Physical activity promotion by GPs: a cross-sectional survey in England

Abstract

BackgroundPhysical activity (PA) contributes to the prevention and management of many health conditions. Primary care practitioners have an important role to play in supporting people to be physically active.AimThe study had three aims; 1) to explore general practitioners’ (GPs) awareness, and knowledge of the PA guidelines, 2) to assess their confidence in promoting PA, and 3) to explore factors that influence PA promotion amongst GPs.Design & settingCross-sectional survey, secondary analysis.MethodUK-based GPs were invited to take part in an online survey in January 2021. Demographic questions were followed by nine multiple choice questions. Categorical data were analysed using descriptive statistics and open-ended data were analysed using content analysis and inductive coding.Results:Eight hundred and nine GPs based in England completed the survey. Most GP respondents (99%) believed that PA is important yet only 36% reported being at least ‘somewhat familiar’ with current PA guidance. Despite this, 74% of GPs reported feeling confident to raise the topic of PA with their patients. Barriers included lack of time, perceptions of patient attitude and perception of risk, language issues and COVID-19. Key facilitators were identified and ‘Couch to 5 k’ and the ‘parkrun practice’ initiative were the most widely used support tools.ConclusionGPs value PA yet well-known barriers exist in embedding promotion into primary care. As primary care reconfigures there is an opportunity to embed PA into systems, services and processes.

UK Doctors Delivering Physical Activity Advice: What Are the Challenges and Possible Solutions? A Qualitative Study

“…Improving inactivity levels in society is a complex and multifactorial issue, demonstrated well by the fact that limited solutions have been developed to combat the rise in physical inactivity despite extensive evidence of the benefits of being active for health and quality of life. The findings of this study are in line with previous papers highlighting the lack of knowledge and confidence of HCPs in giving PA to patients [10,[20][21][22]. Indeed, 10% of junior doctors felt they had been adequately trained in PA [23].…”

“…A similar finding of lack of priority to PA advice during consultations was found amongst physiotherapists [22]. Interestingly, one study found that 98.9% of GPs believe that PA is important for health [10]. Therefore, while the benefits are well acknowledged by doctors, it continues to not be thought of as a priority during consultations.…”

“…One interviewee stated: 'I think having that motivational interviewing approach to the consultation has helped, I think bearing in mind physical activity when talking about different chronic or acute health conditions has helped, again, patient-led' (7). Another interviewee commented on how they have personally found motivational interviewing to be effective: 'I usually use now some motivational interviewing approach, starting with assessing via open questions, what they do at the moment, what they know about the possible benefits of exercise, whether they've contemplated-where they are on the state of change sequence from that point of view' (10).…”

“…There have been schemes to engage HCPs in discussing PA with patients, such as Make Every Contact Count (MECC), which aims to improve confident discussions of PA with patients through HCP training [9]. Despite this, a recent study of 839 UK-based GPs found that only 36% were "somewhat familiar" with the PA guidelines [10].…”

The 5 K run in popular fiction: Reading about parkrun and couch to 5 K

“…But further to this, recent research suggests that these are the two most widely recognised tools for helping people into the world of running. In a 2021 survey exploring general practitioners' awareness of physical activity promotion, it was found that “‘Couch to 5 K’ and the ‘parkrun practice’ initiative were the most widely known and used” physical activity promotion tools ( 12 ). When combined, parkrun and Couch to 5 K have a significant market share when it comes to beginner running initiatives and the impact and influence that they have had is reflected in their representation in popular fiction.…”