Factors Facilitating Participation of Older Adults With Chronic Lung Disease in Community-Based, Peer-Support Exercise Programs: A Metasynthesis

Background & Aim: Community-based peer-support exercise programs are important for enhancing the quality of life for older people with chronic lung disease. Given the strong evidence base for these programs, it is important to have a strong understanding of the factors that facilitate participation and engagement from the perspective of participants. This study aimed to derive empirical evidence from qualitative studies on the facilitating factors supporting the participation of older people with chronic lung disease in community-based peer-support exercise programs. Methods: Five online databases (Scopus, Medline, CINAHL, PsychInfo, and Web of Science) were searched post-2012. Data were analysed using Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Studies were assessed for quality and data extracted. Results were synthesised using qualitative metasynthesis techniques. Results: A total of 12 studies met the inclusion criteria and were included in the review. Three themes were identified as facilitators that support the participation of older people with chronic lung disease in community exercise programs: 1. benefits of pulmonary rehabilitation, with subthemes of health benefits, psychosocial benefits, supportive safe environment, and sustained benefits; 2. barriers to pulmonary rehabilitation, with subthemes of access barriers and personal barriers; and 3. overcoming barriers and building resilience, with subthemes building knowledge and awareness and regaining independence. Conclusions: The review highlights that physical and psychosocial benefits of pulmonary rehabilitation community-based exercise programs for older people with chronic lung disease are facilitators for participation. Peer support in understanding the experiences of others can help increase engagement. There is a need to construct approaches that address the social determinants of health in overcoming barriers to participation in community peer-support exercise programs. A limitation is a risk of losing the nuances of contextual and theoretical aspects of individual studies.