The implementation of behaviour change practices in Physical Activity Referral Schemes: A narrative review.

Background: Physical activity referral schemes have been used extensively as one pathway to support behaviour change in people with long term conditions. Best practice guidance, across countries, recommend that schemes use behaviour change practices. The effectiveness of these schemes is inconsistent, yet, little is known about the implementation of specific approaches, or what influences practitioner’s delivery. This article provides a narrative review of evidence exploring the implementation of behaviour change practices in physical activity referral schemes. Methods: An electronic search of three databases (PubMed, Scopus, Google Scholar) was undertaken. A menu of iterative techniques were also applied from the CLUSTER approach to increase coverage. Results: A total of 45 eligible articles were included covering diverse research designs. Enduring issues with the literature pertain to the insufficient emphasis on implementation, a conflation of behaviour change practice, and an inconsistency of scheme components. Against this backdrop diverse factors within practitioner, attendee, partnership, work environment, and organisational domains influence the implementation of behaviour change practices. Conclusion: The translation of behaviour change practices to applied physical activity settings must tend to the multilevel factors which have the potential to influence the quality of behaviour change implementation.