Guidance

UK CMOs' physical activity guidelines communications framework: main guidance

Published 24 March 2023

Introduction

The need for a UK-wide communications framework to support the dissemination and implementation of the UK Chief Medical Officers’ physical activity guidelines was recognised in the review of the previous 2011 guidelines and subsequently recommended by the UK Chief Medical Officers’ (CMOs) Communications Expert Working Group (appendix 7 – see the PDF appendices attachment published alongside this guidance publication).

Public Health Scotland (PHS) agreed to develop a communications framework, on behalf of the UK CMOs, to support the communication of the CMO guidelines to a professional audience. By doing this, we will raise awareness, increase knowledge and engage the workforce (health and non-health) to support the implementation of the guidelines.

This document has been developed based on national and local knowledge,
insight-gathering, literature search, desk research and peer engagement with members of the UK CMOs’ Physical Activity Communications Expert Working Group, UK and devolved government administrations and their respective agencies for public health and sport. The current landscape within each of the 4 UK home nations has been considered, and activities have been highlighted to help with the implementation of the framework, including broad examples of application.

While public-facing communication falls outside the scope of this work, it is recognised that professionals and practitioners are a key conduit through which messages can be conveyed to the public.

Communications professionals and the communications teams within the UK and devolved government administrations, and their respective public health agencies, are pivotal to the implementation of this framework and the development and delivery of public messaging. The current level of activity and resource will vary across the 4 home nations. It is therefore fully recognised that the availability of resource, capacity and budget will differ.

It is important, when the stage of public engagement is reached, that the 4 UK home nations engage with their respective communications professionals to consider the development of (collaborative) public-facing communications.

A consistent and collaborative approach

The communications framework will primarily assist the UK and devolved government administrations, public health agencies and partners to adopt a consistent and collaborative approach to support the dissemination and implementation of national key messages that promote and raise awareness of the UK CMOs’ physical activity guidelines.

The strategic framework can easily be tailored and applied by all 4 UK home nations to reflect their own existing infrastructure, context and needs.

The following stakeholders have been consulted in the development of the communications framework:

• UK CMOs’ Physical Activity Communications Expert Working Group
• Office of the Chief Medical Officer for England, Department of Health and Social Care (DHSC)
• Office for Health Improvement and Disparities (OHID)
• Scottish Government Office of the Chief Medical Officer and Active
  Scotland Division
• Public Health Scotland (PHS)
• Welsh Government Office of the Chief Medical Officer
• Northern Ireland Government Office of the Chief Medical Officer and Department of Health
• Public Health Wales
• Public Health Agency Northern Ireland
• Sport England
• Sportscotland
• NHS Scotland Physical Activity Special Interest Group

Guidance for professionals to enhance implementation

The aim of the communications framework is to help guide and support UK and devolved government administrations, public health agencies and partners when engaging and communicating with professionals, practitioners and policymakers to enhance the reach, knowledge and understanding and implementation of the UK CMOs’ physical activity guidelines.

Communications framework and process for delivery

This strategic communications framework is underpinned by an evidence-based framework and supporting activity, drawing on published work by members of the UK CMOs’ Physical Activity Communications Expert Working Group^{[footnote 1] [footnote 2] [footnote 3]} and colleagues in Canada.^{[footnote 4]}

The communications framework and process to help guide delivery can be divided into 3 main steps, described in the box below:

Formative research

• situational analysis
• stakeholder analysis

Development of communications

• aims and messages
• channels
• resource audit to support professional communications

Implementation

• delivery
• resources
• measures of effectiveness

The communications framework and process for delivery is equally applicable to the current and any future iterations of the UK CMOs’ physical activity guidelines.

Formative research

The first step of the framework, before developing any communications, is to consider the situation and stakeholder context in which this framework will be implemented. We recommend the following types of analysis:

Situational analysis

Take account of existing physical activity infrastructure, culture, ethnic diversity, population demographics, deprivation, socio-economic status, health status and physical activity related systems.

This could be achieved by:

• auditing the existing landscape to appreciate the already engaged key stakeholders and workforce and any work currently underway
• developing evidence-based actions to engage, influence and share good practice with stakeholders
• gathering insight to appreciate the public engagement challenge – access data (national household surveys from ONS (Office for National Statistics), YouGov) to assist with demographics and community-level data
• understanding the data available and how it can be applied to communicate with the target audience

Stakeholder analysis

Conduct stakeholder mapping focusing on the identified primary audience
detailed below:

• the core professionals and practitioners in health, social care, education and the physical activity sector required to know and apply the UK CMOs’ physical activity guidelines aligned to the 7 different life stages
• national partners (national agencies, professional bodies and networks, third sector) who can assist in the dissemination and implementation of the UK CMOs’ physical activity guidelines
• organisations and sector recognised as physical activity system enablers (in other words, policymakers) who can influence or make changes to the environment, policies or practice for the benefit of the UK population
• individuals within wider non-health specific sectors who have an active interest in enabling physical activity (for example, local authority transport and planning)

Once stakeholder analysis has been completed, an interest–influence matrix tool could be used to support final planning and implementation. This tool can be valuable when considering the level of communication, prioritisation and intensity of engagement required for each stakeholder. An example is shown in appendix 1 (see appendices PDF published alongside this publication).

