Search

Objectives: e-coachER was a web-based intervention designed to support uptake and maintenance of physical activity for people attending exercise referral schemes (ERS) for weight loss, diabetes, hypertension, osteoarthritis or a history of depression/low mood. The aim of this study was to explore the mechanisms of impact of the e-coachER intervention, specifically how participants interacted with e-coachER and the key mediators of increased physical activity., Design: This was a qualitative one-on-one interview study. Interviews were audio-recorded and transcribed and analysed using thematic analysis., Setting: UK primary care ERS., Participants: A purposive sample of adult patients randomised to the intervention arm of the e-coachER randomised controlled trial., Results: Twenty-six participants (20 female), who had logged on to e-coachER at least once were recruited, resulting in a total of 38 interviews (mean duration 48 min). Four broad, inter-related themes were generated from the data (1) catalyst for change, (2) goals and aspirations, (3) support and (4) engagement with the e-coachER programme. Most participants who took part in e-coachER were already motivated to improve their health and perceived e-coachER as an additional source of motivation and accountability. Many felt that the opportunity to set goals and self-monitor supported participant's competence and autonomy by enabling them to progress at their own pace. Many participants reported on how e-coachER helped them to foster a sense of relatedness by encouraging them to seek support from others. Finally, e-coachER was regarded as being generally accessible and engaging. Despite this, some found it too simplistic, and others found it hard to maintain engagement over time., Conclusions: The e-coachER intervention seemed to be generally motivating in the early stages of initiating behaviour change, but engagement waned over time. Our findings highlight how important an online package might be in supporting behaviour change while also highlighting the challenges of achieving sustained physical activity changes., Trial Registration Number: ISRCTN15644451., Competing Interests: Competing interests: All authors declare support from National Institute for Health Research (NIHR), Health Technology Assessment (grant 13/20/25) for the submitted work. SGD's position is supported by NIHR Applied Research Collaboration, Southwest (PenARC). CG was supported in part by a NIHR Career Development Fellowship (CDF-2012-05-259). All other authors have no financial relationships with any organisations that might have an interest in the submitted work since initiation of the study and have no other relationships or activities that could appear to have influenced the submitted work., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)

Objective: Helping people to change their health behaviours is becoming a greater feature within the role of health professionals, including through whole system initiatives such as Making Every Contact Count. Health services provide an ideal setting to routinely promote health behaviours, including physical activity. Snacktivity is a novel approach that promotes small bouts of physical activity (activity snacks) throughout the day. This study explored health professionals' initial experiences of delivering a Snacktivity intervention to promote physical activity within routine health consultations. A further aim was to investigate health professionals' ability/fidelity in delivering the Snacktivity intervention to their patients., Design: Semistructured interviews (n=11) and audio recording of consultations (n=46)., Setting and Participants: Healthcare professionals from a variety of specialisms who delivered the Snacktivity intervention within patient consultations., Results: Analyses revealed two higher-level themes of interest: (1) health professionals' conceptualisation of Snacktivity (subthemes: observations/reflections about patients' understanding, engagement and enthusiasm for delivering the Snacktivity intervention) and (2) health professionals' understanding of Snacktivity and experience in delivering the intervention (subthemes: delivering Snacktivity; limitations, challenges and possible improvements). Consultation audio recordings demonstrated health professionals delivered the Snacktivity intervention with high levels of fidelity. Health professionals were proficient and supportive of delivering the Snacktivity intervention within consultations although practical barriers to implementation such as time constraints were raised, and confidence in doing so was mixed., Conclusions: Health professionals were proficient and supportive of delivering the Snacktivity intervention within consultations. The primary barrier to implementation was the time to deliver it, however, gaining greater experience in the intervention and improving behaviour change counselling skills may reduce this barrier., Trial Registration Number: ISRCTN64851242., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)