title: Collaboration of general practitioners and exercise providers in promotion of physical activity a written survey among general practitioners.
abstract: BACKGROUND
  General practitioners have an ideal position to motivate inactive patients to increase their physical activity. Most patients are able to exercise in regular local facilities outside the health care setting. The purpose of this study was to get insight into general practitioners perceptions and current practices regarding referral of patients to local exercise facilities. Furthermore, collaboration with exercise providers in the community was investigated, and motivators and barriers for referral.
  
  
  METHODS
  A written questionnaire sent to a representative random sample of 800 Dutch general practitioners. Descriptive statistics and Chi(2) tests were used.
  
  
  RESULTS
  All responding general practitioners (340) recommend their patients to take more exercise when necessary and 87 % say to refer patients sometimes. Limited motivation of the patient (44 %) and reduced health status (34 %) are the most mentioned barriers for advising patients to increase physical activity. When referred, most patients are send to a physical therapist (69 %) but also local exercise facilities were mentioned (54 %). The most important barrier for referring patients to local exercise activities are patients limited financial possibilities (46 %). Restricted knowledge of local exercise- or sport facilities was an additional barrier (19 %). There is little structural collaboration between general practitioners and exercise providers, but when collaboration exists general practitioners refer more often. Positive experiences of patients (67 %), affordable offers (59 %) and information of local exercise facilities (46 %) are seen as important promoting factors for referral. Although 32 % of the general practitioners think that good collaboration would be stimulating, regular meetings with sports and exercise providers were considered the least important for increasing referral (3 %).
  
  
  CONCLUSIONS
  Dutch physicians have a positive attitude towards stimulating physical activity but referral to local exercise facilities is low. Referral is partly hindered by restricted knowledge of local exercise facilities. Although general practitioners think that collaboration is important for physical activity promotion, it should not cost them much extra time. A coordinator with knowledge of the local situation can facilitate contacts between GP practices and sports providers.
authors.affiliation: Netherlands Institute for Health Services Research (NIVEL), Department of Local Organization of Care, PO Box 1568, 3500 BN, Utrecht, The Netherlands. C.Leemrijse@nivel.nl.
authors.forename: C J
authors.initials: CJ
authors.lastname: Leemrijse
authors.affiliation: Tilburg University Tranzo, Tilburg School of Social and Behavioral Sciences, PO Box 90153, 5000 LE, Tilburg, The Netherlands. D.deBakker@nivel.nl.
authors.forename: D H
authors.initials: DH
authors.lastname: de Bakker
authors.affiliation: Stichting Onbeperkt Sportief, PO Box 200, 3980 CE, Bunnik, The Netherlands. LOoms@onbeperktsportief.nl.
authors.forename: L
authors.initials: L
authors.lastname: Ooms
authors.affiliation: Department of Rehabilitation, Nursing Science & Sport, University Medical Center Utrecht, Brain Center Rudolf Magnus, PO Box 85500, 3508 GA, Utrecht, The Netherlands. C.Veenhof-2@umcutrecht.nl.
authors.forename: C
authors.initials: C
authors.lastname: Veenhof
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D003299:Cooperative Behavior; D015444:Exercise; D005260:Female; D020446:Fitness Centers; D058006:General Practice / Q000379:methods* / Q000458:organization & administration; D006293:Health Promotion / Q000379:methods* / Q000458:organization & administration; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D012017:Referral and Consultation; D013177:Sports; D011795:Surveys and Questionnaires