Cultural Influences on Physical Activity and Exercise Beliefs in Patients With Chronic Kidney Disease

NCT03709212 | Completed DMC

• 3 other identifiers: KCH-CULTURE CKD241792KCH18-053
• Study Type: observational
• Target: 80
• Locations: 1 country
• Sites: 1

Brief Summary

Cardiovascular disease (CVD) remains the leading cause of death in patients with Chronic Kidney Disease (CKD). Patients who spend a lot of time being inactive have an increased chance of developing CVD. Thus, interventions that can help to increase the levels of physical activity in patients with CKD are needed. A recent study the investigators completed with kidney transplant participants showed a benefit from the investigators supervised exercise programme. However, the investigators results showed that 11 of the 18 patients who dropped out from the 12-month study were from black and minority ethnic groups. Some patient feedback from these participants suggested that cultural beliefs; including women not being comfortable to exercise in front of men in an exercise class environment, and difficulties around appropriate dress for exercise classes, contributed to some of these participants' decisions to withdraw from the study. This has prompted the investigators to investigate, the cultural influences that may contribute to patient decisions about partaking in physical activity and exercise training. The aim of this study is therefore to invite patients with CKD from the three most widely represented ethnic groups found in our South-East London Hospital Trust (Black African and African-Caribbean; South Asian, and White Caucasian patients) to discuss their beliefs and the cultural influences that may affect their decision on whether to engage with exercise and physical activity. Participants will complete a questionnaire on physical activity levels, and a questionnaire that looks at a patient's readiness to be involved in physical activity, prior to attending interviews or group discussions. The questionnaires will be translated for use with non-English speaking participants and will be used to ensure we get views on physical activity from those participants who are active and not, and ready to be involved in physical activity, and not. A combination of individual interviews and group discussions will then be used to explore the understanding of the terms 'physical activity' and 'exercise', and cultural barriers to participation. The investigators will have interpreters present for all discussions, undertaken in the community. The work from this pilot study will be used to inform and design a larger multi-centre study with an aim to design physical interventions that are culturally sensitive, and appropriate for all patients with CKD in the United Kingdom.

Conditions

Chronic Kidney Diseases; Physical Activity; Exercise Therapy

Keywords

Chronic Kidney Disease; Physical Activity; Cultural influences; Exercise

Outcome Measures

Primary Outcomes (2)

• One-to-one semi-structured interview to explore participants experiences of living with Chronic Kidney Disease.

  To establish challenges and perceptions of living with this long term condition and how this has an impact on day to day life.

  Through study completion, an average of one year

• One-to-one semi-structured interview to explore participants experience of exercise and physical activity

  Any difficulties/ barriers to exercise or physical activity determined by a qualitative interview. Experiences of the exercise and physical activity by a qualitative interview. Benefits to under taking physical activity and exercise by a qualitative interview. Facilities and opportunities available to undertake exercise of physical activity by a qualitative interview. Any cultural influences that may have influenced decisions to participate in physical activity and exercise by a qualitative interview.

  Through study completion, an average of one year

Secondary Outcomes (2)

• Physical activity through General Practice Physical Activity Questionnaire (GPPAQ)

  Through study completion, an average of one year

• Self-efficacy to regulate exercise

  Through study completion, an average of one year

Study Arms (7)

Individual semi-structured interview

20 participants will undergo individual semi-structured interviews to explore perceptions of living with Chronic Kidney Disease, attitudes and understanding of exercise and physical activity and any cultural influences that may influence attitudes or decisions regarding this. Participants will be recruited from three ethnic backgrounds; Black African/ Caribbean, South Asian and White Caucasian.

Other: interviews

Focus Group 1

10 participants female black African/ African Caribbean ethnicity will undergo group semi-structured interviews to explore perceptions of living with Chronic Kidney Disease, attitudes and understanding of exercise and physical activity and any cultural influences that may influence attitudes or decisions regarding this.

Other: interviews

Focus Group 2

10 participants male Black African/ African Caribbean ethnicity will undergo group semi-structured interviews to explore perceptions of living with Chronic Kidney Disease, attitudes and understanding of exercise and physical activity and any cultural influences that may influence attitudes or decisions regarding this.

