Narrative review – Barriers and facilitators to promotion of physical activity in primary care

The objective: to provide an overview of the literature on the barriers and facilitators to physical activity (PA) promotion in primary care, as experienced by practitioners and patients. Method: A search strategy of the English-language literature was conducted in EMBASE, MEDLINE and the COCHRANE LIBRARY. Search terms were primary care OR general practice OR family medicine OR family practitioner AND physical activity OR exercise AND barriers OR facilitators. Databases were searched from inception until 21 October 2022. Results: After screening, 63 articles were included within the summary and content analysis of this review. Analysis of the barriers to the implementation of PA highlighted four main themes perceived by practitioners: time, knowledge/skills, resources/support and financial implications. Analysis of the patient perspective identified themes which were categorised into individual (pre-existing health conditions, knowledge of benefits of PA, time/capacity), societal (social support and cultural norms) and environmental (availability of facilities and weather). Conclusions: As the importance of PA increases through the manifestation of sedentary behaviour-related disease, a combined primary care and public health approach to increase PA is required. By identifying the main barriers to PA promotion in primary care, resources and funding can be directed to address this. This is particularly relevant in the United Kingdom, with the re-negotiation of the primary care contract and the changes to healthcare delivery as a consequence of the Covid-19 pandemic. Throughout this review, we have explored ways of addressing the identified barriers through evidence-based interventions.