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Erschienen in: International Journal of Behavioral Medicine 3/2015

01.06.2015

Factors Influencing the Introduction of Physical Activity Interventions in Primary Health Care: a Qualitative Study

verfasst von: Johanna M. Huijg, Nicolette van der Zouwe, Mathilde R. Crone, Marieke W. Verheijden, Barend J. C. Middelkoop, Winifred A. Gebhardt

Erschienen in: International Journal of Behavioral Medicine | Ausgabe 3/2015

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Abstract

Background

The introduction of efficacious physical activity (PA) interventions in routine primary health care (PHC) is a complex process. Understanding factors influencing the process can enhance the development of successful introduction strategies.

Purpose

The aim of this qualitative study was to explore stakeholders’ perceptions on factors influencing the introduction, i.e., adoption, implementation, and continuation, of PA interventions in PHC.

Method

Twenty-eight semistructured interviews were held with intervention managers, PHC advisors, intervention providers, and referring general practitioners of five PA interventions delivered in PHC. A theoretical framework on the introduction of innovations in health care was used to guide the data collection. Influencing factors were identified using thematic analysis.

Results

Stakeholders reported preconditions for the introduction of PA interventions in PHC (e.g., support, resources, and networks and collaborations), in addition to characteristics of PA interventions (e.g., compatibility, flexibility, and intervention materials) and characteristics of PHC professionals (e.g., knowledge, positive attitudes, and beliefs about capabilities) perceived to enhance the introduction process. Furthermore, they proposed strategies for the development of PA interventions (e.g., involvement of future stakeholders, full development, and refinement) and strategies to introduce PA interventions in PHC (e.g., training, assistance, and reinforcement). The majority of the influencing factors were discussed specifically in relation to one or two stages.

