Experiences with health behavior change and perceived needs for digital support in adults with hip and knee osteoarthritis: a qualitative study

Abstract Background Hip and knee osteoarthritis (OA) are increasingly prevalent among older adults and often impair daily functioning. Current OA treatment guidelines emphasize the importance of self-management, particularly through improving physical activity, weight management, and sleep. Although these behaviors are essential for effective OA management, many individuals experience barriers to adopting and maintaining them. To help patients overcome these challenges, support needs to be tailored to their individual needs. Digital interventions offer the potential to deliver personalized support if informed by users’ experiences and needs. Therefore, this study examines the experiences and perceived needs of individuals with OA regarding behavior change in physical activity, weight management, and sleep supported by a digital intervention. Methods Semi-structured interviews were conducted with 20 Dutch adults diagnosed with hip and/or knee OA. The interviews focused on participants’ experiences with changing physical activity, weight management, and sleep, including perceived barriers and facilitators, as well as desired support needs. Visual probes were used to elicit concrete reactions to potential digital support components. Data were analyzed using a thematic analysis approach, combining inductive coding and theme development with a deductive framework structured by behavioral domains (physical activity, weight management, and sleep) and the dimensions of facilitators, barriers, and support needs. Results Pain and other OA-related symptoms were the most prominent barriers to engaging in physical activity and adequate sleeping. Weight management was primarily hindered by psychological and environmental factors. Facilitators for behavior change were categorized into symptom management, motivational drivers, psychological reinforcement, and behavioral strategies. Support needs were discussed less extensively, resulting in relatively few practical suggestions. Nevertheless, across all behaviors, there was a desire for personalized guidance and support in planning, monitoring and feedback, cues to action, and tailored education for behavior change. Conclusions This study enhances the understanding of the barriers and facilitators experienced by individuals with hip and/or knee OA in managing physical activity, weight management, and sleep. It also provides insight into broad categories of support preference regarding behavior change support. These findings can help inform the development of more adaptive and personalized digital interventions to enhance self-management among people with OA.