Promoting physical activity to patients: a scoping review of the perceptions of doctors in the United Kingdom

Abstract

Background The physician–patient encounter presents an ideal opportunity for physical activity (PA) promotion. This review aims to (i) explore the breadth and depth of existing literature investigating doctors’ perceptions of PA promotion in the United Kingdom (UK) and (ii) identify factors influencing the extent to which doctors engage in PA promotion during patient interactions. Methods A five-stage scoping review methodology and the PRISMA-ScR guidance were followed: Stage 1—research questions specified; Stage 2—relevant studies identified by searching five electronic databases and manual screening of references; Stage 3—studies screened using Covidence™; Stage 4—study data extracted and charted; and Stage 5—findings from included studies were analysed, summarised and reported using (i) descriptive numerical analysis to provide insight into study characteristics and (ii) narrative summary of the evidence categorised by factors that influence doctors’ engagement with PA promotion. Results In total, 16,961 studies were screened. Nineteen studies were included in the review with most conducted in primary care focusing on the perceptions of general practitioners. Seven influencing factors were identified: knowledge and training, personal interest and PA level, time, resources, confidence, the perceived role of the doctor and patient relevance. Conclusion This review provides new evidence that historical barriers and influencing factors have a persisting impact on the ability and willingness of UK doctors to engage with PA promotion with patients. Previous efforts to address these factors would appear to have had limited success. Further intervention efforts are required to ensure more widespread and effective PA promotion to patients.

A movement for movement: an exploratory study of primary healthcare professionals’ perspectives on implementing the Royal College of General Practitioners’ active practice charter initiative

“…Furthermore, given practitioner behaviour is a strong predictor of their likelihood to promote PA [ 20 , 21 ], a lack of staff engagement in the APC needs to be addressed. This lack of engagement is multifactorial, with a number of factors being identified in previous research that limit implementation, echoing some of the findings in this study, including: (a) time constraints; (b) insufficient knowledge and skills; (c) a lack of resources and support; and (d) negative financial implications [ 14 , 17 ]. Addressing all the barriers is largely beyond the remit of this work, with input required at an institutional and/or governmental level (as opposed to just an individual one).…”

“…Although staff and patient education are perceived to be major elements of the APC, more education to address this misconception around the value of the APC may be warranted. This is particularly important given the role PHPs’ self-efficacy has as a predictor of likelihood to promote PA [ 12 , 17 ]. Subsequently two key points need to be illustrated, first the effectiveness of brief interventions at increasing PA in patients [ 18 ] as emphasised by the investment of governing bodies (e.g., World Health Organisation BRIEF toolkit [ 19 ]).…”

Physical activity advice given by French general practitioners for low back pain and the role of digital e-health applications: a qualitative study

“…Advice was almost always general with little information about duration and frequency but emphasising the importance of regularly performing patient-appropriate and easily achievable activities such as walking. The main barrier to providing PA advice was that GPs did not feel sufficiently trained and relied on their personal knowledge and experience without any specific support material [ 21 ]. GPs felt physiotherapists were more capable and better trained to provide PA advice.…”

Physical Activity Knowledge and Personal Habits with Recommendations for Patients: Self-Assessment by Primary Care Physicians

“…In these searches, health-care professionals become particularly important agents, as they have excellent opportunities both to advise patients on health-promoting behaviors and to include PA in treatment pathways [ 7 ]. Primary care physicians (PCPs), who are trusted sources of health information [ 8 ] with close to 80% of the population visiting each year for all sorts of health-related issues, should be considered particularly important promoters of PA [ 9 ] that use PA as first-line therapeutic opinion [ 10 ]. However, despite strong evidence supporting the benefits of PA for the prevention and treatment of chronic diseases, it is still rarely recommended by PCPs [ 10 , 11 ].…”

“…The latter is well reflected by the fact that national documents often lack PA promotion guidelines and a clearly defined action plan that PCPs should use. There is also a gap in the scientific literature, as there is still little analysis of the content of doctors’ recommendations on promoting PA to patients, the frequency of the recommendations themselves, and especially in the context of the doctors’ own behavior and health [ 8 , 12 ]. However, one of the most important predictors of PCPs providing health promotion counseling is PCPs’ own health and active behaviors, as it is difficult to encourage behaviors that one does not engage in [ 13 ], even though a considerable number of studies analyze the health-promoting PA or inactivity of various social groups in the context of their weight or BP [ 14 , 15 , 16 ].…”