“Guidelines… yeah, they just haven’t felt relevant to me.” A qualitative exploration of chiropractors’ perspectives on physical activity promotion

BackgroundGlobally, almost one-third of adults are considered physically inactive. Chiropractors knownly promote physical activity (PA) within their musculoskeletal management plans, despite their limited PA and sedentary behavior (SB) guideline knowledge.ObjectiveTo deepen our understanding of chiropractors' perspectives, including factors that may influence PA promotion. Specifically our objectives are to (1) explore chiropractors' knowledge of PA guidelines, (2) examine chiropractors' practices in PA assessment and advice, and (3) identify barriers, enablers, and factors influencing PA promotion in chiropractic.MethodsTwenty registered Australian chiropractors were interviewed to understand their perspectives on promoting PA in practice. We used a qualitative descriptive approach with inductive content analysis to identify patterns and themes.ResultsFour themes captured chiropractors' perspectives regarding PA: (1) chiropractors striving to take a person-centered approach to PA promotion, (2) chiropractors had limited knowledge of the PA/SB guidelines, (3) chiropractors relied on their personal intuitions and experience to try and be PA role models for their patients, and (4) chiropractors identified important enablers including longer appointment time and patient motivation as well as barriers such as limited knowledge, skill and time. Chiropractors identified interest and motivation as patient barriers.ConclusionChiropractors have limited PA/SB guideline knowledge but nevertheless report being confident, safe and person-centered with respect to PA promotion, often relying on their own experiences to be PA role models for their patients. Supporting behavior change among chiropractors, while addressing time constraints and patient motivation are important considerations.