Improving physical activity, sedentary behaviour and sleep in COPD: Perspectives of people with COPD and experts via a Delphi approach
Background: Little is known about how to achieve enduring improvements in physical activity (PA), sedentary behaviour (SB) and sleep for people with chronic obstructive pulmonary disease (COPD). This study aimed to: 1. identify what people with COPD from South Australia and the Netherlands, and experts from COPD- and non-COPD-specific backgrounds considered as important to improve behaviours; and 2. identify areas of dissonance between these different participant groups.
Methods: A four-round Delphi study was conducted, analysed separately for each group. Free-text responses (Round 1) were collated into items within themes and rated for importance on a 9-point Likert scale (Rounds 2-3). Items meeting a priori criteria from each group were retained for rating by all groups in Round 4. Items and themes achieving a median Likert score of ≥7 and an interquartile range of ≤2 across all groups at Round 4 were judged important. Analysis of variance with Tukey’s post-hoc tested for statistical differences between groups for importance ratings.
Results: 73 participants consented to participate in this study, of which 62 (85%) completed Round 4. In Round 4, 81 items (PA n=54; SB n=24; sleep n=3) and 18 themes (PA n=9; SB n=7; sleep n=2) were considered as important across all groups concerning: 1. disease management, 2. targeting behavioural factors, and less commonly 3. adapting the social/physical environments. There were few areas of dissonance between groups.
Conclusion: Important to our Delphi participants is a multifactorial approach to improve PA, SB and sleep. Recognising and addressing important factors may provide a basis for developing interventions to improve these behaviours long-term.