Physical activity attitudes and preferences of adults with opioid use disorder receiving methadone maintenance treatment : a mixed methods study

The prevalence of opioid use disorder (OUD) has grown exponentially, contributing to a significant increase in overdose deaths, and a public health crisis. Methadone maintenance treatment (MMT) is an effective treatment for OUD; yet, retention in MMT and relapse rates are still high. Physical activity (PA) has been shown to improve treatment retention and relapse rates among those with substance use disorders, however little research has examined PA interventions among those in MMT. Therefore, this dissertation study, guided by the Health Promotion Model, explored PA attitudes (i.e., perceived benefits, perceived barriers, self-efficacy, and PA enjoyment), and PA preferences (i.e., type, structure, and delivery) of adults with OUD in MMT. A mixed-methods designed was used to examine PA attitudes and preferences, level of PA, and experiences with and perceptions of PA. Adults (N=100) with OUD accessing MMT clinics in central Texas were recruited to complete a battery of standardized instruments assessing primary study variables; twenty participants participated in one-on-one interviews. Thematic content analysis was used to explore experiences with PA. On average, participants were 37.5 years old (SD= 9.2). A majority were male (55%) and white (75%). Those with higher levels of self-efficacy had fewer recovery attempts (p = .004), and methadone dose was inversely associated with PA level (p=0.03); significant effects were identified between current pain and psych symptoms on interest in discussing or participating in a PA intervention and between gender and PA preferences for interest, supervision, length of engagement, and type of PA. Qualitative data found primary issues to PA engagement are due to population specific barriers. Specifically, significant issues with the side effects of MMT (e.g., fatigue, sweating) and motivation were unique barriers to engaging in PA. Study findings suggest assessing motivation toward PA and increasing PA motivation through motivational interviewing may be fruitful areas of future research for those in MMT. Finally, continuing to utilize mixed-method approaches appears to hold great value and provides meaningful insight that may have been lost with a purely quantitative approach. Incorporating qualitative methods to assess preferences of unique populations or interventions with adherence issues is encouraged in future research.