Different components of interventions to promote Doctors’ referral for exercise professionals: a Protocol for a systematic review and meta-analysis

Doctors play a crucial role in educating patients about physical activity (PA) and exercise, but they often lack confidence and face various barriers in prescribing PA and exercise. Referring patients to qualified exercise professionals is an effective way to promote PA and exercise to more patients. Our goal is to provide practical advice on establishing and maintaining a successful referral program from doctors to exercise professionals. It is important to identify key factors that can contribute to improving doctors’ referrals to exercise professionals. This protocol aims to outline a systematic review that will examine, describe, and evaluate the impact of different interventions designed to encourage doctors to refer patients to exercise professionals. The review will assess doctors’ referral adherence and behavior change during the referral process. The protocol follows the PRISMA statement for reporting systematic reviews. The literature search will include Medline, Scopus, Web of Science, CINAHL, HTA, SPORT Discus, PEDro, Eric, and SpringerLink. Studies will be included if they investigate the referral process to exercise professionals, report outcomes related to doctors’ referrals for exercise professionals, doctors’ adherence referral rates, or doctors’ attitudes towards referrals for exercise professionals. Studies will also be included if doctors refer patients to a qualified exercise professional for physical activity counseling, exercise programming, or supervised exercise, regardless of medical diagnosis. At least two independent reviewers will conduct all stages of the review, including screening citations, data extraction, and bias assessment. A third reviewer will resolve any disagreements. Various study designs will be eligible, and the Effective Public Health Practice Project (EPHPP) will be used to evaluate quality and bias. Data will be primarily synthesized narratively, following intervention component analysis. If possible, a meta-analysis or meta-regression will be conducted to explore specific components’ influence on effect sizes. This systematic review does not require formal ethics approval. The results will be submitted to a peer-reviewed journal and presented at international conferences. This systematic review was registered in OSF (osf.io/6jhxp), DOI 10.17605/OSF.IO/6JHXP.