Delivering brief physical activity interventions in primary care: a systematic review

Louise H Hall; Rachael Thorneloe; Rocio Rodriguez-Lopez; Adam Grice; Mangesh A Thorat; Katherine Bradbury; Meghana Wadnerkar Kamble; Grace N Okoli; Daniel Powell; Rebecca J Beeken

doi:10.3399/BJGP.2021.0312

Delivering brief physical activity interventions in primary care: a systematic review

Br J Gen Pract. 2022 Feb 24;72(716):e209-e216. doi: 10.3399/BJGP.2021.0312. Print 2022 Mar.

Affiliations

¹ National Institute for Health Research (NIHR) in-practice fellow.
² Centre for Behavioural Science and Applied Psychology, Sheffield Hallam University, Sheffield.
³ Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts, and The London School of Medicine and Dentistry, Queen Mary University of London, London.
⁴ NIHR Southampton Biomedical Research Centre, NIHR Applied Research Collaboration Wessex, Southampton.
⁵ School of Health Sciences, University of East Anglia, Norwich.
⁶ Institute of Population Health Sciences, Barts, and The London School of Medicine and Dentistry, Queen Mary University of London, London.
⁷ Institute of Applied Health Sciences, University of Aberdeen, Aberdeen.
⁸ Leeds Institute of Health Sciences, University of Leeds, Leeds.

Abstract

Background: Physical activity (PA) brief interventions (BIs) involving screening and/or advice are recommended in primary care but frequency of delivery is unknown.

Aim: To examine the extent to which PA BIs are delivered in primary care, and explore factors associated with delivery, receipt, and patient receptivity.

Design and setting: A mixed-methods systematic review of studies conducted worldwide, with a narrative synthesis of results.

Method: CINAHL, EMBASE, MEDLINE, and APA PsycINFO index databases were searched for qualitative and quantitative studies, dating from January 2012 to June 2020, that reported the level of delivery and/or receipt of PA BIs in primary care, and/or factors affecting delivery, receipt, and patient receptivity. Quality was assessed using the Mixed Methods Appraisal Tool. Attitudes towards and barriers to delivery were coded into the Theoretical Domains Framework and the Capability, Opportunity, and Motivation Behaviour model.

Results: After screening a total of 13 066 records, 66 articles were included in the review. The extent of PA screening and advice in primary care varied widely (2.4%-100% and 0.6%-100%, respectively). PA advice was delivered more often to patients with a higher body mass index, lower PA levels, and/or more comorbidities. Barriers - including a lack of time and training/guidelines - remain, despite recommendations from the World Health Organization and National Institute for Health and Care Excellence that PA advice should be provided in primary care. Few studies explored patients' receptivity to advice.

Conclusion: PA BIs are not delivered frequently or consistently in primary care. Addressing barriers to delivery through system-level changes and training programmes could improve and increase the advice given. Understanding when patients are receptive to PA interventions could enhance health professionals' confidence in their delivery.

Keywords: brief interventions; disease prevention; health promotion; physical activity; primary care; systematic review.

Publication types

Research Support, Non-U.S. Gov't
Systematic Review

MeSH terms

Crisis Intervention*
Exercise*
Health Personnel
Humans
Motivation
Primary Health Care

Grants and funding

23517/CRUK_/Cancer Research UK/United Kingdom