Bringing the Walk with Ease Programme to the UK: a mixed-methods study to assess the relevance, acceptability, and feasibility of implementation for people with arthritis and musculoskeletal conditions.

Kathryn R Martin, Kevin Stelfox, Gary J Macfarlane, Paul McNamee, Zoe Morrison, Toby O Smith

Journal: Translational behavioral medicine 2023;13(11):851-866

PMID: 37318354

Free Full Text on PubMed Central View on PubMed

Plain Language Summary

Physical inactivity is highly prevalent in populations with arthritis and musculoskeletal conditions. Individuals with osteoarthritis, rheumatoid arthritis, and chronic pain are less active compared to those without. The primary aim was to evaluate the relevance, acceptability, and feasibility of implementing the WWE [The Arthritis Foundation’s Walk With Ease (WWE) is a 6-week, community-based, walking programme developed in the USA] programme in the UK for individuals with arthritis and musculoskeletal conditions. This study was a mixed-methods study involving both quantitative and qualitative approaches. Participants were randomised into two groups: one following the WWE programme and the other receiving usual care. Results showed that: - the WWE programme was found to be highly relevant and acceptable, with 99% of participants indicating they would recommend it to others. - participants in the WWE programme showed improvements in physical performance and arthritis symptoms over the six-week period. Authors concluded that the WWE programme is a relevant and acceptable intervention for people with arthritis and musculoskeletal conditions in the UK. Thus, it is a programme that can be widely implemented to support health and well-being policies.

Abstract

Developed in the United States (US), Walk With Ease (WWE) is a popular evidence-based, 6-week community walking programme for adults with arthritis, delivered in either an instructor-led or self-directed format. While WWE has expanded into communities across the USA, it is relatively unknown in other countries across the globe. This study, in collaboration with community and patient partners, aimed to examine the relevance, acceptability and feasibility of introducing WWE into a UK context. After initial cultural adaptation, participants were recruited into the study. Eligible (≥18 years, doctor diagnosed arthritis (confirmed or self-report), self-reported joint symptoms in last 30 days, BMI ≥25 kg/m2, and <150 min/week of moderate/vigorous PA) and consented participants were randomized into two groups: WWE programme or usual care. A mixed-methods analysis approach integrated quantitative data (physical performance assessment; baseline and post-six week programme questionnaire) and qualitative data (narrative interviews exploring participants' pre- and post-WWE experiences and stakeholders' perceptions). Of 149 participants, the majority were women (70%) aged ≥60 years (76%). Among the 97 receiving the programme, 52 chose instructor-led; 45 chose self-directed. Participants found WWE relevant and acceptable-99% indicating they would recommend WWE to family/friends. Within both WWE formats, mixed differences representing improvement were observed at 6 weeks from baseline for physical performance and arthritis symptoms. Emergent themes included improved motivation, health, and social well-being. WWE is a relevant and acceptable walking programme with scope for wider implementation to support UK health and well-being policy strategies.

Address: Academic Primary Care, Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, UK.; Aberdeen Centre for Arthritis and Musculoskeletal Health (Epidemiology Group), School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, UK.; Health Economics Research Unit, Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, UK.; Aberdeen Business School, Robert Gordon University, Aberdeen, AB10 7QE, UK.; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford OX3 7LD, UK.; School of Health Sciences, University of East Anglia, Norwich, NR4 7TJ, UK.

DOI: 10.1093/tbm/ibad032