Conclusion

This study presents an overview of factors that are perceived to influence the introduction of PA interventions in PHC. It underscores the importance of taking these factors into account when designing introduction strategies and of giving special attention to the distinct stages of the process.
Literatur
1.
Zurück zum Zitat Tulloch H, Fortier M, Hogg W. Physical activity counseling in primary care: who has and who should be counseling? Patient Educ Couns. 2006;64(1–3):6–20.CrossRefPubMed Tulloch H, Fortier M, Hogg W. Physical activity counseling in primary care: who has and who should be counseling? Patient Educ Couns. 2006;64(1–3):6–20.CrossRefPubMed
2.
Zurück zum Zitat Eakin EG, Glasgow RE, Riley KM. Review of primary care-based physical activity intervention studies. J Fam Pract. 2000;49(2):158–68.PubMed Eakin EG, Glasgow RE, Riley KM. Review of primary care-based physical activity intervention studies. J Fam Pract. 2000;49(2):158–68.PubMed
3.
Zurück zum Zitat Orrow G, Kinmonth A-L, Sanderson S, Sutton S. Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials. BMJ. 2012;344:e1389.CrossRefPubMedCentralPubMed Orrow G, Kinmonth A-L, Sanderson S, Sutton S. Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials. BMJ. 2012;344:e1389.CrossRefPubMedCentralPubMed
4.
Zurück zum Zitat Sørensen JB, Skovgaard T, Puggaard L. Exercise on prescription in general practice: a systematic review. Scand J Prim Health. 2006;24:69–74.CrossRef Sørensen JB, Skovgaard T, Puggaard L. Exercise on prescription in general practice: a systematic review. Scand J Prim Health. 2006;24:69–74.CrossRef
5.
Zurück zum Zitat Fallon EA, Wilcox S, Laken M. Health care provider advice for African American adults not meeting health behavior recommendations. Prev Chron Dis. 2006;3(2):1–12. Fallon EA, Wilcox S, Laken M. Health care provider advice for African American adults not meeting health behavior recommendations. Prev Chron Dis. 2006;3(2):1–12.
6.
Zurück zum Zitat Glasgow RE, Eakin EG, Fisher EB, Bacak SJ, Brownson RC. Physician advice and support for physical activity: results from a national survey. Am J Prev Med. 2001;21(3):189–96.CrossRefPubMed Glasgow RE, Eakin EG, Fisher EB, Bacak SJ, Brownson RC. Physician advice and support for physical activity: results from a national survey. Am J Prev Med. 2001;21(3):189–96.CrossRefPubMed
7.
Zurück zum Zitat VanWormer JJ, Pronk NP, Kroeninger GJ. Clinical counseling for physical activity: translation of a systematic review into care recommendations. Diabetes Spec. 2009;22(1):48–55.CrossRef VanWormer JJ, Pronk NP, Kroeninger GJ. Clinical counseling for physical activity: translation of a systematic review into care recommendations. Diabetes Spec. 2009;22(1):48–55.CrossRef
8.
Zurück zum Zitat Verheijden MW, Bakx JC, Delemarre ICG, Wanders AJ, Woudenbergh NM, Bottema BJAM, et al. GPs’ assessment of patients’ readiness to change diet, activity and smoking. Br J Gen Pract. 2005;55:452–7.PubMedCentralPubMed Verheijden MW, Bakx JC, Delemarre ICG, Wanders AJ, Woudenbergh NM, Bottema BJAM, et al. GPs’ assessment of patients’ readiness to change diet, activity and smoking. Br J Gen Pract. 2005;55:452–7.PubMedCentralPubMed
9.
Zurück zum Zitat Helmink JHM, Meis JJM, De Weerdt I, Visser FN, De Vries NK, Kremers SPJ. Development and implementation of a lifestyle intervention to promote physical activity and healthy diet in the Dutch general practice setting: the BeweegKuur programme. Int J Behav Nutr Phys. 2010;7:49.CrossRef Helmink JHM, Meis JJM, De Weerdt I, Visser FN, De Vries NK, Kremers SPJ. Development and implementation of a lifestyle intervention to promote physical activity and healthy diet in the Dutch general practice setting: the BeweegKuur programme. Int J Behav Nutr Phys. 2010;7:49.CrossRef
10.
