Building Momentum (2023)

Physical activity plays a vital role in promoting and maintaining good physical and mental health, but too many of us are not reaching recommended levels of physical activity.

This report outlines why physical activity promotion within primary healthcare (PHC) is an important tenet of the comprehensive, cross-sectoral, systems-wide approach required to increase physical activity levels. It is a cost-effective way to increase physical activity and contribute to the prevention and management of many non-communicable diseases, including many cancers. The World Health Organization (WHO) is clear that promotion of physical activity in primary care is an essential tool that can make a difference, as part of systemic change.

First, it presents the emerging evidence for the benefits of promoting physical activity in PHC, from screening and brief interventions through to prescription and referral. It is crucial for the health of individuals and economies that effective policies on physical activity promotion in PHC are designed and enacted.

However, to date many countries do not have such a policy, with barriers to adoption including lack of national-level evidence, a perceived funding shortfall, or simply a failure to engage policymakers. This report offers a global policy perspective on developments and progress, as well as guidance on foundational policy processes and recommended components for effective policies to promote physical activity in PHC. The guidance offers several recommendations.

a) Establishing sound foundational policy processes to ensure that policymakers understand the benefits:

• Using the evidence to make the case to policymakers, to design and implement physical activity promotion policies in PHC settings, and to ensure sustained take-up. This should include collecting evidence from persons with lived experience.
• Building shared policy understanding and objectives across government departments, using policy champions to drive progress forward.
• Taking context into account designing policy with regards to healthcare system models, political contexts, and social and cultural realities.
• Advancing health equity at every stage of policymaking.

b) Integrating essential components to ensure policies are effective in the promotion of physical activity in PHC:

• Enhancing PHC professional training, capacity and confidence to ensure healthcare practitioners have the tools necessary to promote physical activity in their practice and with their patients.
• Increasing health systems capacity so that PHC professionals are provided with the time, tools and incentives to provide care that is preventive, rather than reactive.
• Providing adequate incentivisation for PHC professionals to incorporate physical activity promotion into their practice.
• Using clear communication and collaboration to ensure that policies are applicable and relevant to PHC practitioners, their practice, and the patients for whom they are providing care.
• Providing a supportive environment for patients, as promotion within PHC will only work if the external environment – where we live, work and play – is supportive of change.

The report draws strongly on the experience of developing and implementing physical activity promotion policy from experts from nine countries. Supplementary annexes provide additional information to support the main report:

• Annex 1 provides detailed snapshots of the policy state of play in World Cancer Research Fund (WCRF) International’s network countries (the Netherlands, the United States and the United Kingdom: England, Scotland and Wales)
• Annex 2 provides an overview of international policy recommendations
• Annex 3 covers a broad typology of ways in which policy may be implemented in practice

This Building Momentum report has been developed to be used as an advocacy tool that can help to build a robust case for the promotion of physical activity within PHC, emphasising the use of evidence-based best practices. Well-designed policy on physical activity promotion in PHC is an opportunity to join the growing number of countries that are contributing to and building the evidence base, improving the short- and long-term health and wellbeing of the population globally.