Physical activity promotion among HIV providers in Colorado: an explanatory sequential mixed-methods study.

Introduction: The purpose of this study was to characterise physical activity promotion and explore strategies to increase physical activity promotion among HIV providers at an outpatient infectious disease clinic. Methods: We conducted a mixed-methods study with an explanatory sequential design using a questionnaire and semi-structured interviews. We recruited providers with an independent caseload of people living with HIV (PLHIV) in an outpatient HIV clinic. We administered a questionnaire asking about physical activity promotion with patients, followed by a semi-structured interview with a subsample of participants. We analysed questionnaire responses descriptively and interview transcripts were analysed using a conventional content analysis. Results: Seventeen providers participated in the study. Questionnaire responses (n=17) indicated that 88% of providers felt that physical activity promotion was a worthwhile intervention, but 65% did not feel that there was sufficient compensation from insurance companies or clinic resources to promote physical activity. In interviews (n=8), providers reported they felt that more structured physical activity advice for patients would be most beneficial. Conclusions: Understanding the extent of physical activity promotion among providers, as well as barriers and facilitators of this behaviour, may inform implementation of strategies to maximise health promotion. Providers generally promoted physical activity but discussed the need for structured physical activity interventions and described the current systems-level barriers for activity promotion. The incorporation of an in-clinic specialist was proposed as a potential strategy to better facilitate initiation and sustained adherence to physical activity with PLHIV but should be explored in future studies.