Barriers and facilitators to health care providers' promotion of physical activity for individuals with mental illness: A scoping review

There is substantive evidence for the importance of physical activity (PA) for people with mental illness (MI). Health care providers play an integral role in helping individuals with MI engage in PA, yet there are numerous factors that impede the promotion of PA within clinical practice. Objective: The purpose of this review was to identify and theoretically analyze the barriers and facilitators for health care providers in promoting PA to individuals with MI. Methods: A scoping review with systematic searches was conducted. Eligible studies required sample populations of health care providers working with individuals with MI that reported empirical data on barriers and/or facilitators to PA promotion using quantitative and/or qualitative methods. Barriers and facilitators were extracted and classified into the fourteen domains of the Theoretical Domains Framework (TDF). Results: Thirty-three studies were included (15 quantitative, 12 qualitative, 6 mixed-methods), with a total of 231 factors extracted and coded to the TDF domains. Barriers and facilitators were most often classified under the domains of 'Beliefs about Consequences' and 'Environmental Context & Resources'. The most common barriers to PA promotion was a belief that clients could not overcome barriers to PA engagement, and a lack of training on how to promote PA to individuals with MI. Conclusions: Education and training that incorporates behaviour change techniques for health care providers are needed to address the identified barriers and to facilitate implementation of clinical guidelines into practice. Greater integration of PA promotion within mental health care will likely require broader systemic change.