Understanding physical activity among individuals receiving opioid substitution treatment - a mixed methods study
This thesis explores the physical activity (PA) practices and experiences of a group of drug users receiving opioid substitution treatment (OST). Opioid Substitution treatment is the most widely used form of treatment for individuals with opioid dependence. Existing research in this group (and drug users in general) has tended to focus on harmful behaviours, as opposed to their everyday lives. Additionally, a recent shift in UK drugs policy has places an increased emphasis on the wider aspects of recovery from drug use, including the improvement of health, well-being and re- integration into society. Despite the numerous benefits associated with PA, little research has explored PA among individuals receiving OST. The use of a social-ecological approach to guide and understand the research findings was utilized, with both quantitative and qualitative data collected. Self- reported quantitative data was first collected on demographic information, PA participation, perceived benefits and barriers to PA and health-related quality of life from 100 participants. Objective PA data was also collected from a smaller sub- sample of participants through the use of pedometers. Secondly, semi-structured interviews were conducted with 30 participants, to gain further understanding of PA in this group, with the qualitative data analyzed using the Framework approach. Both quantitative and qualitative findings indicate that much of this population is physically active, largely through walking as a form of active transport, with participant in structured sport and exercise occurring less frequently. However, nearly all participants reported previous participation in structured PA prior to drug use and an a desire to resume participation. The benefits of PA participation were unanimously recognized, with perceived barriers to participation highlighted at multiple levels of influence in line with the social-ecological approach used to theoretically underpin the study. While many individuals receiving OST appear to be physically active through unstructured PA, increased participation in structured PA is often desired, yet prohibited through the presence of multiple barriers, some similar to the general population and others specific to this group. Participation in structured PA may yield additional benefits beyond those gained from unstructured activity, contributing to the wider aspects of individuals’ recovery from opioid dependence in line with current UK policy. However, strategies to increase participation may need to consider the multiple needs of this group in addressing barriers to participation.
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