Delivering brief physical activity interventions in primary care: a systematic review of the prevalence, and factors associated with delivery, receipt, and patient receptivity

Background: Brief interventions (BI) involving physical activity (PA) screening and/or advice are recommended in primary care. However, the frequency of delivery is unknown. Aim: To examine the extent to which PA BI are delivered in primary care and explore factors associated with delivery, receipt, and patient receptivity. Design: A mixed methods systematic review, with a narrative synthesis of results. Method: CINAHL, EMBASE, MEDLINE and PsychInfo were searched from January 2012 until June 2020 for qualitative and quantitative studies reporting the level of delivery and/or receipt of PA BI within primary care, and/or factors affecting delivery, receipt, and patient receptivity. Quality was assessed using the Mixed Methods Appraisal Tool. Attitudes and barriers towards delivery were coded into the Theoretical Domains Framework and the Capabilities-Opportunities-Motivation Behaviour model. Results: After screening 13066 records, 66 articles were included. The extent of PA screening and advice in primary care varied widely (2.4% – 100%; 0.6% - 100%, respectively). PA advice was delivered more often to patients with a higher body mass index, lower PA levels, and/or more comorbidities. Barriers including a lack of time and training/guidelines remain, despite recommendations from the World Health Organisation and National Institute for Health and Care Excellence. Few studies explored patients’ receptivity to advice. Conclusion: PA BI are not delivered frequently or consistently within primary care. Addressing barriers to delivery through system-level changes and within training programmes could improve and increase the advice given. Understanding when patients are receptive to PA interventions could enhance healthcare professionals’ confidence in their delivery.