From Delivery to Adoption of Physical Activity Guidelines: Realist Synthesis

Area of Science:

• Public Health
• Policy Implementation
• Health Promotion

Background:

• Evidence-based physical activity (PA) guidelines are often implemented unsuccessfully, revealing a gap between scientific evidence and policy.
• This review examines factors affecting the delivery, adoption, and implementation of PA promotion guidelines across diverse policy sectors.

Purpose of the Study:

• To synthesize evidence on factors influencing the implementation of physical activity promotion guidelines.
• To understand the link between PA guideline delivery and professional actions in various sectors.
• To identify mechanisms and threats impacting PA guideline implementation.

Main Methods:

• A realist synthesis approach was used to review 39 studies published between 2002 and 2017.
• Literature searches were conducted using PubMed, EBSCO, and Google Scholar, supplemented by snowball sampling.
• An initial program theory, outlining a four-step chain from evidence emergence to guideline implementation, was tested.

Main Results:

• Key mechanisms for guideline implementation include scientific legitimation, enforcement, feasibility, familiarity with concepts, and established PA habits.
• The study highlights the connection between PA guideline delivery and the actions of professionals in health services, schools, and municipalities.
• Threats to the successful implementation of PA guidelines at national and local levels were identified.

Conclusions:

• The development process of PA guidelines can significantly impact their adoption by policymakers and professionals.
• Synergies between policymaking and professional practices are crucial for effective implementation.
• Multisectoral strategies that promote collaboration can lead to mutually beneficial outcomes for physical activity promotion.