Boman Charlotte, Bernhardsson Susanne, Lauruschkus Katarina, Lundqvist Stefan, Melin Karin
Centre for Physical Activity, Region Västra Götaland, Gothenburg, Sweden.
Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Front Health Serv. 2023 Jan 30;2:1102328. doi: 10.3389/frhs.2022.1102328. eCollection 2022.
Physical inactivity is a main driver of childhood obesity that tracks into adulthood, making it crucial to address early in life. Swedish physical activity on prescription (PAP) is an effective intervention for increasing physical activity levels in adults and is being implemented in primary care in Sweden. Before implementing PAP for children, both intervention effectiveness and implementation prerequisites need to be examined. Framed by the Normalization Process Theory (NPT) domains, this study aimed to investigate perceptions of PAP amongst paediatric staff and managers working with children with obesity, as well as acceptability, appropriateness, feasibility, and barriers and facilitators for implementing PAP in paediatric health care.
Staff and managers in 28 paediatric outpatient clinics in western Sweden were surveyed using validated implementation instruments and open-ended questions. Data were analysed using Mann-Whitney U tests and Kruskal-Wallis tests. Qualitative data were categorised into NPT domains.
The survey response rate was 54% (125/229). Most respondents (82%) reported PAP to be familiar and many (56%) perceived it as a normal part of work; nurses and physiotherapists to a greater extent ( < 0.001). This was anticipated to increase in the future (82%), especially amongst those with the longest work experience ( = 0.012). Respondents reported seeing the potential value in their work with PAP (77%), being open to working in new ways to use PAP (94%), and having confidence in their colleagues' ability to use PAP (77%). Barriers and facilitators were found in all the NPT domains, mainly collective action and reflexive monitoring, where, for example, inadequacies of education, resources, and research on PAP for children were reported as barriers. Most respondents agreed that PAP was acceptable, appropriate, and feasible (71% to 88%).
PAP is familiar and perceived as an acceptable, appropriate, and feasible intervention, and by many viewed as a normal part of clinical routines in paediatric outpatient clinics in western Sweden, especially by physiotherapists and nurses. Barriers and faciliators are mainly related to collective action and reflexive monitoring. The wide acceptance demonstrates receptiveness to PAP as an intervention to promote an active lifestyle for children with obesity.
缺乏体育活动是儿童肥胖的主要驱动因素，且这种情况会持续到成年，因此在儿童早期解决这一问题至关重要。瑞典的体育活动处方（PAP）是一种提高成年人体育活动水平的有效干预措施，正在瑞典的初级保健中实施。在为儿童实施PAP之前，需要考察干预效果和实施前提条件。本研究以正常化过程理论（NPT）的各个领域为框架，旨在调查肥胖儿童相关儿科工作人员和管理人员对PAP的看法，以及在儿科医疗保健中实施PAP的可接受性、适宜性、可行性、障碍和促进因素。
使用经过验证的实施工具和开放式问题对瑞典西部28家儿科门诊诊所的工作人员和管理人员进行调查。使用曼-惠特尼U检验和克鲁斯卡尔-沃利斯检验对数据进行分析。定性数据被归类到NPT各个领域。
调查回复率为54%（125/229）。大多数受访者（82%）表示熟悉PAP，许多人（56%）将其视为工作的正常组成部分；护士和物理治疗师的认同程度更高（<0.001）。预计未来这一比例会上升（82%），尤其是工作经验最长的人（=0.012）。受访者表示看到了PAP在工作中的潜在价值（77%），愿意以新的方式运用PAP开展工作（94%），并且对同事运用PAP的能力有信心（77%）。在NPT的所有领域都发现了障碍和促进因素，主要是集体行动和反思性监测领域，例如，报告称针对儿童的PAP教育、资源和研究不足是障碍。大多数受访者认为PAP是可接受的、适宜的和可行的（71%至88%）。
PAP广为人知，被视为一种可接受、适宜且可行的干预措施，许多人将其视为瑞典西部儿科门诊临床常规工作的正常组成部分，尤其是物理治疗师和护士。障碍和促进因素主要与集体行动和反思性监测有关。广泛的接受度表明对PAP作为一种促进肥胖儿童积极生活方式的干预措施持欢迎态度。
