Evidence map›Paper›PMID 42130000›Full record

ArticleBMJ open2026

Gender-related facilitators and barriers in implementing combined lifestyle interventions for individuals with knee osteoarthritis and overweight or obesity: perspectives of healthcare professionals and patients in a qualitative study.

Chantal M Hulshof, Nuria Ej Jansen, Priya Gharbaran, Dieuwke Schiphof, Pauwke Pl Berkers, Marienke van Middelkoop

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Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Chantal M HulshofDepartment of General Practice, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands c.m.hulshof@erasmusmc.nl.ORCID http://orcid.org/0000-0001-7941-2320
Nuria Ej JansenDepartment of General Practice, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands.
Priya GharbaranDepartment of General Practice, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands.ORCID http://orcid.org/0009-0006-8720-3290
Dieuwke SchiphofDepartment of General Practice, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands.ORCID http://orcid.org/0000-0002-1293-6346
Pauwke Pl BerkersDepartment of Arts and Culture Studies, Erasmus University Rotterdam, Rotterdam, Netherlands.
Marienke van MiddelkoopDepartment of General Practice, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesWeight loss through combined lifestyle interventions (CLIs) can slow down knee osteoarthritis (OA) progression. However, gender-related factors may influence both the implementation of and participation in CLIs. Therefore, the aims were to identify gender-related facilitators and barriers to CLI implementation among healthcare professionals (HCPs) and uptake and adherence among individuals with early-stage knee OA and overweight or obesity.

designSemi-structured interviews were conducted in this qualitative study. Thematic analysis, combining inductive and deductive approaches, was performed according to the Consolidated Framework for Implementation Research (CFIR) domains.

settingHCPs and individuals with knee OA and overweight or obesity were interviewed in Dutch between December 2023 and May 2024.

participants16 HCPs who referred or delivered a CLI and 23 individuals with knee OA and overweight or obesity who participated in a CLI were purposively recruited. 16 participants identified themselves as women and 7 as men; no other gender identities were reported.

resultsHCPs experienced resistance to CLIs of both men and women. Additionally, HCPs perceived that women were more open and available to participate in CLIs, tended to prioritise others over themselves and often lacked familial support compared with men. Women valued trust, preferred female HCPs and struggled with self-prioritisation. Men were motivated by female HCPs and participants due to their empathy and interaction. Across men and women, barriers included conflicting HCP advice, work stress, caregiving tasks and lack of discipline, while social environment support was a key facilitator.

conclusionsAddressing gender-related facilitators and barriers in the design and implementation of the CLI may improve long-term engagement and efficacy in individuals with knee OA and overweight or obesity. TRIAL REGISTRATION NUMBER: Overview of Medical Research in the Netherlands (OMON), managed by the CCMO: NL75367.078.20.

Indexed as

ObesityOsteoarthritis, KneeOverweightWeight Reduction ProgramsAdultAgedAttitude of Health PersonnelFemaleHealth PersonnelHumansLife StyleMaleMiddle AgedNetherlandsQualitative ResearchSex FactorsGeneral PracticeOverweightPrimary Health CareQUALITATIVE RESEARCH

Identifiers

PMID42130000
PMCPMC13182479

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.