Zurück zum Zitat Green LW, Kreuter MW. Health promotion planning: an educational and environmental approach. 3rd ed. Mountain View: Mayfield; 1999. Green LW, Kreuter MW. Health promotion planning: an educational and environmental approach. 3rd ed. Mountain View: Mayfield; 1999.
11.
Zurück zum Zitat Glasgow RE, Lichtenstein E, Marcus AC. Why don’t we see more translation of health promotion research to practice? Rethinking the efficacy-to-effectiveness transition. Am J Public Health. 2003;93:1261–7.CrossRefPubMedCentralPubMed Glasgow RE, Lichtenstein E, Marcus AC. Why don’t we see more translation of health promotion research to practice? Rethinking the efficacy-to-effectiveness transition. Am J Public Health. 2003;93:1261–7.CrossRefPubMedCentralPubMed
12.
Zurück zum Zitat Glasgow RE, Bull SS, Gilette C, Klesges LM, Dzewaltowski DA. Behavior change intervention research in healthcare settings: a review of recent reports with emphasis on external validity. Am J Prev Med. 2002;23(1):62–9.CrossRefPubMed Glasgow RE, Bull SS, Gilette C, Klesges LM, Dzewaltowski DA. Behavior change intervention research in healthcare settings: a review of recent reports with emphasis on external validity. Am J Prev Med. 2002;23(1):62–9.CrossRefPubMed
13.
Zurück zum Zitat Wandersman A, Duffy J, Flaspohler P, Noonan R, Lubell K, Stillman L, et al. Bridging the gap between prevention research and practice: the interactive systems framework for dissemination and implementation. Am J Community Psychol. 2008;41:171–81.CrossRefPubMed Wandersman A, Duffy J, Flaspohler P, Noonan R, Lubell K, Stillman L, et al. Bridging the gap between prevention research and practice: the interactive systems framework for dissemination and implementation. Am J Community Psychol. 2008;41:171–81.CrossRefPubMed
14.
Zurück zum Zitat Dzewaltowski DA, Estabrooks PA, Glasgow RE. The future of physical activity behavior change research: what is needed to improve translation of research into health promotion practice? Exerc Sport Sci Rev. 2004;32(2):57–63.CrossRefPubMed Dzewaltowski DA, Estabrooks PA, Glasgow RE. The future of physical activity behavior change research: what is needed to improve translation of research into health promotion practice? Exerc Sport Sci Rev. 2004;32(2):57–63.CrossRefPubMed
15.
Zurück zum Zitat Aarons GA, Wells RS, Zagursky K, Fettes DL, Palinkas LA. Implementing evidence-based practice in community mental health agencies: a multiple stakeholder analysis. Am J Public Health. 2009;99(11):2087–95.CrossRefPubMedCentralPubMed Aarons GA, Wells RS, Zagursky K, Fettes DL, Palinkas LA. Implementing evidence-based practice in community mental health agencies: a multiple stakeholder analysis. Am J Public Health. 2009;99(11):2087–95.CrossRefPubMedCentralPubMed
16.
Zurück zum Zitat Eakin EG, Brown WJ, Marshall AL, Mummery K, Larsen E. Physical activity promotion in primary care: bridging the gap between research and practice. Am J Prev Med. 2004;27(4):297–303.PubMed Eakin EG, Brown WJ, Marshall AL, Mummery K, Larsen E. Physical activity promotion in primary care: bridging the gap between research and practice. Am J Prev Med. 2004;27(4):297–303.PubMed
17.
Zurück zum Zitat Bartholomew KL, Parcel GS, Kok G, Gottlieb NH, Fernández ME. Planning health promotion programs: an intervention mapping approach. 3rd ed. San Francisco: Jossey-Bass; 2011. Bartholomew KL, Parcel GS, Kok G, Gottlieb NH, Fernández ME. Planning health promotion programs: an intervention mapping approach. 3rd ed. San Francisco: Jossey-Bass; 2011.
18.
Zurück zum Zitat Fleuren M, Wiefferink K, Paulussen T. Determinants of innovation within health care organizations: literature review and Delphi study. Int J Qual Health Care. 2004;16(2):107–23.CrossRefPubMed Fleuren M, Wiefferink K, Paulussen T. Determinants of innovation within health care organizations: literature review and Delphi study. Int J Qual Health Care. 2004;16(2):107–23.CrossRefPubMed
