Challenges and opportunities for promoting physical activity in health care: a qualitative enquiry of stakeholder perspectives

Abstract

Evidence suggests that physical activity (PA) programmes promoted via healthcare settings worldwide may not currently meet the needs of many patients and healthcare professionals (HCPs). This paper describes the outcomes of a qualitative enquiry into the perspectives of patients and professionals from multiple healthcare services regarding the role of PA. 19 patients and 22 HCPs were purposively recruited from physiotherapy, podiatry, chronic pain, diabetes and continence services at a community-based healthcare clinic in the United Kingdom. Participants' views were explored using semi-structured interviews and analysed using thematic analysis. Results identified five themes: differences between the social and medical rationales underpinning PA promotion; the impact of the patient-professional relationship on patient activation, self-management and PA; a risk culture surrounding PA; challenges to meet variation in patients' needs and preferences; and lack of formal role for PA as a core part of routine healthcare. The study highlights tensions between needs and aspirations, and the reality of delivering advice and support for PA. Challenges resonated with patients and HCPs across different care groups and were not condition-specific. This highlights a need for sharing good practice across healthcare services and system-level interventions to address organisational barriers to the promotion of PA.

Physical Activity Promotion: A Systematic Review of The Perceptions of Healthcare Professionals

“…Appendix B provides legends for all the tables in the paper. Twelve (12) of the 34 studies in this review, explored the perceptions of HCPs practising in Europe [53,[63][64][65][66][67][68][69][70][71][72][73], 10 were conducted in Australia and New Zealand [31,51,69,[74][75][76][77][78][79][80], five each from the UK [52,[81][82][83][84] and USA [85][86][87][88][89], two from Africa [75,90], and one from India [91]. The study designs were varied with 20 of the 34 included studies employing a cross sectional design [31,[65][66][67][68][70][71][72][73][74]76,79,…”

“…Across the 34 included studies, 20 explored the perceptions of a homogenous group of HCPs [51,64,[67][68][69][70]72,[74][75][76][77][78][79]81,83,84,[87][88][89][90] including seven physiotherapists studies [64,69,75,76,83,84,90], five GPs studies [51,67,68,77,78], three physician studies [69,72,89] and one each for psychologists [74], nurses [87], sport medicine physicians [88], physical therapists [79], and healthcare assistants [81]. The other 14 studies explored the perceptions of heterogenous groups of HCPs [30,51,52,63,65,66,71,73,…”

“…The other 14 studies explored the perceptions of heterogenous groups of HCPs [30,51,52,63,65,66,71,73,80,82,85,86,91,92]. The HCPs included in these heterogeneous groups included nurses [31,52,53,63,65,66,71,80,82,85,86,92], GPs [52,53,63,65,73,85,91], physicians [53,65,82,86,91], physiotherapists [63,71,73,80,92], dietitians [80,82,92], surgeons [63,80,86], oncologist [31,…”

Working with local people as part of a whole-systems approach to physical activity: reflections from local delivery pilots

“…3,5 commitment to WwLP, for example, through co-production, can address power imbalances for designing and delivering impact 6 and is central to effective health promotion. 7 While user engagement in design of Pa interventions is becoming more common, 8 to date these interventions have not resided within a WSa. this article aims to provide reflections from researchers embedded within two LDPs, calderdale (active calderdale) and Greater Manchester (GM Local Pilot), around efforts to WwLP as part of a WSa to enable active lives.…”

Connecting primary care patients to community-based physical activity: a qualitative study of health professional and patient views

“…Current evidence suggests that barriers for primary care PA promotion by HPs includes: lack of time and incentive, 18 lack of expertise, medico-legal concerns, 19 and lack of role and responsibility. 19 , 20 Furthermore, the evidence for the use and implementation of SP is inconsistent 21 and of limited quality. 22 There remains an evidence gap regarding the processes for delivering SP, 23 which have been described as: signposting, direct referral, or referral to an intermediary.…”