How should family physicians provide physical activity advice? Qualitative study to inform the design of an e-health intervention
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Lindsay Reddeman1, Nicole Bourgeois2, Emily Nicholas Angl3
1Resident physician at the University of Toronto in Ontario and was a medical student in the Faculty of Medicine and in the Institute of Health Policy, Management and Evaluation at the University of Toronto, and a research student in the Institute for Health System Solutions and Virtual Care at Women's College Hospital in Toronto at the time of the study. lindsay.reddeman@mail.utoronto.ca.
Objective:
To explore patient attitudes toward interacting with family physicians regarding physical activity in order to inform the development of an e-health intervention aimed at helping family physicians support patients in becoming more physically active.
Design:
Qualitative study.
Setting:
Women's College Hospital in Toronto, Ont.
Participants:
Ten patients recruited from the academic family practice health centre.
Methods:
Semistructured interviews were conducted with patients using maximum variation sampling until thematic saturation was reached. Interviews explored past experiences and preferences for receiving physical activity advice from family physicians, and tools or techniques that might support increasing physical activity. Interviews were audiorecorded, transcribed, and coded independently by members of the research team before undergoing thematic analysis.
Main Findings:
Patient interviews revealed 4 overarching themes that offered insight to physical activity discussions. Family physicians might provide more meaningful and useful physical activity advice to patients by providing individualized recommendations focused on proximal (ie, near-term) health and functional goals; recognizing and addressing unique environmental and social factors influencing physical activity levels; balancing candour and sensitivity in advice provision while incorporating a broad definition of physical activity; and recommending tools that incorporate planning, goal-setting, and goal-monitoring features.
Conclusion:
Ultimately, physical activity recommendations from family physicians cannot make a difference if patients do not act on them. This study elicits input from patients to develop preliminary strategies that might help family physicians provide physical activity advice in a more patient-centred fashion. Further research is needed to test interventions that help implement these strategies and to assess their effect.
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