19.
Zurück zum Zitat Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O. Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Q. 2004;82(4):581–629.CrossRefPubMedCentralPubMed Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O. Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Q. 2004;82(4):581–629.CrossRefPubMedCentralPubMed
20.
Zurück zum Zitat Cane J, O’Connor D, Michie S. Validation of the theoretical domains framework for use in behaviour change and implementation research. Implement Sci. 2012;7:37.CrossRefPubMedCentralPubMed Cane J, O’Connor D, Michie S. Validation of the theoretical domains framework for use in behaviour change and implementation research. Implement Sci. 2012;7:37.CrossRefPubMedCentralPubMed
21.
Zurück zum Zitat Fixsen DL, Naoom SF, Blase KA, Friedman RM, Wallace F. Implementation research: a synthesis of the literature. Tampa: University of South Florida; 2005. Fixsen DL, Naoom SF, Blase KA, Friedman RM, Wallace F. Implementation research: a synthesis of the literature. Tampa: University of South Florida; 2005.
22.
Zurück zum Zitat Paulussen TGWM, Wiefferink K, Mesters I. Invoering van effectief gebleken interventies. In: Brug J, van Asseman P, Lechner L, editors. Gezondheidsvoorlichting en gedragsverandering. Assen: van Gorcum; 2007. p. 151–72. Paulussen TGWM, Wiefferink K, Mesters I. Invoering van effectief gebleken interventies. In: Brug J, van Asseman P, Lechner L, editors. Gezondheidsvoorlichting en gedragsverandering. Assen: van Gorcum; 2007. p. 151–72.
23.
Zurück zum Zitat Glasgow R, Vogt T, Boles S. Evaluating the public health impact of health promotion interventions: the RE-AIM framework. Am J Public Health. 1999;89:1322–7.CrossRefPubMedCentralPubMed Glasgow R, Vogt T, Boles S. Evaluating the public health impact of health promotion interventions: the RE-AIM framework. Am J Public Health. 1999;89:1322–7.CrossRefPubMedCentralPubMed
24.
Zurück zum Zitat Grol R, Wensing M, Eccles M. Improving patient care: the implementation of change in clinical practice. Oxford: Elsevier; 2005. Grol R, Wensing M, Eccles M. Improving patient care: the implementation of change in clinical practice. Oxford: Elsevier; 2005.
25.
Zurück zum Zitat Chaudoir SR, Dugan AG, Barr CHI. Measuring factors affecting implementation of health innovations: a systematic review of structural, organizational, provider, patient, and innovation level. Implement Sci. 2013;8:22.CrossRefPubMedCentralPubMed Chaudoir SR, Dugan AG, Barr CHI. Measuring factors affecting implementation of health innovations: a systematic review of structural, organizational, provider, patient, and innovation level. Implement Sci. 2013;8:22.CrossRefPubMedCentralPubMed
26.
Zurück zum Zitat Grol R, Grimshaw J. From best evidence to best practice: effective implementation of change in patients’ care. Lancet. 2003;362:1225–30.CrossRefPubMed Grol R, Grimshaw J. From best evidence to best practice: effective implementation of change in patients’ care. Lancet. 2003;362:1225–30.CrossRefPubMed
27.
Zurück zum Zitat Rogers EM. Diffusion of innovations. 3rd ed. New York: The Free Press; 1983. Rogers EM. Diffusion of innovations. 3rd ed. New York: The Free Press; 1983.
28.
Zurück zum Zitat Michie S, Johnston M, Abraham C, Lawton R, Parker D, Walker A. Making psychological theory useful for implementing evidence based practice: a consensus approach. Qual Saf Health Care. 2005;14:26–33.CrossRefPubMedCentralPubMed Michie S, Johnston M, Abraham C, Lawton R, Parker D, Walker A. Making psychological theory useful for implementing evidence based practice: a consensus approach. Qual Saf Health Care. 2005;14:26–33.CrossRefPubMedCentralPubMed
29.
