Priorities for physical activity among under-served populations with musculoskeletal conditions: Findings from a Q-methodology study

Berry, Alice; Brady, Terence; Walsh, Nicola; Dures, Emma; Harris, Nicky; Niyi-Odumosu, Faatihah; Flurey, Caroline

Abstract

Background:
Twenty million individuals (in UK) have a musculoskeletal (MSK) condition, for which physical activity (PA) is a core treatment. People from minority ethnic communities are disproportionately impacted, experiencing higher levels of pain and less engagement with PA. Research highlights various factors that affect PA engagement for minority ethnic communities, including lack of access to support, limited knowledge of resources, language barriers, fear of racial harassment while exercising, and insufficient information from healthcare professionals. This study employed Q-methodology to prioritise areas of concern, utilising factors previously identified in a realist synthesis.

Purpose:
To identify most important factors impacting PA engagement for people from minority ethnic communities with MSK conditions.
Methods:
Q-methodology: 18 participants sorted 25 statements (generated in earlier realist synthesis), covering four topics: 1) Lack of access to support, 2) Shared decision-making (balancing power and expectations), 3) Patient-centred care (trust/therapeutic relationships), 4) Place-based support. To ensure inclusivity, Q-sort sessions were held in various community venues with the presence of translators as needed. Data were analysed using centroid factor analysis with varimax rotation (i.e. participants as variables).

Results:
Two factors were generated, which explained 39% of the study variance, and included no confounding factors. Outputs highlighted most important factors: 1) complex booking procedures/inadequate translation services make health service engagement (for PA advice) difficult, 2) time constraints impact effective patient-centred care, 3) Dismissive attitudes and mismatched expectations affect shared decision-making around PA, 4) importance of re-building trust and cultural relevance in developing therapeutic relationships, 5) clinician recommended PA opportunities increase knowledge and exposure to PA.

Conclusions:
This study illustrates how broad contextual factors impact PA engagement for underserved populations with MSK conditions.

Practical implications:
Our findings contribute to the understanding of inequities across MSK pathways, specifically in relation to support for PA engagement, highlighting priority areas for future research and interventions.

• Presentation Conference Type: Poster
• Conference Name: International Society of Physical Activity and Health
• Start Date: Oct 28, 2024
• End Date: Oct 31, 2024
• Acceptance Date: Oct 1, 2024
• Deposit Date: Apr 14, 2025
• Peer Reviewed: Peer Reviewed
• Public URL: https://uwe-repository.worktribe.com/output/14303587