Factors that Hinder Adherence to Physical Activity and a Healthy Diet among Palestinian Non-Communicable Disease Patients: A Qualitative Study

Abstract

Background: Non-communicable diseases (NCDs) tend to be long-term and are caused by genetic, physiological, environmental, and behavioral factors. Palestine is undergoing an epidemiological transition. It is estimated nearly two out of three elderly Palestinians suffer from NCDs. This study aimed to identify the barriers to practicing physical activity and eating a healthy diet among Palestinian non-communicable disease patients. Methods: This qualitative study was carried out from September 2020 to November 2020 among ten NCDs patients who received care in five governmental primary healthcare centers in the Gaza Strip. A semi-structured interview guide was developed and used to collect data based on the health belief model and the theory of planned behavior. Data analysis was performed using the thematic analysis method. The Consolidated Criteria for Reporting Qualitative research Checklist (COREQ) was used to report the data. Results: The data analysis led to the identification of two main categories, factors affecting the practice of PA, healthy diet, and barriers to adherence to healthy behaviors. The interviewees had a positive attitude towards healthy behaviors. The main barriers to PA practice were lack of accessibility to materials, lack of social support, and a lack of reminders. Also, factors as lack of accessibility to the materials, a lack of social support, and a lack of self-efficacy were the most common barriers to eating a healthy diet. Conclusion: NCD patients understand the importance and benefits of practicing healthy behaviors, but in the absence of basic infrastructure and a supportive community, their awareness may not translate into actions.