Zurück zum Zitat Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009;4:50.CrossRefPubMedCentralPubMed Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009;4:50.CrossRefPubMedCentralPubMed
30.
Zurück zum Zitat Eakin EG, Smith BJ, Bauman AE. Evaluating the population health impact of physical activity interventions in primary care: are we asking the right questions? Phys Health. 2005;2:197–215. Eakin EG, Smith BJ, Bauman AE. Evaluating the population health impact of physical activity interventions in primary care: are we asking the right questions? Phys Health. 2005;2:197–215.
31.
Zurück zum Zitat Estabrooks PA, Glasgow RE. Translating effective clinic-based physical activity interventions into practice. Am J Prev Med. 2006;31(4S):S45–56.CrossRefPubMed Estabrooks PA, Glasgow RE. Translating effective clinic-based physical activity interventions into practice. Am J Prev Med. 2006;31(4S):S45–56.CrossRefPubMed
32.
Zurück zum Zitat Grol RPTM, Bosch MC, Hulscher MEJL, Eccles MP, Wensing M. Planning and studying improvement in patient care: the use of theoretical perspectives. Milbank Q. 2007;85(1):93–138.CrossRefPubMedCentralPubMed Grol RPTM, Bosch MC, Hulscher MEJL, Eccles MP, Wensing M. Planning and studying improvement in patient care: the use of theoretical perspectives. Milbank Q. 2007;85(1):93–138.CrossRefPubMedCentralPubMed
33.
Zurück zum Zitat Fleuren M, Dusseldorp E, van den Bergh S, Vlek H, Wildschut J, van den Akker E, et al. Implementation of a shared care guideline for back pain: effect on unnecessary referrals. Int J Qual Health Care. 2010;22(5):415–20.CrossRefPubMedCentralPubMed Fleuren M, Dusseldorp E, van den Bergh S, Vlek H, Wildschut J, van den Akker E, et al. Implementation of a shared care guideline for back pain: effect on unnecessary referrals. Int J Qual Health Care. 2010;22(5):415–20.CrossRefPubMedCentralPubMed
34.
Zurück zum Zitat de Veer AJE, Fleuren MAH, Bekkema N, Francke AL. Successful implementation of new technologies in nursing care: a questionnaire survey of nurse-users. BMC Med Inform Decis Making. 2011;11:67.CrossRef de Veer AJE, Fleuren MAH, Bekkema N, Francke AL. Successful implementation of new technologies in nursing care: a questionnaire survey of nurse-users. BMC Med Inform Decis Making. 2011;11:67.CrossRef
35.
Zurück zum Zitat Fleuren MAH, Vrijkotte S, Jans MP, Pin R, van Hespen A, van Meeteren NLU, et al. The implementation of the functional task exercise programme for elderly people living at home. BMC Musculoskelet Disord. 2012;13(1):128.CrossRefPubMedCentralPubMed Fleuren MAH, Vrijkotte S, Jans MP, Pin R, van Hespen A, van Meeteren NLU, et al. The implementation of the functional task exercise programme for elderly people living at home. BMC Musculoskelet Disord. 2012;13(1):128.CrossRefPubMedCentralPubMed
36.
Zurück zum Zitat Rosman AN, Vlemmix F, Fleuren MAH, Rijnders ME, Beuckens A, Opmeer BC, et al. Patients’ and professionals’ barriers and facilitators to external cephalic version for breech presentation at term, a qualitative analysis in the Netherlands. Midwifery. 2014;30(3):324–30.CrossRefPubMed Rosman AN, Vlemmix F, Fleuren MAH, Rijnders ME, Beuckens A, Opmeer BC, et al. Patients’ and professionals’ barriers and facilitators to external cephalic version for breech presentation at term, a qualitative analysis in the Netherlands. Midwifery. 2014;30(3):324–30.CrossRefPubMed
37.
Zurück zum Zitat ATLAS.ti Scientific Software Development GmbH. ATLAS.ti version 5.2.0. 2013. ATLAS.ti Scientific Software Development GmbH. ATLAS.ti version 5.2.0. 2013.
38.
Zurück zum Zitat Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77–101.CrossRef Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77–101.CrossRef
39.
