Global Policy Barriers and Enablers to Exercise and Physical Activity in Kidney Care
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- Global Policy Barriers and Enablers to Exercise and Physical Activity in Kidney Care
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Objective: Impairment in physical function and physical performance leads to decreased independence and health-related quality of life in people living with chronic kidney disease and end-stage kidney disease. Physical activity and exercise in kidney care are not priorities in policy development. We aimed to identify global policy-related enablers, barriers, and strategies to increase exercise participation and physical activity behavior for people living with kidney disease. Design and Methods: Guided by the Behavior Change Wheel theoretical framework, 50 global renal exercise experts developed policy barriers and enablers to exercise program implementation and physical activity promotion in kidney care. The consensus process consisted of developing themes from renal experts from North America, South America, Continental Europe, United Kingdom, Asia, and Oceania. Strategies to address enablers and barriers were identified by the group, and consensus was achieved. Results: We found that policies addressing funding, service provision, legislation, regulations, guidelines, the environment, communication, and marketing are required to support people with kidney disease to be physically active, participate in exercise, and improve health-related quality of life. We provide a global perspective and highlight Japanese, Canadian, and other regional examples where policies have been developed to increase renal physical activity and rehabilitation. We present recommendations targeting multiple stakeholders including nephrologists, nurses, allied health clinicians, organizations providing renal care and education, and renal program funders. Conclusions: We strongly recommend the nephrology community and people living with kidney disease take action to change policy now, rather than idly waiting for indisputable clinical trial evidence that increasing physical activity, strength, fitness, and function improves the lives of people living with kidney disease.
Originalsprog | Engelsk |
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Tidsskrift | Journal of Renal Nutrition |
Vol/bind | 32 |
Udgave nummer | 4 |
Sider (fra-til) | 441-449 |
ISSN | 1051-2276 |
DOI | |
Status | Udgivet - 2022 |
Bibliografisk note
Funding Information:
Funding Disclosures: B.R. acknowledges funding from the National Institutes of Diabetes, Digestive and Kidney Diseases (K23 DK0099442 and R03 DK114502) and Dialysis Clinics Incorporated (C-4112). M.M.-D.'s work is supported by NIDDK R01DK114074. C.B. is supported by the Manitoba Medical Services Fund FW Duval Clinical Research Professorship. T.J.W., C.J.L., and A.C.S. gratefully acknowledge funding from the Stoneygate Trust, and their work is supported by the UK National Institute for Health Research Leicester Biomedical Research Centre (NIHR BRC). The views expressed are those of the author and not necessarily those of the National Health Service, NIHR BRC, or the Department of Health. J.L.V.'s work is supported by the Portuguese Foundation of Science and Technology (UID/04045/2020).
Publisher Copyright:
© 2021 National Kidney Foundation, Inc.
ID: 301361823