Other: interviews

Focus Group 3

10 participants female South Asian ethnicity will undergo group semi-structured interviews to explore perceptions of living with Chronic Kidney Disease, attitudes and understanding of exercise and physical activity and any cultural influences that may influence attitudes or decisions regarding this.

Other: interviews

Focus Group 4

10 participants male black South Asian ethnicity will undergo group semi-structured interviews to explore perceptions of living with Chronic Kidney Disease, attitudes and understanding of exercise and physical activity and any cultural influences that may influence attitudes or decisions regarding this.

Other: interviews

Focus Group 5

10 participants female White Caucasian ethnicity will undergo group semi-structured interviews to explore perceptions of living with Chronic Kidney Disease, attitudes and understanding of exercise and physical activity and any cultural influences that may influence attitudes or decisions regarding this.

Other: interviews

Focus Group 6

10 participants male White Caucasian ethnicity will undergo group semi-structured interviews to explore perceptions of living with Chronic Kidney Disease, attitudes and understanding of exercise and physical activity and any cultural influences that may influence attitudes or decisions regarding this.

Other: interviews

Interventions

interviews OTHER

20 participants will undergo individual semi-structured interviews, 60 will undergo one of 6 focus groups comprising of 10 participants of the same gender and ethnicity.

Also known as: individual semi-structured, Focus groups

Focus Group 1; Focus Group 2; Focus Group 3; Focus Group 4; Focus Group 5; Focus Group 6; Individual semi-structured interview

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The investigators aim to recruit up to 20 patients (for the individual interviews) and 60 patients (for the 6 single-sex focus groups), aged over 18 years or over with CKD from the 3 identified ethnic groups, will be recruited to the study. Each patient must have met the inclusion and exclusion criteria at entry level to the study. For focus groups the investigators will aim to meet with six to twelve participants per group. Appropriate topic guides will be developed and discussed with the patient advisory group, and the steering group. The investigators will continue with individual interviews and focus groups until data saturation is reached, there is no new data, no new themes, no new coding and the investigators are able to replicate the study.

You may qualify if:

• Participants with a diagnosis of CKD that are representative of one of the 3 ethnic groups that will be studied (Black African and African-Caribbean; South Asian, and White Caucasian patients)
• Age \> 18 years of age
• able to provide Informed consent

You may not qualify if:

• Uncontrolled medical condition (e.g. uncontrolled angina)
• Unstable psychiatric condition

Sponsors & Collaborators

• King's College Hospital NHS Trust: lead
• Kidney Care UK: collaborator
• British Renal Society: collaborator

Study Sites (1)

King's College Hospital

London, SE5 9RS, United Kingdom

Location

Related Publications (1)

• Mayes J, Castle EM, Greenwood J, Ormandy P, Howe PD, Greenwood SA. Cultural influences on physical activity and exercise beliefs in patients with chronic kidney disease: 'The Culture-CKD Study'-a qualitative study. BMJ Open. 2022 Jan 11;12(1):e046950. doi: 10.1136/bmjopen-2020-046950.

  PMID: 35017229 DERIVED

MeSH Terms

Conditions

Renal Insufficiency, Chronic; Motor Activity

Interventions

Interviews as Topic; Focus Groups

Condition Hierarchy (Ancestors)

Renal Insufficiency; Kidney Diseases; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Male Urogenital Diseases; Chronic Disease; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Behavior

Intervention Hierarchy (Ancestors)

Data Collection; Epidemiologic Methods; Investigative Techniques; Health Care Evaluation Mechanisms; Quality of Health Care; Health Care Quality, Access, and Evaluation; Public Health; Environment and Public Health

Study Officials

• Sharlene A Greenwood, PhD, BSc

  King's College Hospital NHS Trust

  STUDY CHAIR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: August 8, 2018
• First Posted: October 17, 2018
• Study Start: May 31, 2018
• Primary Completion: December 30, 2019
• Study Completion: December 30, 2019
• Last Updated: February 27, 2020

Record last verified: 2018-10

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP
• Time Frame: within 12 months of study completion
• Access Criteria: with open access publication

Locations

GB (1)