Zurück zum Zitat Allenspach EC, Handschin M, Kutlar Joss M, Hauser A, Nüscheler M, Grize L, et al. Patient and physician acceptance of a campaign approach to promoting physical activity: the “Move for Health” project. Swiss Med Wkly. 2007;137:292–9.PubMed Allenspach EC, Handschin M, Kutlar Joss M, Hauser A, Nüscheler M, Grize L, et al. Patient and physician acceptance of a campaign approach to promoting physical activity: the “Move for Health” project. Swiss Med Wkly. 2007;137:292–9.PubMed
40.
Zurück zum Zitat Bize R, Cornuz J, Martin B. Opinions and attitudes of a sample of Swiss physicians about physical activity promotion in a primary care setting. Swiss Med Wkly. 2007;55:97–100. Bize R, Cornuz J, Martin B. Opinions and attitudes of a sample of Swiss physicians about physical activity promotion in a primary care setting. Swiss Med Wkly. 2007;55:97–100.
41.
42.
Zurück zum Zitat Patel A, Schofield GM, Kolt GS, Keogh JWL. General practitioners’ views and experiences of counselling for physical activity through the New Zealand Green Prescription program. BMC Fam Pract. 2011;12:119.CrossRefPubMedCentralPubMed Patel A, Schofield GM, Kolt GS, Keogh JWL. General practitioners’ views and experiences of counselling for physical activity through the New Zealand Green Prescription program. BMC Fam Pract. 2011;12:119.CrossRefPubMedCentralPubMed
43.
Zurück zum Zitat Swinburn BA, Walter LG, Arroll B, Tilyard MW, Russell DG. Green prescriptions: attitudes and perceptions of general practitioners towards prescribing exercise. Brit J Gen Pract. 1997;47(422):567–9. Swinburn BA, Walter LG, Arroll B, Tilyard MW, Russell DG. Green prescriptions: attitudes and perceptions of general practitioners towards prescribing exercise. Brit J Gen Pract. 1997;47(422):567–9.
44.
Zurück zum Zitat van Sluijs EMF, van Poppel MNM, Stalman WAB, van Mechelen W. Feasibility and acceptability of a physical activity promotion programme in general practice. Fam Pract. 2004;21(4):429–36.CrossRefPubMed van Sluijs EMF, van Poppel MNM, Stalman WAB, van Mechelen W. Feasibility and acceptability of a physical activity promotion programme in general practice. Fam Pract. 2004;21(4):429–36.CrossRefPubMed
45.
Zurück zum Zitat Winzenberg T, Reid P, Shaw K. Assessing physical activity in general practice: a disconnect between clinical practice and public health? Brit J Gen Pract. 2009;59:e359–67.CrossRef Winzenberg T, Reid P, Shaw K. Assessing physical activity in general practice: a disconnect between clinical practice and public health? Brit J Gen Pract. 2009;59:e359–67.CrossRef
46.
Zurück zum Zitat Gribben B, Goodyear-smith F, Grobbelaar M, O’Neill D, Walker S. The early experience of general practitioners using Green Prescription. N Z Med J. 2000;113:372–3.PubMed Gribben B, Goodyear-smith F, Grobbelaar M, O’Neill D, Walker S. The early experience of general practitioners using Green Prescription. N Z Med J. 2000;113:372–3.PubMed
47.
Zurück zum Zitat Märki A, Bauer GB, Angst F, Nigg CR, Gillmann G, Gehring TM. Systematic counselling by general practitioners for promoting physical activity in elderly patients: a feasibility study. Swiss Med Wkly. 2006;136:482–8.PubMed Märki A, Bauer GB, Angst F, Nigg CR, Gillmann G, Gehring TM. Systematic counselling by general practitioners for promoting physical activity in elderly patients: a feasibility study. Swiss Med Wkly. 2006;136:482–8.PubMed
48.
Zurück zum Zitat Petrella RJ, Wight D. An office-based instrument for exercise counseling and prescription in primary care. The Step Test Exercise Prescription (STEP). Arch Fam Med. 2000;9(4):339–44.CrossRefPubMed Petrella RJ, Wight D. An office-based instrument for exercise counseling and prescription in primary care. The Step Test Exercise Prescription (STEP). Arch Fam Med. 2000;9(4):339–44.CrossRefPubMed
49.
