title: Physical activity on prescription (PAP) from the general practitioner's perspective - a qualitative study.
abstract: BACKGROUND
  Physical activity on prescription (PAP) is a successful intervention for increasing physical activity among patients with a sedentary lifestyle. The method seems to be sparsely used by general practitioners (GPs) and there is limited information about GPs' attitudes to counselling using PAP as a tool. The aim of the study was to explore and understand the meaning of prescribing physical activity from the general practitioner's perspective.
  
  
  METHODS
  Three focus group interviews were conducted with a purposive sample of 15 Swedish GPs in the south of Sweden. Participants were invited to talk about their experience of using PAP. The interviews were transcribed verbatim, analysed using qualitative content analysis.
  
  
  RESULTS
  The analysis resulted in four categories: The tradition makes it hard to change attitude, Shared responsibility is necessary, PAP has low status and is regarded with distrust and Lack of procedures and clear guidelines. Traditionally GPs talk with patients about the importance of an increased level of physical activity but they do not prescribe physical activity as a treatment. Physician's education focuses on the use of pharmaceuticals. The responsibility for patients' physical activity level is shared with other health professionals, the patient and society. The GPs express reservations about prescribing physical activity. A heavy workload is a source of frustration. PAP is regarded with distrust and considered to be a task of less value and status. Using a prescription to emphasize an increased level is considered to be redundant and the GPs think it should be administered by someone else in the health care system. Scepticism about the result of the method was also expressed.
  
  
  CONCLUSIONS
  There is uncertainty about using PAP as a treatment since physicians lack education in non-pharmaceutical methods. The GPs do not regard the written referral as a prioritized task and rather refer to other professionals in the health care system to prescribe PAP. GPs pointed out a need to create routines and arrangements for the method to gain credibility and become everyday practice among GPs.
authors.affiliation: Blekinge Centre of Competence, SE-371 81, Karlskrona, Sweden. gerthi.persson@ltblekinge.se.
authors.forename: Gerthi
authors.initials: G
authors.lastname: Persson
authors.forename: Annika
authors.initials: A
authors.lastname: Brorsson
authors.forename: Eva
authors.initials: E
authors.lastname: Ekvall Hansson
authors.forename: Margareta
authors.initials: M
authors.lastname: Troein
authors.forename: Eva Lena
authors.initials: EL
authors.lastname: Strandberg
mesh_terms: D001291:Attitude of Health Personnel; D003376:Counseling; D005081:Exercise Therapy; D005260:Female; D017144:Focus Groups; D058005:General Practitioners; D006801:Humans; D008297:Male; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care / Q000379:methods*; D036301:Qualitative Research; D040242:Risk Reduction Behavior; D013548:Sweden