Abstract
BackgroundThe introduction of efficacious physical activity interventions in primary health care is a complex process. Understanding factors influencing the process can enhance the development of effective introduction strategies. This Delphi study aimed to identify factors most relevant for the adoption, implementation, and continuation of physical activity interventions in primary health care by examining experts’ opinions on the importance and changeability of factors previously identified as potentially relevant for the process.MethodsIn the first round, 44 experts scored factors on their importance for each stage of the introduction process, as well as on their changeability. In the second round, the same experts received a questionnaire containing a reduced list of factors, based on the first-round results. They were asked to indicate their top-10 most important factors for each stage, and to re-rate factors’ changeability. Thirty-seven experts completed this round.ResultsMost important factors could be identified for each stage. Some factors were found important for a specific stage, e.g., the presence of intervention champions within the organization (adoption), provider knowledge (implementation), and the intervention’s sustainability (continuation), while others were perceived important for all stages, i.e., the intervention’s financial feasibility, the intervention’s accessibility to the target group, and time to deliver the intervention. The majority of most important factors was perceived changeable. However, for some factors no consensus could be reached regarding their changeability.ConclusionsThis study identified general and stage-specific factors relevant for the introduction of physical activity interventions in primary health care. It emphasizes the importance of taking these factors into account when designing introduction strategies, and of giving special attention to the distinct stages of the process. Due to lack of consensus on the changeability of most important factors, the extent to which these factors can be influenced by introduction strategies remains unclear.
Highlights
The introduction of efficacious physical activity interventions in primary health care is a complex process
Two out of 89 factors were found to be changeable by the majority of experts: provider knowledge and provider attitudes towards the intervention’s effectiveness
The importance of the presence of intervention champions within the adoption stage has been confirmed by Carlfjord et al [29] and Huijg et al [21] and might reflect the idea that the adoption of physical activity (PA) interventions requires some degree of awareness [16]
Summary
The introduction of efficacious physical activity interventions in primary health care is a complex process. Understanding factors influencing the process can enhance the development of effective introduction strategies This Delphi study aimed to identify factors most relevant for the adoption, implementation, and continuation of physical activity interventions in primary health care by examining experts’ opinions on the importance and changeability of factors previously identified as potentially relevant for the process. To have an impact on public health, efficacious PHCbased PA interventions need to be effectively introduced in practice. This process involves several stages which often require changes in organizations and professionals’ behavior. The process, and each of the stages within it, may be influenced by a multitude of factors related to the innovation, adopting person, patient, social setting, organizational context, and innovation methods and strategies [12,13,14,15,16,17]
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