Co-Constructing Physical Activity Interventions with Multiple Stakeholders: Findings from the Application of a Promising Approach

Background: Physical activity (PA) counselling by primary care providers (PCP) is recommended, but its implementation remains challenging, with PCPs citing lack of time and training as primary barriers. Moreover, such interventions may exacerbate health inequities, with rural, racialized, and economically disadvantaged populations experiencing reduced access to preventative care. Co-construction with stakeholder engagement is foundational to achieving acceptability and broader implementation.

Program Delivery: We adopted a co-construction approach of an evidence-based PA promotion intervention to be implemented by PCPs, targeting patients with cardiometabolic conditions. A 2-day facilitator-led workshop brought together 32 stakeholders, including patient-partners, clinicians (kinesiologists, physicians, nurses, psychologists), and researchers. The workshop followed deliberative consultation methods and used small group discussions (both expertise- and context-specific, and transdisciplinary).

Evaluation: Participants identified patients with higher SES, recently diagnosed with a cardiometabolic condition, and previously engaged in PA, as those most likely to be receptive to PA counselling. Patients with lower SES, who were allophones (i.e., first language other than English or French), and those experiencing social isolation, were identified as those most in need of PA counselling, but hardest to reach and least likely to seek PA counselling. Engaging social workers and caregivers, increasing intervention visibility with health and social service providers, and building more extensive communication channels with community partners, were identified as strategies to better address the needs of under-resourced and marginalized groups, enhance reach and adherence, and deliver impactful PA counselling efforts.

Conclusions: Our approach was deemed feasible, allowed for a greater understanding of the barriers faced by patients and clinicians, and generated solutions to facilitate the adoption of this intervention.

Practical Implications: Co-construction with multiple stakeholders is an insightful intervention development strategy. As in our case, resulting interventions should be piloted for feasibility and acceptability, and subsequently, for real-world effectiveness.

Funding: CIHR, FRQS, and the CMDO network.