Original Research
Understanding physical activity adherence in vulnerable adults with type 2 diabetes in the rural Brazilian Amazon
AUTHORS
Tiago Assunção dos Santos Farias1
Thalyta Mariany Rêgo Lopes Ueno2,3 Professor
Wagner Ferreira Monteiro2,3 Professor
Camila Fabiana Rossi Squarcini4 Professor
Roseanne Gomes Autran1 Adjunct Professor
Hércules Lázaro LM Morais Campos1,5,6 Teacher and researcher 
Elisa Brosina De Leon1 Post Doctorate, Professor *
AFFILIATIONS
1 Programa de Pós-graduação em Ciências do Movimento Humano, Faculdade de Educação Física e Fisioterapia, Universidade Federal do Amazonas, Manaus, Brazil
2 Escola de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil
3 Programa de Pós-graduação em Enfermagem em Saúde Pública, Escola de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil
4 Programa de Pós-Graduação em Enfermagem, Universidade Estadual de Santa Cruz, Ilhéus, Brazil
5 Instituto de Saúde e Biotecnologia, Universidade Federal do Amazonas, Coari, Brazil
6 Programa de Pós-Graduação Interdisciplinar em Estudos Rurais, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
ACCEPTED: 20 January 2026
Early Abstract:
Introduction: Adopting healthy behaviors is challenging in any context, especially related to physical activity (PA) in individuals with chronic conditions. In socially vulnerable settings, challenges are even greater.
Objective: This study aimed to understand the barriers and facilitators to PA adherence in a vulnerable population with type 2 Diabetes Mellitus (T2DM) in the Brazilian Amazon setting.
Methods: We conducted an exploratory qualitative study using a phenomenological approach. We used semi-structured interviews with participants with type 2 diabetes and the World Café group technique with community health workers. The meetings were recorded. In the organization and processing of the data, the recordings of the semi-structured interviews, the content of the tablecloths, and the videos were transcribed using the Reshape© website, coded, and organized using the ATLAS.ti24 software. We used thematic analysis to identify the main facilitators and barriers. The Ecological Model was employed to guide data collection, analysis, and message development.
Results: The main barriers identified were physical limitations, financial difficulties, lack of knowledge, lack of trained and qualified professionals, distance from PA locations, and lack of motivation. The major facilitators included an appropriate location within the coverage area of the Primary Health Care units, professional guidance, trained and qualified professionals, personal motivation, family support, and adequate financial conditions.
Conclusion: Environmental factors, personal motivation, and qualified professional guidance were crucial for adherence to physical activity. Our findings underscore the need for public policies and health interventions tailored to vulnerable populations.
Keywords: attitudes, health knowledge, healthy lifestyle, physical activity, population, practice, vulnerable noncommunicable diseases.