Factors influencing primary health care professionals' physical activity promotion behaviors: a systematic review.
BACKGROUND
Despite the promising findings related to the efficacy of interventions aimed at promoting physical activity (PA) in primary health care (PHC), the translation of these interventions to PHC practice does not always happen as desired.


OBJECTIVE
To help understand why efficacious PHC-based PA interventions are not effectively translated to practice, this study systematically reviewed the literature on factors influencing PHC professionals' PA promotion practices.


METHODS
Literature searches were conducted in Web of Science, PubMed, and PsycINFO for peer-reviewed articles published in English from 1990 onwards. Studies were included that met the following criteria: (1) involving PHC-based PA interventions, and (2) reporting factors influencing PHC professionals' PA promotion behaviors. Two researchers independently screened studies and extracted data. A narrative synthesis using thematic analysis was conducted to identify factors.


RESULTS
Of the 4,469 identified articles, 59 were included in the review. Factors were identified by qualitative methods, barrier/facilitator ratings, and the examination of the relationship between factors and PA promotion, and the effectiveness of introduction strategies. Many factors related to the development, delivery, and effects of the innovation, the sociopolitical and organizational culture, resources, and support, patient and PHC professional characteristics, and innovation strategies were identified as potential influences on PHC professionals' PA promotion practices. However, the lack of evidence on the relationship between factors and PA promotion indicated insufficient evidence on PA promotion determinants.


CONCLUSIONS
This extensive overview of potential factors can inform intervention developers and implementers on which factors may play a role when introducing PA interventions in PHC. Future research should further investigate relationships between factors and PA promotion, which should be guided by qualitative in-depth knowledge on influencing factors.
Clinical, Health and Neuropsychology, Leiden University, Wassenaarseweg 52, Leiden, The Netherlands, huijgjm@fsw.leidenuniv.nl.
Johanna M
JM
Huijg
Winifred A
WA
Gebhardt
Marieke W
MW
Verheijden
Nicolette
N
van der Zouwe
Juriena D
JD
de Vries
Barend J C
BJ
Middelkoop
Mathilde R
MR
Crone
D015438:Health Behavior; D006282:Health Personnel / Q000458:organization & administration*; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D009043:Motor Activity; D011320:Primary Health Care / Q000458:organization & administration*