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

Abstract

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.