Perceived barriers and enablers to physical activity participation in people with Alopecia Areata: a constructivist grou
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RESEARCH ARTICLE
Perceived barriers and enablers to physical activity participation in people with Alopecia Areata: a constructivist grounded theory study Yamuna Rajoo1* , J. Wong2, I. S. Raj1 and G. A. Kennedy1,3,4
Abstract Background: Alopecia Areata (AA) is an autoimmune disease that is characterised by hair loss. Individuals diagnosed with it often describe feelings of trauma and social rejection due to cosmetic repercussions and are at high risk of experiencing psychological distress. Physical activity (PA) participation has been associated with better mental health outcomes in diverse populations. A preliminary study of individuals with AA indicated that severe hair loss is associated with symptomatic depression, anxiety and stress, which negatively impacted PA participation. While strategies to increase PA participation in the general population have been established, little is known about PA participation in people with AA. This study aimed to understand barriers and enablers to PA participation in people with AA to inform the development of evidence-based interventions. Methods: The study used a grounded theory (GT) methodology, relying on an iterative and simultaneous process of data collection, coding, theory development, and data comparisons to explore the perceived barriers and enablers to PA. Data were collected through a focus group (8 participants [33.38 ± 10.81 years]) and individual telephone interviews (8 participants [33.89 ± 11.87 years]). The study was conducted in Melbourne, Australia. Interview data were recorded digitally, transcribed verbatim and analysed. Recruitment continued until theoretical saturation was achieved. Results: The constructivist grounded theory method used has assisted to develop an explanatory model which is used to explain the themes for barriers and enablers to PA participation. The four phases in the explanatory model are as follows (1) onset of AA; (2) reaction towards the condition; (3) adjustment; and (4) acceptance. Conclusion: The findings highlighted perceived barriers and enablers to PA participation in people with AA. Future interventions could consider addressing these barriers specifically to maximise effectiveness and to improve mental health status based on the phases of the explanatory model. Keywords: Physical activity, Alopecia areata, Body image, Mental health, Anxiety, Depression, Stress, Constructivist grounded theory, Adjustment and acceptance
*Correspondence: [email protected] 1 School of Health and Biomedical Science, RMIT University, Bundoora Campus, Bundoora, Melbourne, VIC 3083, Australia Full list of author information is available at the end of the article
Introduction Alopecia Areata (AA) is an autoimmune-mediated disease that causes non-scarring hair loss with a prevalence of 0.1–0.2% and lifetime incidence of 2.1% [1]. The scalp is most commonly involved in clinically treated AA, but any hair-bearing surface of the body may be affected [2]. Hair loss ranges from patchy hair loss (AA), hair loss involving the e
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