Barriers and facilitators to the implementation of sit-less and move-more interventions within Australian primary healthcare settings

澳大利亚基层医疗保健机构中实施减少久坐和增加活动干预措施的障碍和促进因素

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Abstract

BACKGROUND: Due to the excessive burden and health costs of noncommunicable diseases, public health and clinical practice guidelines emphasize the importance of targeting population changes in risk factors of physical activity and sedentary behavior. Primary healthcare presents a pragmatic setting for embedding interventions targeting sitting less and moving more. However, to design effective implementation strategies for such interventions, it is necessary to understand the determinants that drive implementation in this setting. PURPOSE: To determine the barriers and facilitators influencing the implementation of sit-less and move-more interventions within Australian primary healthcare, as perceived by general practitioners and general practice nurses. METHODS: Ten general practitioners and 10 general practice nurses completed online semi-structured individual interviews. Interviews were digitally transcribed and analyzed deductively; both the interview guide and analysis were guided by the Theoretical Domains Framework. RESULTS: All domains within the Theoretical Domains Framework were represented. Notable barrier domains were: Environmental Context and Resources, related to reported time constraints; Skills, relating to limited formal training; Social Influences, relating to patient engagement challenges. Notable facilitator domains were: Beliefs about Consequences, reflecting perceived health benefits for patients with healthier movement behaviors, Environmental Context and Resources, including use of educational resources and integration of sit-less and move-more assessments within clinic workflows; and Social/Professional Role and Identity, highlighting how both general practitioners and general practice nurses have a role in implementation. CONCLUSIONS: These findings provide a foundation for future research focusing on the co-design of strategies supporting the implementation of such interventions within primary healthcare.

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