Zurück zum Zitat Graham RC, Dugdill L, Cable NT. Health professionals’ perspectives in exercise referral: implications for the referral process. Ergonomics. 2005;48:1411–22.CrossRefPubMed Graham RC, Dugdill L, Cable NT. Health professionals’ perspectives in exercise referral: implications for the referral process. Ergonomics. 2005;48:1411–22.CrossRefPubMed
50.
Zurück zum Zitat Schmid M, Egli K, Brian MW, Bauer GF. Health promotion in primary care: evaluation of a systematic procedure and stage specific information for physical activity counselling. Swiss Med Wkly. 2009;139:665–71.PubMed Schmid M, Egli K, Brian MW, Bauer GF. Health promotion in primary care: evaluation of a systematic procedure and stage specific information for physical activity counselling. Swiss Med Wkly. 2009;139:665–71.PubMed
51.
Zurück zum Zitat Douglas F, Van Teijlingen E, Torrance N, Fearn P, Kerr A, Meloni S. Promoting physical activity in primary care settings: health visitors’ and practice nurses’ views and experiences. J Adv Nurs. 2006;55(2):159–68.CrossRefPubMed Douglas F, Van Teijlingen E, Torrance N, Fearn P, Kerr A, Meloni S. Promoting physical activity in primary care settings: health visitors’ and practice nurses’ views and experiences. J Adv Nurs. 2006;55(2):159–68.CrossRefPubMed
52.
Zurück zum Zitat Puig Ribera A, McKenna J, Riddoch C. Attitudes and practices of physicians and nurses regarding physical activity promotion in the Catalan primary health-care system. Eur J Public Health. 2005;15(6):569–75.CrossRefPubMed Puig Ribera A, McKenna J, Riddoch C. Attitudes and practices of physicians and nurses regarding physical activity promotion in the Catalan primary health-care system. Eur J Public Health. 2005;15(6):569–75.CrossRefPubMed
53.
Zurück zum Zitat Sassen B, Kok G, Vanhees L. Predictors of healthcare professionals’ intention and behaviour to encourage physical activity in patients with cardiovascular risk factors. BMC Public Health. 2011;11:246.CrossRefPubMedCentralPubMed Sassen B, Kok G, Vanhees L. Predictors of healthcare professionals’ intention and behaviour to encourage physical activity in patients with cardiovascular risk factors. BMC Public Health. 2011;11:246.CrossRefPubMedCentralPubMed
54.
Zurück zum Zitat Puig Ribera A, McKenna J, Riddoch C. Physical activity promotion in general practices of Barcelona: a case study. Health Educ Res. 2006;21(4):538–48.CrossRef Puig Ribera A, McKenna J, Riddoch C. Physical activity promotion in general practices of Barcelona: a case study. Health Educ Res. 2006;21(4):538–48.CrossRef
55.
Zurück zum Zitat Smith PA, Gould MM, See Tai S, Iliffe S. Exercise as therapy? Results from group interviews with general practice teams involved in an inner-London “prescription for exercise” scheme. Health Educ J. 1996;55(4):439–46.CrossRef Smith PA, Gould MM, See Tai S, Iliffe S. Exercise as therapy? Results from group interviews with general practice teams involved in an inner-London “prescription for exercise” scheme. Health Educ J. 1996;55(4):439–46.CrossRef
56.
Zurück zum Zitat Walsh JM, Swangard DM, Davis T, McPhee SJ. Exercise counseling by primary care physicians in the era of managed care. Am J Prev Med. 1999;16(4):307–13.CrossRefPubMed Walsh JM, Swangard DM, Davis T, McPhee SJ. Exercise counseling by primary care physicians in the era of managed care. Am J Prev Med. 1999;16(4):307–13.CrossRefPubMed
Metadaten
Titel
Factors Influencing the Introduction of Physical Activity Interventions in Primary Health Care: a Qualitative Study
verfasst von
Johanna M. Huijg
Nicolette van der Zouwe
Mathilde R. Crone
Marieke W. Verheijden
Barend J. C. Middelkoop
Winifred A. Gebhardt
Publikationsdatum
01.06.2015
Verlag
Springer US
Erschienen in
International Journal of Behavioral Medicine / Ausgabe 3/2015
Print ISSN: 1070-5503
Elektronische ISSN: 1532-7558
DOI
https://doi.org/10.1007/s12529-014-9411-9

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