The promotion of non-treatment physical activity in physiotherapy and exercise physiology practice in an Australian regional hospital: A mixed-methods study

Summary: Objectives: To describe the frequency of non-treatment physical activity (NTPA) promotion by physiotherapists and accredited exercise physiologists (AEPs) practicing in an Australian regional hospital. To identify factors that influence whether physiotherapists and AEPs promote NTPA to hospital patients. Design: Mixed-methods using sequential explanatory design. Methods: Physiotherapists and AEPs working in a regional hospital setting were invited to complete an online clinician survey and participate in semi-structured interviews. Likert scale questions measured frequency and factors influencing NTPA promotion. Qualitative descriptive analysis was used to analyse interview data. Results: In total, 41 clinicians completed the survey. Of the survey respondents, 66% reported always or often promoting NTPA to their patients. In outpatient settings, 72% of respondents always or often promoted NTPA compared to 54% in inpatient settings. Survey respondents reported high levels of knowledge and confidence in NTPA promotion. Confidence promoting NTPA with unmotivated patients was 54%. Eleven clinicians participated in the interviews. The interviews identified three themes that influenced NTPA promotion in hospital practice: (1) clinicians prioritise addressing the presenting condition before NTPA; (2) clinicians believe that the patients’ motivation influences NTPA promotion; and (3) clinicians rely on their professional and interpersonal skills, and exposure to appropriate training, to promote NTPA. Conclusion: Physiotherapists and AEPs frequently promote NTPA, especially in outpatient settings. The results suggest that low patient motivation to be active, the need to prioritise hospital discharge criteria before NTPA promotion and having few resources guiding NTPA promotion might negatively impact clinicians’ ability to promote NTPA as often as they would like.