A Qualitative Exploration of the Multidimensional Influences on Physical Activity Among People With Arthritis

OBJECTIVE: To explore the individual, interpersonal, community, organisational, and policy-level factors that influence physical activity among people with arthritis in England, using the Social Ecological Model as the analytical framework. STUDY DESIGN: Qualitative research. METHODS: Semi-structured interviews were conducted with three stakeholder groups: people with arthritis (n = 10), healthcare professionals (n = 18), and providers of community physical activity services (n = 6). Participants were recruited via the charity Arthritis UK. Interviews were audio-recorded, transcribed verbatim, and analysed thematically, with the identified themes mapped to the domains of the social-ecological model. RESULTS: Factors influential on physical activity were identified at individual, interpersonal, community, organisational, policy, and environmental levels. Individual-level factors included the relationship with physical activity, knowledge, understanding and reassurance, physical and emotional pain, and alignment with personal interests. Interpersonal influences encompassed support from family and peers, and conversations with healthcare professionals, particularly physiotherapists. Community-level factors included access, suitability, and the opportunity for social interactions. Organisational-level factors included short-term funding, staffing shortages and expertise, and signposting challenges. Policy and environmental factors included social norms around physical activity, and the interpretation of the physical activity guidelines. CONCLUSIONS: Physical activity promotion for people with arthritis requires a multi-level approach that addresses barriers and harnesses facilitators across the social-ecological spectrum. Tailored advice, improved referral pathways, sustainable funding, and inclusive activity promotion and provision are needed to support participation. These findings can inform the design of person-centred, contextually relevant interventions to increase physical activity in this population.