Evaluation of the initial rollout of the physical activity referral standards policy in Scotland: a qualitative study

Objectives Physical activity referral schemes (PARS) allow healthcare professionals to refer patients for physical activity support. Evidence of effectiveness is equivocal. Public Health Scotland has developed ‘physical activity referral standards’ that aim to enhance quality, reduce variability in...

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Main Authors: Paul Kelly, Nadine Dougall, Coral L Hanson, Lis Neubeck, Sheona Mchale
Format: Article
Language:English
Published: BMJ Publishing Group 2025-01-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/1/e089723.full
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author Paul Kelly
Nadine Dougall
Coral L Hanson
Lis Neubeck
Sheona Mchale
author_facet Paul Kelly
Nadine Dougall
Coral L Hanson
Lis Neubeck
Sheona Mchale
author_sort Paul Kelly
collection DOAJ
description Objectives Physical activity referral schemes (PARS) allow healthcare professionals to refer patients for physical activity support. Evidence of effectiveness is equivocal. Public Health Scotland has developed ‘physical activity referral standards’ that aim to enhance quality, reduce variability in design and delivery and build further evidence of what works. This study evaluated stakeholder perspectives on the initial reach, adoption, implementation and effectiveness of the standards.Design A qualitative study using individual, online, semistructured interviews to explore stakeholder awareness and willingness to use the standards. We analysed data using the framework method within the context of the RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance) framework.Setting Data were collected across 28 local authorities in rural and urban areas of Scotland between December 2022 and June 2023.Participants 73 stakeholders, including scheme managers (n=34), senior managers from provider organisations (n=9), healthcare professionals (n=19) (general practitioners, nurses, occupational therapists and physiotherapists) and policy stakeholders (n=11).Results 72.6% of stakeholders were aware of the physical activity referral standards, and they were widely welcomed. Healthcare professionals were the least informed. Participants appeared willing to adopt the standards, and stakeholders reported using them to help with service planning, audit delivery processes, identify service gaps, inform monitoring and evaluation plans and understand and communicate the roles and responsibilities of different partners. Barriers to implementation included lack of healthcare professional awareness, funding and workforce capacity. Views about the minimum dataset (suggested essential or desirable data fields to be collected for monitoring and evaluation) contained in the standards were divided. Some thought it useful, but others considered it onerous or aspirational, and it was unclear whether all service delivery stakeholders would have the resources or capacity to collect and analyse the data.Conclusions The delivery of the standards could be enhanced by a comprehensive communication strategy and by addressing the lack of funding, workforce delivery capacity and skills/capacity required to collect and interpret the proposed minimum national dataset.
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spelling doaj-art-b462bd7ffbd14f53a7e60b6a2982b3e42025-02-03T11:40:13ZengBMJ Publishing GroupBMJ Open2044-60552025-01-0115110.1136/bmjopen-2024-089723Evaluation of the initial rollout of the physical activity referral standards policy in Scotland: a qualitative studyPaul Kelly0Nadine Dougall1Coral L Hanson2Lis Neubeck3Sheona Mchale46 University of Edinburgh Institute for Sport Physical Education and Health Sciences, Edinburgh, UKSchool of Health and Social Care, Edinburgh Napier University, Edinburgh, UK7 School of Health and Social Care, Edinburgh Napier University, Edinburgh, UKSchool of Health and Social Care, Edinburgh Napier University, Edinburgh, Midlothian, UKSchool of Health and Social Care, Edinburgh Napier University, Edinburgh, Midlothian, UKObjectives Physical activity referral schemes (PARS) allow healthcare professionals to refer patients for physical activity support. Evidence of effectiveness is equivocal. Public Health Scotland has developed ‘physical activity referral standards’ that aim to enhance quality, reduce variability in design and delivery and build further evidence of what works. This study evaluated stakeholder perspectives on the initial reach, adoption, implementation and effectiveness of the standards.Design A qualitative study using individual, online, semistructured interviews to explore stakeholder awareness and willingness to use the standards. We analysed data using the framework method within the context of the RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance) framework.Setting Data were collected across 28 local authorities in rural and urban areas of Scotland between December 2022 and June 2023.Participants 73 stakeholders, including scheme managers (n=34), senior managers from provider organisations (n=9), healthcare professionals (n=19) (general practitioners, nurses, occupational therapists and physiotherapists) and policy stakeholders (n=11).Results 72.6% of stakeholders were aware of the physical activity referral standards, and they were widely welcomed. Healthcare professionals were the least informed. Participants appeared willing to adopt the standards, and stakeholders reported using them to help with service planning, audit delivery processes, identify service gaps, inform monitoring and evaluation plans and understand and communicate the roles and responsibilities of different partners. Barriers to implementation included lack of healthcare professional awareness, funding and workforce capacity. Views about the minimum dataset (suggested essential or desirable data fields to be collected for monitoring and evaluation) contained in the standards were divided. Some thought it useful, but others considered it onerous or aspirational, and it was unclear whether all service delivery stakeholders would have the resources or capacity to collect and analyse the data.Conclusions The delivery of the standards could be enhanced by a comprehensive communication strategy and by addressing the lack of funding, workforce delivery capacity and skills/capacity required to collect and interpret the proposed minimum national dataset.https://bmjopen.bmj.com/content/15/1/e089723.full
spellingShingle Paul Kelly
Nadine Dougall
Coral L Hanson
Lis Neubeck
Sheona Mchale
Evaluation of the initial rollout of the physical activity referral standards policy in Scotland: a qualitative study
BMJ Open
title Evaluation of the initial rollout of the physical activity referral standards policy in Scotland: a qualitative study
title_full Evaluation of the initial rollout of the physical activity referral standards policy in Scotland: a qualitative study
title_fullStr Evaluation of the initial rollout of the physical activity referral standards policy in Scotland: a qualitative study
title_full_unstemmed Evaluation of the initial rollout of the physical activity referral standards policy in Scotland: a qualitative study
title_short Evaluation of the initial rollout of the physical activity referral standards policy in Scotland: a qualitative study
title_sort evaluation of the initial rollout of the physical activity referral standards policy in scotland a qualitative study
url https://bmjopen.bmj.com/content/15/1/e089723.full
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