Health care professionals’ experiences of supporting persons with metabolic risk factors to increase their physical activity level – a qualitative study in primary care

Figures & data

Table 1. Number of focus groups, profession, number of participants and years of clinical experience.

Focus group ID	Profession	Number of participants (men/women)	Number of regions represented in each group	Experience from clinical work in primary care
				≤5 years, n	>5 years, n
FGPT1	Physiotherapists	3 (0/3)	2	2	1
FGPT2	Physiotherapists	6 (1/5)	3	4	2
FGPH1	Physicians	6 (0/6)	2	3	3
FGPH2	Physicians	4 (1/3)	2	3	1
FGNU1	Nurses	3 (0/3)	2	1	2
FGNU2	Nurses	2 (0/2)	2	1	1

FGPT: Focus group with physiotherapists; FGPH: Focus group with physicians; FGNU: Focus group with nurses.

Table 2. Overview of generic categories and sub-categories identified from focus group discussions with the health care professionals.

Generic categories	Patient readiness for change	Supporting the process of change	The professional role	The organisation of primary care
Sub-categories	The patient’s attitude to physical activity	The conversation that promotes motivation and behaviour change	The health care professional’s own view	Support from management
	The patient’s insight into their own disease	Usability of tools for supporting physical activity	The views of the profession responsible for physical activity	Priorities of time and resources connected to economic consequences
			The own knowledge and competence	The role of prevention and routines within primary care
			Collaboration between professions	Primary care collaboration with other actors

Table

No. item	Description	Section #
Domain 1: Research team and reflexivity
Personal characteristics
1. Inter viewer/facilitator	Which author/s conducted the interview or focus group?	Data collection
2. Credentials	What were the researcher’s credentials? E.g. PhD, MD	Data collection
3. Occupation	What was their occupation at the time of the study?	Data collection
4. Gender	Was the researcher male or female?	Data collection
5. Experience and training	What experience or training did the researcher have?	Data collection
Relationship with participants
6. Relationship established	Was a relationship established prior to study commencement?	Data collection
7. Participant knowledge of the interviewer	What did the participants know about the researcher? e.g. personal goals, reasons for doing the research	Data collection
8. Interviewer characteristics	What characteristics were reported about the inter viewer/facilitator? e.g. Bias, assumptions, reasons and interests in the research topic	Data collection
Domain 2: Study design
Theoretical framework
9. Methodological orientation and Theory	What methodological orientation was stated to underpin the study? e.g. grounded theory, discourse analysis, ethnography, phenomenology, content analysis	Data analysis
Participant selection
10. Sampling	How were participants selected? e.g. purposive, convenience, consecutive, snowball	Setting and participants
11. Method of approach	How were participants approached? e.g. face-to-face, telephone, mail, email	Setting and participants
12. Sample size	How many participants were in the study?	Setting and participants
13. Non-participation	How many people refused to participate or dropped out? Reasons?	Setting and participants
Setting
14. Setting of data collection	Where was the data collected? e.g. home, clinic, workplace	Data collection
15. Presence of non-participants	Was anyone else present besides the participants and researchers?	Data collection
16. Description of sample	What are the important characteristics of the sample? e.g. demographic data, date	Data collection
Data collection
17. Interview guide	Were questions, prompts, guides provided by the authors? Was it pilot tested?	Data collection
18. Repeat interviews	Were repeat inter views carried out? If yes, how many?	Data collection
19. Audio/visual recording	Did the research use audio or visual recording to collect the data?	Data collection
20. Field notes	Were field notes made during and/or after the inter view or focus group?	Data collection
21. Duration	What was the duration of the inter views or focus group?	Data collection
22. Data saturation	Was data saturation discussed?	We took a pragmatic approach and decided that it was enough, as the tendency was that no new information emerged.
23. Transcripts returned	Were transcripts returned to participants for comment and/or correction?	Discussion, strengths and limitations
Domain 3: Analysis and findings
Data analysis
24. Number of data coders	How many data coders coded the data?	Data analysis
25. Description of the coding tree	Did authors provide a description of the coding tree?	Data analysis
26. Derivation of themes	Were themes identified in advance or derived from the data?	Data analysis
27. Software	What software, if applicable, was used to manage the data?	Data analysis
28. Participant checking	Did participants provide feedback on the findings?	Discussion, strengths and limitations
Reporting
29. Quotations presented	Were participant quotations presented to illustrate the themes/findings? Was each quotation identified? e.g. participant number	Results
30. Data and findings consistent	Was there consistency between the data presented and the findings?	Results
31. Clarity of major themes	Were major themes clearly presented in the findings?	Results
32. Clarity of minor themes	Is there a description of diverse cases or discussion of minor themes?	Results

Table

Generic categories	Patient readiness for change	Supporting the process of change	The professional role	The organisation of primary care
Sub-categories	The patients’ attitude to physical activity B: Low knowledge and self-awareness F: High knowledge and self-awareness	The conversation that promotes motivation and behavior change B: Lack of patient motivation F: Creating a positive climate of change F: Individualise to the patient	The health care professional’s own view B: Hard to support patients with MetS risk factors F: The importance of the supportive work F: Manage to give the patients’ the support they require	Support from management B: Mangers not interested in supporting physical activity F: Mangers are interested in supporting physical activity
	The patients’ insight to their own disease B: Feeling guilt and shame B: Patients with no established type 2 diabetes F: Patients with established type 2 diabetes	Usability of tools for supporting physical activity B: Hard to use physical activity on prescription F: Several practical methods	The view of the profession responsible for physical activity B: Physicians may disregard from talking about physical activity F: All professions perceived that they were responsible	Priorities of time and resources connected to economic consequences B: Lack of time and resources B: The economic compensation F: Enough time and resources F: More economic compensation
			The own knowledge and competence B: Lack of tools to support B: Lack of knowledge F: Having enough tools to support F: Having enough knowledge	The role of prevention and routines within primary care B: Lack of routines for the preventive work B: Low prioritization for preventive work B: Lack of collaboration between health care centers F: Having routines for the preventive work F: Having goal setting for the preventive work F: Large interest for prevention
			Collaboration between professions B: Lack of teamwork F: Work in team F: Refer patients to other professions F: Health educators as complement	Primary care collaboration with other actors B: Lack of system for referring patients to other actors B: Different prices for physical activity at different actors F: Referring patients to other actors F: Early prevention in school

B: Barriers; F: Facilitators; MetS: Metabolic syndrome.