Qualitative Analysis of Physical Activity Engagement in Women with Self-Reported SLE: The Role of Symptoms, Healthcare Providers, and the Environment.

Abstract

Physical activity is a promising modifiable behavior for systemic lupus erythematosus (SLE) symptom management. Yet, most patients do not achieve recommended physical activity levels. Social risk factors are known to influence physical activity levels in the general population, but their effects on individuals with complex autoimmune conditions like SLE are not fully understood. This study aimed to describe how individuals with self-reported SLE navigate physical activity, with particular attention to the influence of healthcare provider relationships and the built environment. We conducted semi-structured interviews among adults with self-reported SLE. We analyzed de-identified transcripts using interpretive phenomenological analysis and developed themes to reflect how participants make sense of the relationship between SLE and social risk factors and managed this interplay in relation to physical activity. Our sample consisted of 31 individuals with self-reported SLE (100% female, age range = 24-65 years). Participants described how factors related to SLE management, encounters with healthcare providers, and the social and built environment impact physical activity engagement. Our analysis identified three main themes: 1) The challenges of SLE management in maintaining an active and social lifestyle; 2) Underutilized position of power: Healthcare provider influence on physical activity engagement; and 3) SLE amplifies the challenges of navigating the built environment. Our findings highlight the impact of individual context and social risk factors on physical activity in SLE. Future work is needed to determine whether improvements in healthcare guidance and collaborative community planning can address gaps in promoting physical activity among individuals with SLE.