“It’s a slightly different vibe”. New pathways in condition-specific rehabilitation for people with new or existing joint pain

Abstract

Background Musculoskeletal (MSK) conditions are a leading cause of pain and disability in adults. Exercise-based rehabilitation programmes are recommended however, sustained behaviour change is often poor. New rehabilitation pathways designed to promote adherence to exercise, can be iteratively developed using behaviour change models. This study explored the experiences of people living with joint pain participating in a Joint Pain Programme (JPP), a unique community-based rehabilitation initiative delivered by exercise professionals, that is offered ‘free of charge’ to patients and provides supplementary access to a local fitness and well-being centre. The findings are mapped to behaviour change models to inform implementation strategies that enhance exercise adherence in this population. Methods A qualitative design, informed by pragmatism, using semi-structured interviews was used to explore participants’ experiences of uptake and attendance at a 12-week community-based rehabilitation programme for joint pain. Findings were analysed using inductive thematic analysis. NVivo software was used to facilitate analysis, with models of behaviour change used to interpret the findings. The study is reported in accordance with the consolidated criteria for reporting qualitative (COREQ) research. Results 21 interviews took place online with individuals who attended the programme. Four themes were identified: 1) The programme supports my needs; 2) What motivates me; 3) The ‘value add’ environment; and 4) What hinders me from exercising. Conclusion The JPP provides a new pathway for MSK rehabilitation that is perceived positively by people living with joint pain. Uptake and attendance in the early stage of exercise adoption is influenced by multiple interventions acting at the policy, community, organisational, interpersonal and intrapersonal level. Recommendations for policy and programme designers are made. The structure of the JPP could act as a potential springboard where programmes for other long-term conditions could be rolled out, reducing the burden on valuable health service resources.