Table 1 A summary of the qualitative content analysis for the survey assessing the perceived impact, experiences, and challenges of the APC initiative

Education

Practices share educational information with their patients about the benefits of physical activity

69.8%

“As a surgery we are always promoting the benefits of being active, this is shared with our patients through social prescribing and also through our social media platforms.”

“There is a lot more information on both staff and patient notice boards about ways of getting more active and a lot of promotion within the staff”

Engagement with Third Party Providers

Collaboration between practices and PA providers to promote and deliver physical activity, for example parkrun

66.7%

“we have great relationships with active partnerships locally and are building on this to bring in more opportunities for pts”

“We are able to suggest local activities available to patients looking to increase activity and encourage this”

Referral Systems

Healthcare professionals can refer patients to non-medical staff specifically trained in delivering physical activity promotion

33.3%

“GP referral and self referral schemes”

“Social prescribing for local outdoor activities and Nordic walking”

Participation in staff-based PA challenges

Many practices adopted time-limited physical activity challenges to promote staff engagement and cohesion, for example a combined practice team virtual walk from Lands End to John O’Groats.

24.2%

“Staff members have taken on active challenges they were thrilled to achieve ie Keswick to Barrow 40 mile walk”

“Step challenge, Lands End to John O Groats virtual walk on strava 5 k Race for life as a practice”

Investment in infrastructure

Practices looked to invest in aids to promote physical activity and decrease sedentary behaviour. These included standing desks and bike lock-up areas.

18.2%

“I’d love to hear ideas from other practices and what they’ve done to make changes. I love the idea of putting a watt/spin type bike in the waiting room, but the idea of cleaning/wiping down/safety measures could outweigh the actual use of it.”

“using standing desks…to reduce sedentary behaviour”

Themes relating to perceived impact of APC.

Positive impact health and wellbeing

The APC has been perceived to have a positive impact at improving patients and staffs PA, decreasing SB and improving wellbeing

66.6%

“Patients are getting involved in local community activities that we advertise in the waiting room, staff are more conscious of their own activity levels - using standing desks more to reduce sedentary behaviour.”

“This is a fabulous initiative and encourages us to consider exercise as a priority when seeing our patient population”

“Helped resilience within the team”

No clear impact

Respondents did not feel that the APC had positively impacted themselves, patients or staff. Many agreed with the idea but felt delivery needed reformed.

33.3%

“What is it, other than a badge?”

“I feel I need more in house support to deliver more effectively”

Themes relating to challenges of APC implementation

Engagement

Difficulty in persuading staff and patients to implement lifestyle changes to increase their personal PA and decrease their SB, and staff engagement in promotion of PA

45.5%

“Keeping staff motivated to continue to reduce sedentary behaviour and increase activity when tired and have been busy”

“it has been difficult to motivate patients to reduce sedentary behaviour”

Time

Restrictions on personal time leading to lack of uptake of PA in both patients and staff, and restrictions on staff time limiting engagement in PA promotion

27.3%

“Off the scale demand in general practice at the moment”

“[patients] are so busy they don’t want to take it on”

Financial implications

PA activities can lead to financial costs to patients, and infrastructure to encourage PA and decrease SB within medical centres can also be costly.

12.1%

“Rurality with associated costs”

“Equipment i.e. standing desks expensive”