Numerous studies have demonstrated clinical and cost-effectiveness of physical
activity (PA) promotion in healthcare, with healthcare professionals (HCPs) identified
as a trusted resource for addressing increasing physical inactivity and its impact on
chronic disease management. The recently launched Irish Physical Activity Pathways
in Healthcare (PAPH) aims to integrates PA assessment/promotion into routine
healthcare using a 4-step approach; 1) assess 2) advise, 3) refer and 4) re-assess
PA levels. General Practice is central to PAPH integration due to its extensive reach
and its delivery of the national Chronic Disease Management programme.
Real-world implementation of initiatives like the PAPH can often be suboptimal.
Hence, having a deep understanding of local context-and-intervention specific
determinants and using this understanding to design tailored implementation
strategies (an implementation intervention) can help promote professional
engagement/patient motivation and is recommended to support regional/national
scale-up.
This study will use implementation science to deliver a targeted, theory and evidenceinformed
intervention aimed at optimising implementation of the national PAPH in
General Practice. Our implementation intervention (iPAPH) will be a first, and
although designed for the Irish context, it will be modifiable and adaptable so that it
can guide implementation of PAPH internationally.
Underpinned by the Theoretical Domains Framework, the research is mapped across
four steps. We will identify current practice and quantify gaps in PAPH
implementation nationally (using audit and cross-sectional survey) (step 1). We will
interview HCPs and patients to explore barriers/enablers that need addressing to
facilitate better PAPH implementation (step 2). Using results from steps 1 and 2, we
will develop an implementation intervention (iPAPH) using co-design, to ensure its
feasibility, acceptability and local relevance (step 3). Finally, step 4, will produce a
logic model detailing how the iPAPH intervention is expected to achieve its outcomes,
facilitating alignment of resources to goals and providing a basis for evaluation.
