BACKGROUND Physical activity is recognised as important for diabetes management and improved overall health of individuals with diabetes, yet many adults with diabetes are inactive. Healthcare professionals have been identified as key to promoting physical activity, including individuals with diabetes, but are ill-prepared to deliver this. Our paper evaluates the barriers/facilitators of healthcare professionals' delivery of physical activity guidance to adults with diabetes and aims to inform efforts to investigate and enhance their preparedness to promote physical activity. METHODS A sequential mixed method, two-phase design was adopted involving a purposeful sample of healthcare professionals. Phase one was an online pilot survey designed to test assumptions around healthcare professionals' knowledge, training and preparedness to deliver physical activity guidance. Phase two comprised eighteen semi-structured interviews, thematically analysed to provide an in-depth exploration of healthcare professionals' experiences of delivering physical activity guidance to adults with diabetes. RESULTS Healthcare professionals are committed to promoting physical activity to adults with diabetes and are reasonably confident in giving basic, generic guidance. Yet, significant challenges prevent them from achieving this in their practice, including: lack of education and training around physical activity, diabetes and health; ignorance of recommended physical activity and diabetes guidelines; lack of awareness of referral options; limited time and accessibility to appropriate resources. Nevertheless, healthcare professionals believed discussions around physical activity needed to be an integral part of consultations, incorporating improved communication strategies for conveying key physical activity messages. CONCLUSIONS HCPs have a key role in the promotion of physical activity to people with long-term conditions such as diabetes and they are identified within both the strategic policy context and national interventions for physical activity. Yet, this study indicated that HCPs face multiple and at times complex barriers to physical activity promotion generally and with diabetes patients. Conversely HCPs also reported what works, why and how, when promoting physical activity. Rich information derived from the day-to-day, working healthcare professional is integral to shaping future practices going forward. The bottom up, iterative design adopted in this study provides an approach to tap into this information.

中文翻译：

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医疗保健专业人员如何为糖尿病患者提供体育锻炼指导？形成性评估。

背景技术体育活动被认为对糖尿病管理和改善糖尿病个体的整体健康很重要，然而许多糖尿病成年人却不活跃。医护人员已被认为是促进体育锻炼的关键，包括糖尿病患者，但他们准备不足以做到这一点。我们的论文评估了医疗保健专业人员向糖尿病成年人提供体育锻炼指导的障碍/促进者，旨在为调查和加强他们为促进体育锻炼做好准备提供信息。方法采用顺序混合法，两阶段设计，涉及目标人群的医疗保健专业人员。第一阶段是一项在线试点调查，旨在测试有关医疗保健专业人员知识的假设，提供体育锻炼指导的培训和准备。第二阶段包括十八次半结构化访谈，并进行了专题分析，以深入探讨医疗保健专业人员向成年人提供体育锻炼指导的经验。结果医疗保健专业人员致力于促进糖尿病成年人的体育锻炼，并对提供基本的通用指导意见充满信心。然而，严峻的挑战阻止他们在实践中实现这一目标，包括：缺乏有关体育锻炼，糖尿病和健康的教育和培训；不了解建议的体育锻炼和糖尿病指南；对推荐选项的认识不足；时间有限，无法使用适当的资源。不过，医疗保健专业人员认为，围绕身体活动的讨论必须成为咨询的组成部分，并结合改进的沟通策略来传达重要的身体活动信息。结论HCP在促进糖尿病等长期病患者的体育锻炼中起关键作用，并且在战略政策背景和国家体育锻炼干预措施中均已发现。然而，这项研究表明，对于普通人群和糖尿病患者，HCP面临着多种有时有时是复杂的促进体育锻炼的障碍。相反，HCP也报告了在促进体育锻炼时有效的方法，原因和方式。从日常工作的医疗保健专业人员那里获得的丰富信息对于塑造未来的实践至关重要。自下而上