0339 A phenomenological study on facilitators and barriers of Zero-time exercise in physically inactive adults with insomnia disorder

Abstract Introduction Zero-time Exercise (ZTEx), a lifestyle-integrated exercise, might have beneficial effects on relieving insomnia. Exercise adherence is a key component for the success of exercise therapy. This study is to explore facilitators and barriers of Zero-time exercise adherence and the improvement in sleep quality in physically inactive adults with insomnia disorder. Methods The qualitative study used ten 1-hour focus group interviews (5 groups at immediately after training program, and groups at the end of 24-week study period) on improving sleep quality of 35 physically inactive adults with insomnia disorder who had enrolled in our previous randomized controlled trial, from Oct 2019 to Mar 2022. A framework approach with a semi-structured interview guide was used to reflect subjects' facilitators and barriers of adherence to Zero-time exercise. Different strategies were used to ensure the credibility, dependability, confirmability, and transferability of the study. Transcripts were analyzed using qualitative thematic content analysis. The interviews were audio-recorded and transcribed verbatim. In addition, the contents of each group were summarized into generalized descriptions using NVivo 11.0. Results 35 physically inactive adults with insomnia disorder (female: 58.7%, mean age: 47.2 years). Four themes were identified: (1) perceived benefits or changes (e.g. perceived better sleep quality; perceived improved physical health and more energetic, and positive lifestyle changing), (2) facilitators to intervention delivery (e.g. the understanding of benefits of doing exercises and risks of not doing exercise, expectations of participants, monitoring and reminders provided in the study, and belief and responsibility of participation), (3) barriers to intervention delivery (e.g. difficulties in integrating exercises into daily live, physical health challenges faced by participants, limited improvement, and lack of support from people around) and (4) suggestions from participants (e.g. modifying the content of ZTEx to be more interesting; and providing more easily accessible exercise video). Conclusion Participants perceived benefits from the ZTEx intervention besides improving sleep quality. Participants’ compliance could be further enhanced if more assistance in helping them to integrate exercise into daily life. Social and familial support was also essential for their adherence. Support (if any) The study was supported by the Research Grants Council, General Research Fund, Hong Kong SAR (Project no.: 15100419)