Physical activity: brief advice for adults in primary care

Gaps in the evidence

The Public Health Interventions Advisory Committee (PHIAC) identified a number of gaps in the evidence related to the programmes under examination based on an assessment of the evidence and stakeholder comments. These gaps are set out below.

1. Whether practitioners are more likely to give brief advice if it can be delivered effectively in less than a few minutes.

2. The effectiveness of differing durations of brief advice on physical activity levels.

3. What information should be provided (or not provided) when delivering brief advice.

4. What infrastructure and systems are effective in increasing delivery – for example, whether the use of incentives increases the number of brief interventions carried out by practitioners.

5. The impact of brief advice in increasing physical activity levels, as quantified by objective measures and in comparison with self-reported measures.

6. Whether any specific, or combination of, behaviour-change techniques should be used to deliver brief advice.

7. Whether practitioner knowledge and motivation have an impact on the delivery of brief advice.

8. Whether brief advice is more effective when delivered as the opportunity arises, or during an appointment made specifically for the task.

9. The effectiveness and cost effectiveness of brief advice in increasing physical activity levels among identified groups at risk of health conditions due to inactivity. This includes, for example, people with disabilities, those aged 65 and over, and people with a lower socioeconomic status. In other words, whether tailoring brief advice by population group is more effective than giving generic advice.

10. Barriers to, and facilitators for, increasing physical activity levels in response to brief advice.

11. The effectiveness of specific brief advice interventions (in terms of frequency, intensity and duration) and maintenance of behaviour change in the longer term

12. A comparison of the relative effectiveness of brief advice for physical activity in the general population compared with a sedentary population.

13. Whether there is a differential effect of different durations and frequency of follow-up on the effectiveness of brief advice to increase physical activity.

14. Current level of use of the original brief intervention recommendations from NICE public health guidance 2, general practice physical activity questionnaire (GPPAQ) and the 'Let's get moving' physical activity care pathway.

The Committee made a number of recommendations for research into areas that it believes will be a priority for developing future guidance. These are listed in recommendations for research.