DISCUSSION
MSK, arthritis, pain
ARTHRITIS
Our findings from this study suggest that the culturally adapted WWE programme is acceptable and relevant to a UK population. Recruiting physically inactive adults with arthritis and MSK conditions through general practice was successful. Once enrolled, the majority of participants engaged with and successfully completed the programme, even maintaining their physical activity levels after the programme had concluded. Participants reported high levels of satisfaction with WWE overall and stated they would recommend it to family or friends. The findings provide a signal that this intervention is effective and is feasible to implement community-wide within the UK. A majority of the measures show improvement over six weeks, with this improvement being maintained to some extent at 18 weeks, for example, pain symptoms, HRQOL (EQ-5D-5L) and life satisfaction. A larger sample size would be needed to assess whether different mode of delivery have differential effects.Various issues with and challenges to culturally adapting evidence-based interventions have previously been described in the literature [Despite the positive feedback, findings from the qualitative interviews with participants and key stakeholders indicated scope for developing additional supplementary WWE-UK materials. We received feedback about enhancing the accessibility of WWE-UK for individuals with lower levels of literacy, poorer eyesight, and for whom holding a book may cause difficulties due to their arthritis/MSK condition. Illiteracy has been demonstrated to be independently associated with poorer health in the general population [Previous research has highlighted that there are disparities in the types of individuals who volunteer to take part in research, as well as community-based health programmes such as WWE [