Physical Activity Promotion in Healthcare Systems

Physical inactivity is a leading contributor to non-communicable disease burden worldwide, prompting healthcare systems to adopt strategies that integrate physical activity promotion into routine care. Key approaches include the provision of brief advice during consultations, systematic referral schemes to community or exercise specialists, embedding simple assessment tools into electronic health records and training clinicians in motivational counselling. Digital platforms and multi-behaviour frameworks have emerged to support patient self-monitoring and feedback, while theoretical models such as Self-Determination Theory guide autonomy-supportive interactions. Despite evidence that structured referral schemes and vital sign measures can enhance activity levels, barriers persist in time-constrained settings, including limited training, competing priorities and variable practitioner confidence. Ongoing efforts focus on optimising scheme components, strengthening referral pathways between generalists and physical activity specialists, and leveraging technology to personalise follow-up, with the aim of embedding sustainable, scalable interventions across primary and secondary care.

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Physical Activity Promotion in Healthcare Systems publication trend

The graph below shows the total number of articles in physical activity promotion in healthcare systems across all publications each year (not limited to Nature Index journals).

Technical terms

Physical Activity Referral Scheme (PARS): structured programmes whereby healthcare professionals direct inactive patients to supervised exercise or community activities, often comprising consultations, monitoring and follow-up.

Motivational interviewing: a collaborative counselling method aiming to enhance intrinsic motivation for behaviour change through open questioning, reflective listening and goal planning.

Exercise Vital Sign: a brief self-reported assessment integrated into routine clinical records to quantify weekly moderate-to-vigorous physical activity and prompt counselling.

Self-Determination Theory (SDT): a theory of human motivation positing that supporting autonomy, competence and relatedness fosters sustained behavioural engagement.

References

1. A systematic review and narrative synthesis of physical activity referral schemes’ components. International Journal of Behavioral Nutrition and Physical Activity (2023).
2. Promoting physical activity to patients: a scoping review of the perceptions of doctors in the United Kingdom. Systematic Reviews (2023).
3. Concurrent Validity of a Self-Reported Physical Activity “Vital Sign” Questionnaire With Adult Primary Care Patients. Preventing Chronic Disease (2016).
4. Effects of a standard provision versus an autonomy supportive exercise referral programme on physical activity, quality of life and well-being indicators: a cluster randomised controlled trial. International Journal of Behavioral Nutrition and Physical Activity (2014).
5. The Development of a Mobile Monitoring and Feedback Tool to Stimulate Physical Activity of People With a Chronic Disease in Primary Care: A User-Centered Design. JMIR mHealth and uHealth (2013).
6. Primary care staff's views and experiences related to routinely advising patients about physical activity. A questionnaire survey. BMC Public Health (2006).