Physical Activity Promotion Tools in the Portuguese Primary Health Care: An Implementation Research

Mendes, Romeu; Silva, Marlene N.; Silva, Catarina Santos; Marques, Adilson; Godinho, Cristina; Agostinho, Marcos; Madeira, Sara Alexandra Gamboa; Rebelo-Marques, Alexandre; Martins, Henrique; Teixeira, Pedro J.; Cruz, Diogo

doi:10.3390/ijerph17030815

Cited by 17 publications

(18 citation statements)

References 31 publications

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“…There was an increase in the number of countries with national programmes to provide prescription or counselling for PA through primary care, which is known to be an effective intervention to increase population PA [23] . There have also been a notable expansion in the methods reported by countries including by treating exercise as medicine and counselling and prescribing PA [24] as well as by assessing PA as a vital sign [25] . There was a small increase in the number of countries that reported the inclusion of modules on HEPA in the undergraduate or postgraduate training curriculum for health professionals, which can be effective in building capacity of medical doctors [26] and allied health professionals [27] to promote PA among their patients.…”

Section: Discussionmentioning

confidence: 99%

Promoting health-enhancing physical activity in Europe: Surveillance, policy development and implementation 2015–2018

et al. 2021

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Section: Discussionmentioning

confidence: 99%

Promoting health-enhancing physical activity in Europe: Surveillance, policy development and implementation 2015–2018

et al. 2021

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“… 21 Adding simple tools such as the “Ask-Assess-Advise” or digital tools that have developed for the primary healthcare context can take few minutes and improve the promotion of physical activity. 22 , 23 However, adequate training should be provided to professionals before the provision of these forms of brief counselling.…”

Section: Discussionmentioning

confidence: 99%

Physical activity promotion in community pharmacies: pharmacists’ attitudes and behaviours

Viegas

Godinho

Romano³

2021

Pharm Pract (Granada)

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Background: Health systems and their professionals play a key role in the promotion and maintenance of behaviours contributing to increased physical activity levels. Pharmacists are well placed within communities, making them an accessible source to provide brief advice to people on how to be more physically active. Objective: This study aimed to characterize physical activity promotion actions taking place in the Portuguese community pharmacies, as well as the major facilitators and barriers faced by pharmacists in their daily practice. Methods: A cross-sectional study based on an online questionnaire targeting community pharmacists was developed based on COM-B model and the Theoretical Domains Framework (TDF) and distributed by email to 94% of the Portuguese pharmacies. Results: In total, 396 complete responses from community pharmacists were obtained. Three out of four participants reported to promote physical activity in their daily routine, of which 87.7% reported doing it in only a few attendances. The majority (92.3%) mentioned to provide information orally, with walking being the activity most promoted (99.4%). More active and younger pharmacists were more likely to promote physical activity. Nearly all pharmacists (98.7%) believed it was important or very important to practice regular physical activity for the health, but only 41.4% of the respondents were able to correctly identify the WHO general recommendations for physical activity. The lack of coordination with other healthcare professionals (M=3.35; SD=1.11), lack of interest by customers (M=3.25; SD=1.09) and lack of time (M=3.06; SD=1.10) were the main barriers to physical activity promotion, all scoring above the scale mid-point (i.e., 3). Conclusions: Physical activity promotion in the Portuguese community pharmacies is still not present as daily activity. Younger pharmacists seem to be a generation that better understand this need and could easily integrate this practice in their daily routine. Possibilities for including pharmacies and pharmacists as promoters of physical activity in the primary health care sector in the future are discussed in the light of these findings.

