Assessing physical activity in general practice: a disconnect between clinical practice and public health?
Winzenberg, T and Reid, P and Shaw, K, Assessing physical activity in general practice: a disconnect between clinical practice and public health?, British Journal of General Practice, 59, (568) pp. 850-855. ISSN 0960-1643 (2009) [Refereed Article]
GPs comply poorly to public health recommendations
to routinely assess their patients' physical activity. The
reasons for this disconnect between recommended
practice and GPs' actual practice are unclear.
To investigate GPs' perceptions of assessing physical
activity, and to explore how GPs assess their patients'
Design of the study
Semi-structured interviews were performed with 15
randomly selected southern Tasmanian GPs, with
stratification to include GPs with a range of
demographic characteristics. Each interview was
recorded, transcribed in full, and analysed using an
iterative thematic approach to identify major themes.
GPs recognised the importance of assessing physical
activity, but rather than assessing every patient, they
target at-risk patients and those with conditions likely
to benefit from increased physical activity. Depth of
assessment and GPs' definition of sufficient physical
activity varied according to the clinical and social
context of each patient. Major barriers were the time
needed to perform an adequate assessment and lack
of time to deal with physical inactivity in patients once
it was identified.
GPs' assessment of physical activity is a complex and
highly individualised process that cannot be divorced
from the issue of managing physical inactivity once it is
identified. Expectations that GPs will assess physical
activity levels in all their patients are unlikely to be met.
This must be taken into account when developing
strategies to improve physical activity assessment in
general practice, and should be considered in policy
decisions about approaches to take to improve
physical activity levels at a population level.
assessment; general practice; physical activity; primary health care