Perceived barriers to physical activity among North Carolinians with arthritis: findings from a mixed-methodology approach

A goal of the North Carolina Arthritis Plan is to reduce arthritis burden through regular physical activity. We identified community and personal factors that influence physical activity in individuals with arthritis. In 2004 and 2005, 2479 individuals (53% self-reported arthritis) from 22 North Carolina communities completed a telephone survey (59.5% response rate) assessing health status, neighborhood characteristics, health attitudes, and demographic variables. Qualitative discussions (N=32) were conducted to further examine understanding of community and health and were enhanced with photographs. Descriptive analyses were conducted. A 2-sided binomial test (for each reason given for not being physically active) was used to test for significance between individuals with arthritis and the general population, using a Bonferroni test for multiple comparisons. Interviews and photographs were analyzed using qualitative software ATLAS.ti Version 5.0. Quantitative results show similar community-level reasons for physical inactivity (rural environment, heavy traffic, and lack of sidewalks) despite arthritis status. Yet personal reasons differed as individuals with arthritis more often cited physical inability and illness. In qualitative discussions, walking surfaces emerged as a primary barrier for those with arthritis. Findings from this exploratory study may have limited generalization and warrant further study. The built environment and personal barriers should be considered when examining physical activity in individual with arthritis.