Identifying Potential Determinants That Can Impact the Implementation of a Physical Activity Pathway in Outpatient Physical Therapy: A Mixed Methods Study.
Mariana Wingood, Jennifer L Vincenzo, Justin B Moore and 1 others
PMID 40590492WHAT IT FOUND
Outpatient PTs approved a new physical activity pathway, calling it simple and feasible.
However, they lacked the specific skills and confidence for behavior change techniques like goal setting. Barriers included time, patient disinterest, and missing documentation templates in the electronic health record.
Key findings
01Physical therapists perceived the physical activity pathway as acceptable, appropriate, and feasible, with high agreement that it was easy to use and well designed.
02Despite recognizing the importance of physical activity, most participants did not consistently use evidence-based behavior change techniques like goal setting or action planning with their patients.
03Key barriers to implementation included lack of time, patient preference against activity, and the absence of documentation templates within the electronic health record.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was conducted in a single academic health care system, so the organizational culture and electronic health record issues described may not apply to private practice or other regions. Participants were introduced to the pathway during the study but did not actually use it in clinical practice, meaning the reported barriers are anticipated rather than experienced. The sample size for interviews was small (16 participants), and the survey respondents were predominantly female, White, and held doctorates, which may not represent the broader physical therapy workforce. There was a discrepancy between quantitative and qualitative findings regarding reimbursement, leaving the impact of financial barriers uncertain.
Declared interests
The study was funded by multiple entities including the National Center for Advancing Translational Sciences, the American Physical Therapy Association, and the National Institute on Aging. The funders played no role in the design, conduct, or reporting of the study.
The easy way to misread this
Do not assume this pathway is proven to increase patient activity levels or improve outcomes. This was a pre-implementation study that measured therapist perceptions and anticipated barriers, not actual clinical results or patient behavior change.