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“…Digital systems can facilitate PA advice when they improve communication, which could be through providing templates with recommendations, set phrases or prompts. Digital systems could be used to generate personalised recommendations in an appropriate language to facilitate delivering PA advice (Wattanapisit et al, 2021a), which can be time-efficient by utilising tools prior to the consultation ( (Christian et al, 2011;Mendes et al, 2020;Wattanapisit et al, 2021a;Poppe et al, 2018;O'Regan et al, 2021). MHealth tools can perform important tasks such as diagnosis, helping to reduce workload (Wattanapisit et al, 2020b).…”

Section: Discussionmentioning

confidence: 99%

“…As an example, digital systems could be used to generate personalised, printable guides from computer-based assessments of readiness to change and PA levels, as has been recently implemented in the Portuguese NHS (Mendes et al, 2020). The provision of digital templates and elearning within existing platforms could facilitate HCPs lacking in communication skills or knowledge of PA, with a monitoring system to provide follow-up.…”

Section: Implications For Research Practice and Policymentioning

confidence: 99%

Barriers and facilitators to the use of digital systems in primary care to deliver physical activity advice using COM-B and theoretical domains framework

Bondaronek¹,

Dicken²,

Jennings³

et al. 2021

Preprint

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Background: Physical inactivity is a leading risk factor for many health conditions, including cardiovascular disease, diabetes and cancer; increasing physical activity (PA) is therefore a public health priority. Healthcare professionals (HCPs) in primary care have been identified as being pivotal in addressing physical inactivity, yet few HCPs provide PA advice to patients. There can be obstacles to delivering PA advice, including a lack of time, confidence or knowledge. Digital technology has the potential to overcome obstacles and facilitate delivering PA advice. However, it is unknown if and how digital systems are used to deliver physical activity advice in primary care consultations, and what factors influence their use.The aim of this study was to understand the use of digital systems to support primary care consultations and to identify the barriers and facilitators to using these systems.Methods: 25 semi-structured interviews were conducted with HCPs in primary care. Professionals were sampled purposively based on profession (general practitioners, practice nurses and healthcare assistants), prevalence of long-term conditions within their practice area, and rural-urban classification. Data were analysed using thematic analysis to identify influences on the use of digital systems. Themes were categorised using COM-B and the theoretical domains framework (TDF) to identify the barriers and facilitators to using digital systems to support the delivery of PA advice in primary care consultations.Results: Identified themes fell within eight TDF domains (linked COM-B component follows in parentheses): Knowledge (Psychological Capability), Skills (Psychological Capability), Environmental Context and Resources (Physical Opportunity), Social Influence (Social Opportunity), Beliefs about Capabilities (Reflective Motivation), Beliefs about Consequences (Reflective Motivation), Reinforcement (Automatic Motivation), and Emotions (Automatic Motivation). The most prominent barrier/facilitator within psychological capability was ‘having the skills to use digital systems’. ‘Training in the use of digital systems’ was also mentioned several times. The most notable barriers/facilitators within physical opportunity were ‘time constraints’, the ‘efficiency of digital systems’, the ‘simplicity and ease of use’ of digital systems, and ‘integration with existing systems’. Other physical opportunity barriers were ‘lack of access to digital systems’ and ‘technical support in the use of digital systems’. With respect to social opportunity, a notable barrier was the sense that ‘digital systems reduce interpersonal communications’ with patients. ‘Patient preference’ was also mentioned as a barrier/facilitator. Several important barriers and/or facilitators were within reflective motivation, including ‘confidence to use digital systems’, ‘beliefs about the usefulness of digital systems’, the ‘belief that digital systems ‘are the way forward’’, ‘beliefs related to data privacy and security concerns’, and ‘perceptions about patient capabilities’. With respect to automatic motivation, barriers/facilitators included ‘familiarity and availability’ regarding digital systems, and the fact that digital systems ‘prompt behaviour’. Conclusions: A variety of influences were identified on the use of digital systems to support primary care consultations. These findings provide a foundation to design a digital system that addresses the barriers and leverages the facilitators to support PA advice provision within primary care, to elicit patient behaviour change and increase PA.

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Physical Activity Promotion Tools in the Portuguese Primary Health Care: An Implementation Research

Cited by 17 publications

References 31 publications

Promoting health-enhancing physical activity in Europe: Surveillance, policy development and implementation 2015–2018

Promoting health-enhancing physical activity in Europe: Surveillance, policy development and implementation 2015–2018

Physical activity promotion in community pharmacies: pharmacists’ attitudes and behaviours

Barriers and facilitators to the use of digital systems in primary care to deliver physical activity advice using COM-B and theoretical domains framework

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