PURPOSE Despite the known health benefits of physical activity (PA), few primary care pediatricians discuss, evaluate, or prescribe PA for children. The goal of this study was to examine pediatricians' thoughts and practices related to child PA and the perceived facilitators and barriers to implementing PA evaluation and prescription in pediatric primary care clinics. METHODS The Consolidated Framework for Implementation Research was used to explore implementation barriers and facilitators. A mixed-method design combined questionnaires and focus groups with 27 pediatricians. RESULTS Despite the pediatricians' beliefs that PA is important for patients, there was wide practice variability in their approaches to discussing PA. Several perceived barriers to implementing PA evaluation and prescription were identified, including lack of knowledge and training, managing time for PA with multiple demands, the need for a team approach and simple PA tools and resources, support for patient tailoring of PA messaging, and a need for PA best practice champions. CONCLUSION The identified barriers to implementing evidence in PA suggest several directions for improvement, including a care-team approach; quick, inexpensive, and simple PA tools; community PA partnerships; PA training in medical education; evidence-based strategies; and PA directories for families. These efforts could facilitate the implementation of PA best practices in pediatrics.

中文翻译：

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探索在初级儿科护理中实施运动医学最佳实践的障碍和促进因素——儿科医生的观点。

目的 尽管体力活动 (PA) 对健康有益，但很少有初级保健儿科医生讨论、评估或为儿童开出 PA 处方。本研究的目的是检查儿科医生与儿童 PA 相关的想法和实践，以及在儿科初级保健诊所实施 PA 评估和处方的感知促进因素和障碍。方法 实施研究综合框架用于探索实施障碍和促进因素。混合方法设计将问卷和焦点小组与 27 名儿科医生相结合。结果 尽管儿科医生认为 PA 对患者很重要，但他们讨论 PA 的方法存在广泛的实践差异。确定了实施 PA 评估和处方的几个感知障碍，包括缺乏知识和培训，管理有多种需求的 PA 的时间，需要团队方法和简单的 PA 工具和资源，支持患者定制 PA 消息，以及需要 PA 最佳实践冠军。结论 在 PA 中实施证据的已确定障碍提出了几个改进方向，包括护理团队方法；快速、廉价和简单的 PA 工具；社区 PA 合作伙伴关系；医学教育PA培训；循证策略；和家庭的 PA 目录。这些努力可以促进在儿科中实施 PA 最佳实践。结论 在 PA 中实施证据的已确定障碍提出了几个改进方向，包括护理团队方法；快速、廉价和简单的 PA 工具；社区 PA 合作伙伴关系；医学教育PA培训；循证策略；和家庭的 PA 目录。这些努力可以促进在儿科中实施 PA 最佳实践。结论 在 PA 中实施证据的已确定障碍提出了几个改进方向，包括护理团队方法；快速、廉价和简单的 PA 工具；社区 PA 合作伙伴关系；医学教育PA培训；循证策略；和家庭的 PA 目录。这些努力可以促进在儿科中实施 PA 最佳实践。