Improving physical activity, sedentary behaviour and sleep in COPD: Perspectives of people with COPD and experts via a Delphi approach

Hayley Lewthwaite, Tanja W. Effing, Anke Lenferink, Tim Olds, Marie T. Williams

Research output: Contribution to journalArticlepeer-review

18 Citations (Scopus)
25 Downloads (Pure)


Background. Little is known about how to achieve enduring improvements in physical activity (PA), sedentary behaviour (SB) and sleep for people with chronic obstructive pulmonary disease (COPD). This study aimed to: (1) identify what people with COPD from South Australia and the Netherlands, and experts from COPD- and non-COPD- specific backgrounds considered important to improve behaviours; and (2) identify areas of dissonance between these different participant groups. Methods. A four-round Delphi study was conducted, analysed separately for each group. Free-text responses (Round 1) were collated into items within themes and rated for importance on a 9-point Likert scale (Rounds 2-3). Items meeting a priori criteria from each group were retained for rating by all groups in Round 4. Items and themes achieving a median Likert score of ≥ 7 and an interquartile range of ≤ 2 across all groups at Round 4 were judged important. Analysis of variance with Tukey's post-hoc tested for statistical differences between groups for importance ratings. Results. Seventy-three participants consented to participate in this study, of which 62 (85%) completed Round 4. In Round 4, 81 items (PA nD54; SB nD24; sleep nD3) and 18 themes (PA n D 9; SB n D 7; sleep n D 2) were considered important across all groups concerning: (1) symptom/disease management, (2) targeting behavioural factors, and (3) less commonly, adapting the social/physical environments. There were few areas of dissonance between groups. Conclusion. Our Delphi participants considered a multifactorial approach to be important to improve PA, SB and sleep. Recognising and addressing factors considered important to recipients and providers of health care may provide a basis for developing behaviour-specific interventions leading to long-term behaviour change in people with COPD.
Original languageEnglish
Article numbere4604
Number of pages24
Publication statusPublished - 27 Apr 2018

Bibliographical note

© 2018 Lewthwaite et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: (the “License”), which permits unrestricted use, distribution, reproduction and adaptation in any medium and for any purpose provided that it is properly attributed. For attribution, the original author(s), title, publication source (PeerJ) and either DOI or URL of the article must be cited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.


  • Behaviour change
  • Chronic obstructive pulmonary disease
  • Disease management
  • Habitual behaviours
  • Health behaviour
  • Patient preference


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