1. Methods of connecting primary care patients with community‐based physical activity opportunities: A realist scoping review
- Author
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Francis Sullivan, Gozde Ozakinci, Rayna Hilary Rogowsky, Kathryn B Cunningham, and Sharon A. Carstairs
- Subjects
medicine.medical_specialty ,referral and consultation ,Sociology and Political Science ,health promotion ,media_common.quotation_subject ,review ,systematic reviews ,MEDLINE ,physical activity ,State Medicine ,primary care ,primary care research ,03 medical and health sciences ,0302 clinical medicine ,Promotion (rank) ,Nursing ,health psychology ,medicine ,Humans ,030212 general & internal medicine ,media_common ,Primary Health Care ,exercise ,030503 health policy & services ,Health Policy ,Public health ,Public Health, Environmental and Occupational Health ,Health services research ,Theory of change ,United Kingdom ,health services research ,Health psychology ,Health promotion ,Systematic review ,Scotland ,evaluation research ,behavioural medicine ,0305 other medical science ,Psychology ,Social Sciences (miscellaneous) - Abstract
Deemed a global public health problem by the World Health Organization, physical inactivity is estimated to be responsible for one in six deaths in the United Kingdom (UK) and to cost the nation's economy £7.4 billion per year. A response to the problem receiving increasing attention is connecting primary care patients with community-based physical activity opportunities. We aimed to explore what is known about the effectiveness of different methods of connecting primary care patients with community-based physical activity opportunities in the United Kingdom by answering three research questions: 1) What methods of connection from primary care to community-based physical activity opportunities have been evaluated?; 2) What processes of physical activity promotion incorporating such methods of connection are (or are not) effective or acceptable, for whom, to what extent and under what circumstances; 3) How and why are (or are not) those processes effective or acceptable? We conducted a realist scoping review in which we searched Cochrane, Medline, PsycNET, Google Advanced Search, National Health Service (NHS) Evidence and NHS Health Scotland from inception until August 2020. We identified that five methods of connection from primary care to community-based physical activity opportunities had been evaluated. These were embedded in 15 processes of physical activity promotion, involving patient identification and behaviour change strategy delivery, as well as connection. In the contexts in which they were implemented, four of those processes had strong positive findings, three had moderately positive findings and eight had negative findings. The underlying theories of change were highly supported for three processes, supported to an extent for four and refuted for eight processes. Comparisons of the processes and their theories of change revealed several indications helpful for future development of effective processes. Our review also highlighted the limited evidence base in the area and the resulting need for well-designed theory-based evaluations.
- Published
- 2020