Improving physical activity promotion in primary care through a co-developed consultation toolkit: a qualitative interview study
1
Health and Community Sciences, University of Exeter, Exeter, United Kingdom
2
School of Medicine, Keele University, Keele, United Kingdom
3
Department for Health, University of Bath, Bath, United Kingdom
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
Physical activity (PA) promotion in primary care is effective for preventing and managing long-term conditions, yet implementation remains inconsistent and may exacerbate health inequalities. Barriers such as limited consultation time and training are well documented, fewer studies translate behavioural determinants, across patient and workforce perspectives, into practical, equitable tools that can be embedded within routine primary care. This study explored determinants of PA promotion to inform the co-development of a primary care consultation toolkit, in collaboration with the Royal College of General Practitioners.
METHODS:
Semi-structured interviews were conducted with 29 participants across England, including multidisciplinary primary care healthcare professionals (HCPs) and patients. Purposive sampling captured variation in professional role, socioeconomic context and lived experience, supporting an equity-informed analysis. Data were analysed using Framework Analysis informed by Theoretical Domains Framework and the COM-B model to identify behavioural, organisational and contextual determinants influencing PA promotion.
RESULTS:
HCPs described time pressure, cognitive load, limited confidence and training, and reduced continuity of care as barriers to routine physical activity promotion. Determinants mapped primarily to three domains; Environmental context and resources, Belief about capabilities and Memory attention and decision processes. Role credibility and social norms shaped whether advice was raised, trusted and acted upon. HCPs reported reliance on social prescribing roles to extend support beyond brief consultations and highlighted the need for structured guidance, prompts and follow-up mechanisms embedded within routine systems. Patients emphasised autonomy-supportive, non-judgemental communication and valued personalised, inclusive advice. Both groups prioritised accessible resources and clear links to community-based opportunities.
CONCLUSIONS:
Integrating patient and workforce perspectives through behavioural science identifies actionable determinants for equitable implementation. These findings are informing the co-development of an implementation-focused toolkit to strengthen feasible, inclusive and sustainable PA promotion within primary care workforces.
Physical activity (PA) promotion in primary care is effective for preventing and managing long-term conditions, yet implementation remains inconsistent and may exacerbate health inequalities. Barriers such as limited consultation time and training are well documented, fewer studies translate behavioural determinants, across patient and workforce perspectives, into practical, equitable tools that can be embedded within routine primary care. This study explored determinants of PA promotion to inform the co-development of a primary care consultation toolkit, in collaboration with the Royal College of General Practitioners.
METHODS:
Semi-structured interviews were conducted with 29 participants across England, including multidisciplinary primary care healthcare professionals (HCPs) and patients. Purposive sampling captured variation in professional role, socioeconomic context and lived experience, supporting an equity-informed analysis. Data were analysed using Framework Analysis informed by Theoretical Domains Framework and the COM-B model to identify behavioural, organisational and contextual determinants influencing PA promotion.
RESULTS:
HCPs described time pressure, cognitive load, limited confidence and training, and reduced continuity of care as barriers to routine physical activity promotion. Determinants mapped primarily to three domains; Environmental context and resources, Belief about capabilities and Memory attention and decision processes. Role credibility and social norms shaped whether advice was raised, trusted and acted upon. HCPs reported reliance on social prescribing roles to extend support beyond brief consultations and highlighted the need for structured guidance, prompts and follow-up mechanisms embedded within routine systems. Patients emphasised autonomy-supportive, non-judgemental communication and valued personalised, inclusive advice. Both groups prioritised accessible resources and clear links to community-based opportunities.
CONCLUSIONS:
Integrating patient and workforce perspectives through behavioural science identifies actionable determinants for equitable implementation. These findings are informing the co-development of an implementation-focused toolkit to strengthen feasible, inclusive and sustainable PA promotion within primary care workforces.
| eISSN: | 2654-1459 |
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