Understanding physical activity adherence in vulnerable adults with type 2 diabetes in the rural Brazilian Amazon

INTRODUCTION: Adopting healthy behaviors is challenging in any context, especially related to physical activity in individuals with chronic conditions. In socially vulnerable settings, challenges are even greater. This study aimed to understand the barriers and facilitators to physical activity adherence in a vulnerable population with type 2 diabetes mellitus in the Brazilian Amazon setting. METHODS: We conducted an exploratory qualitative study using a phenomenological approach. We used semi-structured interviews with participants with type 2 diabetes and the World Café group technique with community health workers. The meetings were recorded. In the organization and processing of the data, the recordings of the semi-structured interviews, the content of the tablecloths, and the videos were transcribed using the Reshape website, coded, and organized using the ATLAS.ti24 software. We used thematic analysis to identify the main facilitators and barriers. The ecological model was employed to guide data collection, analysis, and message development. RESULTS: The main barriers identified were physical limitations, financial difficulties, lack of knowledge, lack of trained and qualified professionals, distance from physical activity locations, and lack of motivation. The major facilitators included an appropriate location within the coverage area of the primary healthcare units, professional guidance, trained and qualified professionals, personal motivation, family support, and adequate financial conditions. CONCLUSION: Environmental factors, personal motivation, and qualified professional guidance were crucial for adherence to physical activity. Our findings underscore the need for public policies and health interventions tailored to vulnerable populations.