How Can We Help People With Long‐Term Health Conditions Understand and Engage in Physical Activity Maintenance From Healthcare to Community Settings? Perspectives of Patients, Carers and Professionals

INTRODUCTION: Physical activity (PA) is vital for managing long-term health conditions (LTCs), yet maintaining regular PA remains a global challenge. Partnerships between healthcare, leisure, and community services can provide accessible PA opportunities, but current pathways focus on initiating, rather than maintaining PA. Understanding factors influencing progression along PA pathways and engagement of professionals is essential. METHODS: Four focus groups of people with LTCs (n = 21; aged 39-82 years) were complemented by interviews with 19 professionals (aged 26-66) and five carers (aged 20-78 years). Inductive thematic analysis was used to generate understanding about recommendations for an integrated PA maintenance pathway, before mapping themes to the COM-B (Capability, Opportunity, Motivation, Behaviour) model. RESULTS: Key themes were: i) limited access to, and information about PA services; ii) a need for improved intersectoral collaboration; and iii) opportunities and barriers to developing a PA maintenance pathway. Primary care and community centres were deemed reliable and accessible locations to advertise local opportunities, but without digital platforms, lacked recency and condition-appropriate activities. Intermediaries emerged as community navigators, working intersectorally with knowledge of local communities, and behaviour change techniques to support maintenance. However, funding cuts limited intersectoral working. CONCLUSION: Maintaining PA among people with LTCs and carers requires a coordinated, intersectoral pathway between healthcare and community services, which extends beyond initial consultation and referral. Investment in collaborative infrastructure, accessible digital systems, and sustainable funding is lacking. However, community-based intermediaries trained in digital tools, can play a pivotal role in supporting maintenance by connecting individuals with appropriate opportunities and providing ongoing behaviour change.