The authors declare that they have no competing interests.
TH, CB, RN & CV conceived the idea for this paper. CV, TH, AW & RN designed the qualitative aspects of the study. CV & AW conducted the PACE-Lift group interview; CV, CB & RN conducted the PACE-UP focus group and RN carried out the individual nurse interviews. CV, RN, TH & CB carried out the analyses. The manuscript was prepared by CB with substantial input from CV, TH & RN. TH, DC, CV and SK conceived the initial idea for the PACE-Lift trial and TH, DC, CV, SK, SI, PW, MU & J F-R conceived the idea for the PACE-UP trial. All of the author team reviewed and approved the manuscript prior to submission.
Physical activity (PA) is important for physical and mental health in adults and older adults. Interventions incorporating theory-based behaviour change techniques (BCTs) can be useful in helping people to increase their PA levels and can be delivered by practice nurses in primary care. We undertook two primary care based complex walking interventions among adults and older adults. Both interventions were underpinned by BCTs and delivered by practice nurses and we sought their views and experiences of delivering over 1400 complex PA consultations.
Semi structured interviews with two practice nurse groups (n = 4 and n = 5) and two individual interviews (total n = 11) were conducted by independent facilitators; audio-recorded, transcribed verbatim and analysed using thematic analysis.
Five key themes emerged as enablers and/or barriers to delivering the intervention: preparation and training; initial and ongoing support; adherence to the protocol; the use of materials and equipment; and engagement of participants. The themes were organised into a framework of ‘pre-trial’ and ‘delivery of the intervention’. Two additional ‘post-trial’ themes were identified; changed practice and the future feasibility of the intervention. Nurses believed that taking part in the trial, especially the BCT training, enhanced the quality and delivery of advice and support they provided within routine consultations, although the lack of time available routinely makes this challenging.
Delivering an effective behaviour change intervention in primary care requires adequate training and support for practice nurses both initially and throughout the trial as well as adequate consultation time. Enhanced skills from participating in such trials can lead to long-term changes, including more patient-centred consulting.