The Importance of Physical Activity for Health
Physical activity (PA) is a foundational element of good health. It has been shown to have wide-ranging benefits, from improving physical and mental wellbeing to preventing disability and chronic diseases. The World Health Organization (WHO) defines PA as any bodily movement produced by the skeletal muscles that requires increased energy expenditure above resting levels, including household tasks, leisure time activities, and structured exercise.
Despite the well-documented advantages of regular PA, the burden of physical inactivity (PI) continues to grow. Over 35% of the global population fails to meet the recommended PA guidelines, and 5.3 million premature deaths are now directly linked to PI. Experts estimate that a 25% reduction in PI could prevent over 1.3 million deaths each year.
To address this concerning trend, PA promotion programs have been developed worldwide since the 1990s. These programs typically involve PA counseling, advice on behavioral change, and/or referrals to specialists for an individualized PA program within a healthcare context. Public health policies are also being used to motivate healthcare professionals (HCPs) to deliver these types of behavioral change activities, with initiatives like Healthy People 2020 and Exercise is Medicine advocating for the inclusion of PA into patient treatment plans.
The Role of Healthcare Professionals in Promoting Physical Activity
HCPs are widely recognized as pivotal conduits for promoting PA and improving population health. They have frequent one-on-one contact with patients, providing valuable opportunities to assess PA levels and advise on behavioral changes. Successful PA interventions have been attributed to the cumulative impact of patients receiving PA promotion at each healthcare encounter, making “every contact count.”
The WHO and other agencies have emphasized the crucial role of HCPs in reducing chronic diseases and PI. However, the evidence regarding the key factors that impact the effectiveness of PA promotion among HCPs remains inconclusive. Several barriers have been identified that hinder the successful implementation of PA promotion in primary healthcare settings, including:
- Limited consultation time
- Lack of knowledge and confidence in effective PA promotion strategies
- Insufficient training
- Beliefs about patient readiness to change PA habits
- Current workload and practice constraints
If these barriers are not urgently addressed, the growing prevalence of chronic diseases and PI could lead to worsening cases of premature deaths, long-term disabilities, increased hospitalizations, and an unsustainable burden on healthcare systems.
Exploring HCPs’ Perceptions on Physical Activity Promotion
To gain a deeper understanding of this critical issue, a recent systematic review examined the perceptions of HCPs regarding key determinants of effective PA promotion. The review, which included 34 studies involving 11,862 participants, revealed several important insights:
Knowledge and Confidence in PA Promotion
The majority of HCPs (60-95%) reported having some knowledge and confidence in promoting PA. However, some GPs, physicians, nurses, and rheumatologists indicated a need for more training on PA. HCPs’ confidence was often linked to their own personal PA habits and interest in particular sports or activities.
Importance and Role of PA Promotion
Most HCPs (86-100%) viewed PA promotion as important, especially for managing chronic conditions, rehabilitation, and improving quality of life. However, views on their specific role in PA promotion were more mixed, with some HCPs seeing it as outside their scope of practice.
Assessment and Delivery of PA Promotion
The most common form of PA promotion was providing verbal advice or counseling, with 50-98% of HCPs reporting this approach. A smaller proportion (24-93%) also utilized written resources or referrals to exercise specialists. Some HCPs tailored their PA advice based on the patient’s perceived motivation or interests.
Barriers and Facilitators to PA Promotion
The main barriers identified were limited consultation time, lack of knowledge, and beliefs about patient readiness to change. Key facilitators included providing incentives, access to PA educational resources, and strengthening the social/professional role of HCPs in PA promotion.
Strategies for Enhancing PA Promotion in Healthcare Settings
The insights from this review suggest several promising strategies for improving PA promotion within healthcare systems:
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Expand the use of standardized physical activity vital signs (PAVS): Integrating the PAVS into electronic health records (EHRs) can prompt HCPs to regularly assess and document patients’ PA levels, facilitating more targeted counseling and referrals.
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Develop a pediatric PAVS: A tailored physical activity vital sign for children and adolescents could help increase PA assessment and promotion in pediatric healthcare settings.
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Leverage wearable devices for PA monitoring: Incorporating data from wearable activity trackers into clinical workflows can provide valuable insights to support personalized PA interventions, especially for high-risk populations.
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Implement routine fitness assessments: Measures like grip strength testing and the 6-minute walk test can help identify areas for improvement and prompt referrals to targeted exercise programs, particularly for older adults.
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Enhance HCP training and support: Providing HCPs with more education, resources, and incentives for PA promotion can boost their knowledge, confidence, and engagement in this crucial health behavior.
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Foster cross-sector collaboration: Partnerships between HCPs, PA specialists, community organizations, and policymakers can help create a comprehensive, integrated approach to PA promotion across the healthcare continuum.
Conclusion
Healthcare settings present a prime opportunity to promote physical activity and improve population health. By addressing the key barriers identified by HCPs and implementing targeted strategies, we can empower HCPs to become more effective advocates for regular PA. This, in turn, can help reduce the burden of chronic diseases, premature deaths, and long-term disabilities associated with physical inactivity.
To learn more about PA promotion initiatives and resources available in your local community, please visit https://www.stanleyparkhigh.co.uk/. Together, we can work towards a healthier, more active society.
