Skip to main content

Table 4 Barriers and enablers to implementation of the intervention (the system and organisational level) and to the uptake of PA (individual-related levels)

From: A scoping study of interventions to increase the uptake of physical activity (PA) amongst individuals with mild-to-moderate depression (MMD)

1. Crone, D., Johnston, L.H., Gidlow, C., Henley, C., James, D.V.B. [33].
A) Barriers
i) Organisational & system level
 • Physical activity referral scheme is less suited to the needs of MMD patients.
 • Those with mental health problems find that there are barriers impeding their ability to access health services [53].
 • Primary health care professionals are insufficiently trained to work with patients affected by mental health issues.
ii) Provider/practitioner level
 • Some healthcare professionals remain skeptical of the role of physical activity as an adjunct treatment for those with mental health problems [54].
iii) Individual level
 • The uptake of the scheme was significantly lower in the mental health referrals.
 • Difficulties in access.
 • Financial constraints.
 • The side effect(s) of antidepressants [53].
 • Lack of social network and support.
B) Enablers None listed.
2. Duda, J., Williams, G., Ntoumanis, N., Daley, A., Eves, F., Mutrie, N., Rouse, P.C., Lodhia, R., Blamey, R.V., Jolly, K. [28].
A) Barriers
i) Organisational & system level
 • Insufficient training for practitioners delivering the intervention.
 • A low training attendance due to work-related commitments.
 • Lack of infrastructure e.g. limited access to PCs making it difficult for practitioners to watch training videos or receive email reminders sent by the research team.
ii) Provider/practitioner level
 • Poor treatment fidelity (e.g. an inadequate provision of autonomy support).
iii) Individual level
 • Poor engagement with minority ethnic communities, who do not speak English with sufficient fluency.
iv) Intervention level
 • Practicalities of organising an intervention: the use of interpreters proved challenging.
B) Enablers: None listed
3 Forsyth A., Deane F.P., Williams P. [24].
A) Barriers
i) Organisational & system level
 • Engaging healthcare staff in the delivery of the intervention.
ii) Provider/practitioner level None listed.
iii) Individual level
 • Engaging patients proved difficult and approximately 50% of all appointments were either cancelled or missed.
iv) Intervention level None listed.
B) Enablers
i) Intervention level
 • Calming effects of PA.
 • A preferred form of PA was walking.
4 Littlecott, H.J., Moore G.F., Moore, L., Murphy S. [29].
A) Barriers
i) Organisational & system level None listed.
ii) Provider/practitioner level
 • Poor treatment fidelity e.g. motivational interviewing and goal setting were not fully delivered [58].
iii) Individual level
 • Time and costs.
 • The nature of the intervention.
iv) Intervention level
 • Intervention design: lack of measurable goals might have led to reduced self-efficacy.
v) Context level
B) Enablers:
i) Intervention level
 • Increased participants’ confidence in using gym equipment and in exercising safely.
ii) Social context
 • Family can positively impact the participants’ engagement with the interventions; friends do not seem to have a similar impact.
5 Mailey E.L., Wójcicki T.R., Motl R.W., Hu L, Strauser D.R., Collins K.D., McAuley E. [25].
A) Barriers
i) Organisational & system level None listed.
ii) Provider/practitioner level None listed.
iii) Individual level
 • Poor engagement with PApost intervention.
 • Participants’ self-efficacy declining over time.
iv) Intervention level
 • Inadequate intervention interface design.
B) Enablers
i) Intervention level
 • Participants’ satisfaction with a number of intervention components such as meetings with intervention staff or using pedometers.
6 Oeland A.M., Laessoe U., Olesen A.V., Munk-Jørgensen P. [31].
A) Barriers
i) Organisational & system level None listed.
ii) Provider/practitioner level None listed.
iii) Individual level
 • A low uptake of amongst patients suffering from ill mental health.
 • In the follow-up period improvement stops.
iv) Intervention level
 • Post-intervention, levels of PA decrease over time e.g. due to the lack of professional instructions.
B) Enablers:
i) Intervention level
 • The presence of the instructor.
 • Mode of deliver: group exercises (which might have heightened motivation as a result of social interactions).
7 Pentecost C., Farrand P., Greaves C.J., Taylor R.S., Warren F.S., Hillsdon M., Green C., Welsman J. R., Rayson K., Evans P.H., Taylor A.H. [32].
A) Barriers
i) Organisational & system level
 • Staff turnover and absences.
 • Heavy workload.
• Clinical work and the service’s performance targets take the priority over intervention delivery
ii) Provider/practitioner level
 • Practitioners and participants’ preference for psychological treatments.
 • Practitioners not giving information booklets.
• Poor treatment fidelity; deviations from the intervention delivery protocol.
iii) Individual level
  • The nature of the condition resulting in unwillingness to engage in PA.
iv) Intervention level
 • Intervention design; information booklets –potentially overwhelming.
 • Information booklet being too heavy:‘I must admit, because I have so much to carry as a PWP, it was a bit too much’.
v) Extraneous circumstances
 • Illness of a member of the research team.
B) Enablers
i) Intervention level
 • Behavioural Activation and PA enhancing recovery rates.
 • Information booklets..
 • The diaries seemed to be one of the most useful tools in the booklets (to plan and monitor PAs).
 • Preferred types of PA: walking, gardening and exercising in a gym.
 • Monitoring PA levels with pedometers.
i) Individual level
 • PA promotion was acceptable to patients.
8 Piette J.D., Richardson C., Himle J., Duffy S., Torres T., Vogel M., Barber K., Valenstein M. [26].
A) Barriers
i) Organisational & system level: None listed.
ii) Provider/practitioner level: None listed.
iii) Individual level
 • an initial uptake: 32% of contacted individuals refused participation.
iv) Intervention level
 • Underrepresentation of individuals from various ethnic minorities (16% of the
 • study population).
B) Enablers:
i) Intervention level
 • The use of CBT to increase an uptake of PA.
9 Pomp S., Fleig L., Schwarzer R., Lippke S. [27].
A) Barriers
i) Organisational & system level: None listed.
ii) Provider/practitioner level: None listed.
iii) Individual level
 • Individuals with depressive symptoms did not increase their exercise levels.
 • Individuals’ depleted self-regulatory resources resulting in fewer capabilities to implement health behaviour; they planned less; struggled to set realistic plans and to monitor their PA levels. Also, they did not adhere to their plans.
iv) Intervention level: None listed.
B) Enablers:
i) Intervention level
 • Participants suffering from depression may benefit from weekly reminders and booster sessions; also, from additional psychotherapeutic support such as Cognitive behavioural therapy (CBT).
 • Integrated approaches that address the management of depressive symptoms and health behaviour.
10 Suija K., Pechter U., Kalda R., Tähepõld H., Maaroos J., Maaroos H.I. [18]
A) Barriers
i) Organisational & system level: None listed.
ii) Provider/practitioner level: None listed.
iii) Individual level
 • Lack of time.
• The rainy and cold weather.
iv) Intervention level
 • Type of PA intervention: unsupervised home-based exercise.
B) Enablers:
i) Individual level
 • Positive PA experience.