Insights Into Physical Activity Adoption in Diabetes Patients: When Cultural Materialism Met the Transtheoretical Model

Background: Although physical activity (PA) is a key behaviour for preventing and controlling diabetes (T2DM), low adoption-adherence continues to impair patient progress. Importantly, for many patients, intentional PA may have never been central to their wider cultural context. Therefore, progress in behaviour change may be more about collective than individual processes. The aim of this study was to identify barriers to undertake and maintain PA overtime and describe the relationship and the influence between these barriers in T2D patients’ real-life. Methods Twenty-two T2D patients contributed either to focus groups (n = 5) or to semi-structured interviews (n = 4). We explored adoption-adherence using an established behaviour change model (Transtheoretical) and an anthropological research method (Cultural Materialism) throughout a qualitative analysis. Results Findings suggested patients responded to PA promoted through medicalised services, using two basic, yet inter-related, social processes. To consider adopting PA a Basic Social Psychological Process was used. In contrast, patients willing to sustain PA focused on prominent ‘infrastructural’ barriers, using a Basic Social Structural Process. Conclusion This interpretation simplifies in two processes the change of behaviour related to PA. At the same time, defines the barriers’ relationship between the different levels and the influence that each level has in patients’ real-life. These insights support using phased, ecological frameworks to design and promote PA to patients with T2D, so they maintain changes over time.