numbers of baseline steps/day (OR [95% CI] 1.11 [1.02-1.21] per increase of 1000 steps, p<0.05) and living with a partner (2.77 [1.41-5.48], p<0.01) were related to a higher probability of completion while more neighborhood vulnerability (0.70 [0.57-0.86] per increase of 0.1 units in urban vulnerability index, p<0.01) was related to a lower probability. Among the completers, working (3.14 [1.05-9.33], p<0.05) and having an endocrino-metabolic disease (4.36 [1.49-12.80], p<0.01) were related to a higher probability of response while unwillingness to follow the intervention (0.21 [0.05-0.98], p<0.05) was related to a lower probability.

Conclusions: This study found that 12-month completion of a behavioral physical activity intervention was generally determined by previous physical activity habits as well as interpersonal and environmental physical activity facilitators while response was related to diverse factors thought to modify the individual motivation to change to an active lifestyle.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Behavior Therapy*
  • Exercise Therapy*
  • Female
  • Humans
  • Life Style
  • Male
  • Prospective Studies
  • Pulmonary Disease, Chronic Obstructive / rehabilitation*
  • Quality of Life*
  • Self Care

Associated data

  • ClinicalTrials.gov/NCT01897298

Grant support

HD is the recipient of a joint ERS/SEPAR Fellowship (LTRF 2015) (Sociedad Española De Neumología Y Cirugía Torácica (Separ) www.separ.es) and is a post-doctoral research fellow of the FWO-Flanders (Fonds voor Wetenschappelijk Onderzoek – Vlaanderen https://www.fwo.be/en). The Urban TrainingTM study (NCT01897298) was funded by grants from Fondo de Investigación Sanitaria, Instituto de Salud Carlos III (ISCIII, PI11/01283 and PI14/0419) (Fondo de Investigación Sanitaria, Instituto de Salud Carlos III http://www.isciii.es), integrated into Plan Estatal I+D+I 2013-2016 and co-funded by ISCIII-Subdirección General de Evaluación y Fomento de la Investigación and Fondo Europeo de Desarrollo Regional (FEDER); Sociedad Española de Neumología y Cirugía Torácica (SEPAR, 147/2011 and 201/2011), Societat Catalana de Pneumologia (Ajuts al millor projecte en fisioteràpia respiratòria 2013). ISGlobal is a member of the CERCA Program, Generalitat de Catalunya (El programa de centres de recerca de Catalunya http://cerca.cat/). Anael Barberan-Garcia had personal funding from AGAUR 2014-SGR-661, Catalan Government (Agencia de Gestión de Ayudas Universitarias y de Investigación http://agaur.gencat.cat/es). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.