Osinaike Jimi, Copeland Robert J, Myers Anna, Hardcastle Sarah J
School of Sport and Physical Activity, Sheffield Hallam University, Sheffield, UK
School of Sport and Physical Activity, Sheffield Hallam University, Sheffield, UK.
BMJ Open. 2025 Jul 13;15(7):e093632. doi: 10.1136/bmjopen-2024-093632.
To investigate physical activity (PA) promotion practices among primary care health professionals in England. To assess whether attitudes, confidence, role perceptions, knowledge of PA guidelines, and PA behaviour were related to PA promotion practices. To examine the barriers to and facilitators of PA promotion practices.
A cross-sectional online survey study with open (free text) questions.
National survey and online-administered survey conducted in England.
The outcome variables were attitudes, confidence, role perceptions, PA behaviour, knowledge of the PA guidelines and PA promotion practices. Structural equation modelling evaluated associations between these variables.
A total of 181 primary care healthcare professionals completed an online survey. The majority were general practitioners (GPs) (66.7%), followed by first contact physiotherapists (13.8%), practice nurses (12.2%) and link workers (7.7%).
Most (59%) healthcare professionals did not meet recommended levels of PA and could not accurately identify the PA guidelines (53%). Most provided PA advice to patients but fewer than 40% assessed PA, supported behaviour change or made referrals to PA support programmes. More first contact physiotherapists and link workers reported more frequent engagement in collaborative aspects of PA promotion, including assessing PA motivation, supporting behaviour change and providing follow-up. Confidence in promoting PA (β=0.30, p<0.001) and positive attitudes (β=0.30, p<0.001) were the only significant predictors of PA promotion practices. Positive associations were observed between confidence, attitudes, PA behaviour and PA promotion practices. Barriers to PA promotion included time constraints and limited and affordable local PA programmes. Facilitators included time and affordable local PA programmes.
Most primary care professionals routinely provide PA advice and feel confident doing so. However, with fewer than half able to accurately recall current PA guidelines and routine assessment and behaviour change support rarely reported, the quality and specificity of this advice remain unclear. While time constraints remain a major barrier to PA promotion, particularly among GPs, the addition of first contact physiotherapists and link workers is likely to enhance capacity for promoting PA in busy primary care settings.
调查英格兰初级保健卫生专业人员中促进身体活动（PA）的实践情况。评估态度、信心、角色认知、PA指南知识和PA行为是否与PA促进实践相关。研究PA促进实践的障碍和促进因素。
一项带有开放式（自由文本）问题的横断面在线调查研究。
在英格兰进行的全国性调查和在线管理的调查。
结果变量包括态度、信心、角色认知、PA行为、PA指南知识和PA促进实践。结构方程模型评估这些变量之间的关联。
共有181名初级保健卫生专业人员完成了在线调查。大多数是全科医生（GPs）（66.7%），其次是首诊物理治疗师（13.8%）、执业护士（12.2%）和联络人员（7.7%）。
大多数（59%）卫生专业人员未达到推荐的PA水平，且无法准确识别PA指南（53%）。大多数人向患者提供了PA建议，但不到40%的人评估PA、支持行为改变或转介到PA支持项目。更多的首诊物理治疗师和联络人员报告更频繁地参与PA促进的协作方面，包括评估PA动机、支持行为改变和提供随访。促进PA的信心（β=0.30，p<0.001）和积极态度（β=0.30，p<0.001）是PA促进实践的唯一显著预测因素。在信心、态度、PA行为和PA促进实践之间观察到正相关。PA促进的障碍包括时间限制以及当地PA项目有限且费用高昂。促进因素包括时间和当地费用合理的PA项目。
大多数初级保健专业人员常规提供PA建议且对此感到自信。然而，不到一半的人能够准确回忆当前的PA指南，很少报告进行常规评估和行为改变支持，因此该建议的质量和具体性仍不明确。虽然时间限制仍然是PA促进的主要障碍，尤其是在全科医生中，但增加首诊物理治疗师和联络人员可能会提高繁忙的初级保健环境中促进PA的能力。
