The Breath project (Project Number: 2022-1-PL01-KA220-HED-000089283) has been Co-funded by the European Union. Views and opinions expressed are however those of the author or authors only and do not necessarily reflect those of the European Union or the Foundation for the Development of the Education System. Neither the European Union nor the entity providing the grant can be held responsible for them.

Determinants of study completion and response to a 12-month behavioral physical activity intervention in chronic obstructive pulmonary disease: A cohort study.

Koreny M, Demeyer H, Arbillaga-Etxarri A, Gimeno-Santos E, Barberan-Garcia A, Benet M, Balcells E, Borrell E, Marin A, Rodríguez Chiaradía DA, Vall-Casas P, Vilaró J, Rodríguez-Roisin R, Garcia-Aymerich J.

Thematic Area
Management, Rehabilitation structures, Patients’ perspective
Summary
Objectives: Physical activity is key to improve the prognosis of chronic obstructive pulmonary disease (COPD). To help to tailor future interventions we aimed to identify the baseline characteristics of COPD patients which predict 12-month completion and response to a behavioral physical activity intervention.
Methods: This is a 12-month cohort study of the intervention arm of the Urban Training randomized controlled trial (NCT01897298), an intervention proven to be efficacious to increase physical activity. We considered baseline sociodemographic, interpersonal, environmental, clinical and psychological characteristics as potential determinants of completion and response. We defined completion as attending the 12-month study visit. Among completers, we defined response as increasing physical activity ≥1100 steps/day from baseline to 12 months, measured by accelerometer. We estimated the factors independently for completion and response using multivariable logistic regression models.
Results: Of a total of 202 patients (m (SD) 69 (9) years, 84% male), 132 (65%) completed the study. Among those, 37 (28%) qualified as responders. Higher numbers of baseline steps/day (OR [95% CI] 1.11 [1.02–1.21] per increase of 1000 steps, p<0.05) and living with a partner (2.77 [1.41–5.48], p<0.01) were related to a higher probability of completion while more neighborhood vulnerability (0.70 [0.57–0.86] per increase of 0.1 units in urban vulnerability index, p<0.01) was related to a lower probability. Among the completers, working (3.14 [1.05–9.33], p<0.05) and having an endocrino-metabolic disease (4.36 [1.49–12.80], p<0.01) were related to a higher probability of response while unwillingness to follow the intervention (0.21 [0.05–0.98], p<0.05) was related to a lower probability.
Conclusions: This study found that 12-month completion of a behavioral physical activity intervention was generally determined by previous physical activity habits as well as interpersonal and environmental physical activity facilitators while response was related to diverse factors thought to modify the individual motivation to change to an active lifestyle.

Relevance
Among a broad range of potential predictors of 12-month completion or response to a behavioral physical activity intervention, this study found that completion was generally determined by previous physical activity habits as well as interpersonal and environmental physical activity facilitators while response was related to diverse factors thought to modify the individual motivation to change to an active lifestyle. These results support a look beyond the traditional clinical and functional variables and the consideration of psychological, interpersonal and environmental factors related to habits and motivation to optimize the outcome of physical activity interventions in COPD.