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

Abstract

Despite strategies to enable Health Care Professionals (HCPs) to give physical activity (PA) advice to patients, this appears to be rarely done in consultations. The aims of the present study were to gain an understanding of doctors’ awareness of current PA guidelines and to explore their opinions on barriers and solutions. A qualitative approach using semi-structured interviews was adopted. This study included 15 doctors currently working in the UK’s National Health Service (NHS). A thematic analysis approach was used to analyse the transcripts. Four themes and twelve sub-themes were deciphered. Intrinsic factors limiting the delivery of PA advice included a lack of knowledge of PA guidelines and PA being an afterthought. Barriers to delivering PA guidance included a lack of PA education, time pressures, and patient engagement. Solutions included staff training, incorporating PA into undergraduate training, and encouraging staff to be physically active. Methods to optimise PA guidance included individualised PA advice, local exercise services and schemes, utilising online and visual resources, and motivational interviewing. This study provides an updated insight into doctors’ opinions on barriers and solutions to discussing PA with patients. It is clear that further work is needed to ensure greater awareness of PA guidelines amongst clinicians.

UK physiotherapists delivering physical activity advice: what are the challenges and possible solutions? A qualitative study

“…Awareness of the CMO PA guidelines was also recently reported to be limited in a qualitative study of 15 general practitioners (GPs) by Vishnubala et al . 22 Another larger study in 2016 of 1013 GPs found that 30% had never heard of the CMO PA guidelines and a further 50% had heard of them but were very unfamiliar. 27 Arguably, the lack of awareness of the CMO PA guidelines could be a result of HCPs using alternative PA guidelines, with some participants in this study reporting using the WHO guidelines.…”

“…Interviews adopted a semistructured design, which is a common method in healthcare research, 20 to encourage open-ended responses that could be elaborated on with probing for the limited responses, which explores participants’ thoughts and beliefs. 21 The interview guide was created by Vishnubala et al 22 and adapted to make questions specific to physiotherapists (see online supplemental file ). The guide included 30 interview questions, split into 5 sections: (1) demographics, (2) PA knowledge and education, (3) resources and interventions, (4) COVID-19 and (5) other, providing an opportunity for the participants to express any other thoughts or ideas that emerged during the interview.…”

“…Not all data collected from the interview questions were analysed as they addressed aspects beyond the aims of this paper. 22 All interviews were conducted through the Zoom meeting platform by the lead researcher AS. DV provided training to AS and a mock interview was performed to practice and refine the interview technique and reduce any researcher influence emerging in the delivery of the interview questions.…”

Movement Foundations. The perceived impact of a digital rehabilitation tool for returning to fitness following a period of illness, including COVID-19 infection: a qualitative study

“… 22 Moreover, practitioners point towards the need for more individualised approaches for PA guidance that use resources effectively. 21 Interventions to increase knowledge on how and why to engage in PA may not be enough.…”

“…This refers to the behaviour change framework of capability (skills and capacity for movement), opportunity and motivation (opportunities, motivations and barriers for movement) 20 ; with additional aspects of guidance, structure and permission not to push oneself too hard (a personalised, safe space in which to develop), that participants felt enabled a protective and beneficial effect. 21 and a small effect that likely wanes over time. 22 Moreover, practitioners point towards the need for more individualised approaches for PA guidance that use resources effectively.…”