Embedding Physical Activity in the Heart of the NHS: The Need for a Whole-System Approach

Speake, Helen; Copeland, Robert J.; Till, Simon; Breckon, Jeff; Haake, Steve; Hart, Oliver

doi:10.1007/s40279-016-0488-y

Cited by 35 publications

(51 citation statements)

References 42 publications

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“…However, despite these aspirations, it has been suggested that there is little evidence that PA is being comprehensively promoted in healthcare settings 15. The barriers to increasing health promotion and preventative care in healthcare settings are consistent across professional groups and include lack of time, perceived lack of knowledge, lack of confidence and lack of organisational support 16–18…”

Section: Introductionmentioning

confidence: 99%

Physical activity promotion in physiotherapy practice: a systematic scoping review of a decade of literature

et al. 2016

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Section: Introductionmentioning

confidence: 99%

Physical activity promotion in physiotherapy practice: a systematic scoping review of a decade of literature

et al. 2016

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“…HCP are considered desired, credible and well-placed messengers for the delivery of PA advice (11,17).…”

Section: Strategies To Optimize Pa Prescription Among Hcpmentioning

confidence: 99%

“…Among CF patients, regular physical activity (PA) has the potential to decrease the annual rate of decline in pulmonary function, improve airway clearance, reduce hospitalization frequency and improve longevity, while also improving aerobic capacity, muscle strength, bone health and enhancing health-related quality of life (9,10). The HCP plays an integral role in the promotion of PA behaviours among their patients (11). According to the American College of Sports Medicine Exercise is Medicine initiative, all HCP should incorporate discussions about PA and exercise into every patient interaction (12).…”

Section: Introductionmentioning

confidence: 99%

Recommendations to Improve Physical Activity Prescription for the Cystic Fibrosis Population: An Irish Perspective

Hurley

Furlong

McCaffrey³

et al. 2020

Preprint

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Background: Physical activity (PA) is a well-established therapeutic modality for the maintenance and improvement of long-term health in cystic fibrosis (CF). Health care professionals (HCP) play a significant role in the promotion of PA behaviours. Limited research exists investigating the extent of PA prescription within CF care. This study aimed to identify Irish HCP i) knowledge and practice of prescribing PA, ii) motivation and barriers of PA prescription; and iii) proposed strategies to optimize PA promotion and prescription in CF populations.Methods: 48 HCP (physiotherapists n=24, other n=24) from six CF centers in Ireland and members of the national physiotherapy clinical interest group completed a 30-item online survey. Results: Most HCP (81%) acknowledged that discussing PA with CF patients was part of their professional role. Almost all physiotherapists (95%) reported having sufficient knowledge regarding PA prescription, compared to 17% of other HCP. All physiotherapists reported discussing PA at every patient interaction, with 81% employing the current consensus guidelines, compared to 33% and 5% of other HCP, respectively. Among the most common barriers reported by HCP to prescribing PA to their CF patients were; lack of motivation and compliance among patients to adhere to PA advice, limited availability of PA programmes to refer their patients to, limited time with patients during clinic visits, lack of knowledge regarding PA prescription for CF care, and patients’ health status deeming PA inappropriate. Three-quarters of HCP reported a need to improve PA services for CF patients in Ireland.Conclusion: As people with CF are living longer, it is imperative that HCP are expanding their scope of practice to consistently include discussions around PA at every patient visit, as physical fitness has been shown to be a key predictor of longevity and quality of life in patients with CF. Formal educational opportunities in the form of continuing professional development programmes, with respect to PA prescription for CF populations, are warranted for CF HCP to optimize long-term patient management and outcomes. There is also a need to introduce or enhance motivational interviewing during patient interactions, to elicit positive PA behaviour change.

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“…There was also an over-representation of physiotherapists within the current study as a result of the survey invitation being sent to the National Physiotherapy CF Clinical Interest Group and not to other professional clinical interest groups. Also, as the nature the data is self-reported, there is a risk that social desirability bias may have occurred making the results more desirable and portraying a less realistic representation of current knowledge and practice 12,20 . Clinical exercise physiologists and exercise scientists were not included in this survey as the has not yet been recognized by the Health Service Executive in Ireland.…”

Section: Limitationsmentioning

confidence: 99%

Recommendations to Improve Physical Activity Prescription for the Cystic Fibrosis Population: An Irish Perspective

Hurley

Furlong

McCaffrey

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Physical activity (PA) is a well-established therapeutic modality for the maintenance and improvement of long-term health in cystic fibrosis (CF). Healthcare professionals (HCP) are considered credible and well-placed messengers for the delivery of PA advice. Limited research exists investigating the extent of PA prescription within CF care. This study aimed to identify Irish HCP i) knowledge and practice of, and ii) motivators and barriers to PA prescription, and iii) proposed strategies to optimize PA promotion and prescription in CF populations.Methods: HCP from six designated CF centres in Ireland and members of the national physiotherapy CF clinical interest group were invited to participate. Following an expression of interest, each HCP (n=81) received an email containing the plain language statement and link to the online survey. 48 HCP (physiotherapists n=24, other n=24) completed the 30-item investigator-developed survey, which included multiple choice single answer, matrix style and open-ended questions.Results: Most HCP (81%) acknowledged that discussing PA with CF patients was part of their professional role. Almost all physiotherapists (95%) reported having sufficient knowledge regarding PA prescription, compared to 17% of other HCP. All physiotherapists reported discussing PA at every patient interaction, with 81% employing the current consensus guidelines, compared to 33% and 5% of other HCP, respectively. Among the most common barriers reported by HCP to recommending PA to their CF patients were; lack of motivation and compliance among patients to adhere to PA advice, limited availability of PA programmes to refer their patients to, limited time with patients during clinic visits and a lack of knowledge regarding PA prescription for CF care. Three-quarters of HCP reported a need to improve PA services for CF patients in Ireland.Conclusion: As people with CF are living longer, it is imperative that HCP are expanding their scope of practice to include discussions around PA at every patient visit. Formal educational opportunities in the form of continuing professional development programmes are warranted for CF HCP to optimize long-term patient management and outcomes. There is also a need to develop patient-centered and evidence-based PA programmes underpinned by theories of behaviour change to enhance motivation and compliance among CF patients.

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Embedding Physical Activity in the Heart of the NHS: The Need for a Whole-System Approach

Cited by 35 publications

References 42 publications

Physical activity promotion in physiotherapy practice: a systematic scoping review of a decade of literature

Physical activity promotion in physiotherapy practice: a systematic scoping review of a decade of literature

Recommendations to Improve Physical Activity Prescription for the Cystic Fibrosis Population: An Irish Perspective

Recommendations to Improve Physical Activity Prescription for the Cystic Fibrosis Population: An Irish Perspective

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