Development of communications

When developing communications, consider the following 3 components:

• aims and messages
• channels
• resource audit

Aims and messages

The UK CMOs’ physical activity guidelines have been translated into educational key messages for professionals and practitioners, and advocacy messages for system enablers, to enhance the reach, knowledge and understanding and implementation of the UK CMOs’ physical activity guidelines.

The target audience has been categorised as health or non-health (social care, education and physical activity sector) and the purpose of the communication has been broken down as advocacy or education with the aim of the guideline communications also stated within appendix 2. This method of segmenting the key messages has been adapted from Milton and co-authors.^{[footnote 1]} This has been expanded on to include a breakdown of stakeholders based on advocates (those who can make a difference in their sphere of influence) and system enablers (those in a position to make the necessary changes).

Appendix 2 sets out all relevant key messages in an accessible format providing overarching messages, sector and purpose-specific messages and dose messages for different life stages.

In addition to key messages, we have identified specific ‘calls to action’ for professionals, practitioners and system enablers. Appendix 2 provides a list of the messages curated for use across the UK. It also sets out the communication aim relevant to the target audience and purpose of the communication itself.

Communications will target professionals, practitioners and policymakers within health, social care, education and the physical activity sector. These have been identified as the core workforce to implement the guidelines.

Channels

It is anticipated that the 4 UK home nations will communicate the guidelines in several ways. A series of measurable tactics have been identified to ensure that engagement and communication activity can be evaluated.

As previously mentioned, the use of an interest–influence matrix can assist with determining the intensity and actions for stakeholders. In advance of dissemination, identify and map out communication channels available and used by each stakeholder through which the UK CMOs’ physical activity guidelines can be disseminated. Consider the integration of messages and content into existing communications and learning development opportunities. Appendix 3, in the appendices PDF, provides a working example of stakeholder channel mapping for Scotland.

Examples of engagement tactics:

• use known networks to disseminate key messages
• develop online content (professional-facing) to disseminate key messages
• develop peer review journal content for publications
• develop shareable digital content for use on stakeholder websites and
  in newsletters
• plan guest blog opportunities with stakeholders
• create a web statement and/or blog and social media channels to raise awareness of the UK CMOs’ physical activity guidelines
• develop visual assets to promote shareable content
• develop other digital media, such as animations, to support communications on specific topics or for specific audiences
• develop case studies based on different life stages
• create a communications and social media calendar of annual events, conferences, pertinent awareness days, and hook communications around themes
• plan or link with relevant events and conferences

The above tactics can form part of a stakeholder toolkit to enable professionals and practitioners to integrate physical activity messaging into their practice. Content examples would be:

• the key messages
• content for email communication
• web content
• sample newsletter text
• presentation content
• social media posts and assets
• sharable content - for example, infographics, animation and talking head videos per sector

Resource audit to support professional communications

An audit of current physical activity resources, websites and learning opportunities should be conducted as it will help to capture key assets available, or any already in development for professionals, practitioners and policymakers. This exercise can help with signposting or as a method of updating with the new guidelines. Appendix 4 provides a resource audit conducted as part of the development of this framework.

Implementation

The implementation stage of the framework consists of 3 elements:

• delivery
• resources
• measures of effectiveness

Communications delivery

The delivery and dissemination of communication messages should be implemented through the identified communications channels. Partnership working with the identified stakeholder organisations is key to reaching the target audience for the UK CMOs’ physical activity guidelines - in other words, the identified practitioners, professionals and system-enablers. Application of the recommended engagement and communications tactics are key to delivery.

However, delivery is subject to planning and the resources available within each of the home nations.

Resources

The resources available within each of the home nations in terms of finance and staff capacity to enable implementation of this framework must be considered by each home nation respectively. It is acknowledged that resources may differ considerably and so this may impact on the scale and pace of dissemination and application of the UK CMOs’ physical activity guidelines within each home nation. It is therefore essential that resources are identified by each of the home nations at an appropriate scale to fully implement the UK CMOs’ physical activity guidelines.

It is recommended that, in addition to an audit of existing communications and learning resources, existing assets should, where possible, be shared between the home nations and, where new communication assets are required, these should be resourced and developed collaboratively by the home nations for use across the UK (for example, the UK CMOs’ physical activity infographics).

Measures of effectiveness

Implementation of this communications framework, to support activity to raise awareness of the UK CMOs’ physical activity guidelines with professionals, will be taken forward by each of the 4 home nations. To measure effectiveness and evaluate impact, a broad set of measures and evaluation processes should be planned, as set out below. Again, it is recognised that additional resource and budget may be required for this activity.

When planning communication activities, performance indicators should be identified to capture the impact of the tactics employed. For example:

• increased traffic to the UK CMOs’ physical activity guidelines webpages as a percentage
• analytics (social media - reach and engagement)
• online web analytics (views, pages and time spent)
• identification of user behaviours - for example, visits to website and download of specific information
• if appropriate, as part of each home nation’s plans, capture the number of new ‘sign-ups’ or ‘registrations’ for a specific campaign of targeted activity
• identification of unique online tracking goals to identify desired behaviour changes that the stakeholders may make
• deploying online marketing activity to ‘push’ targeted content towards specifically targeted groups of users

It is important to note that to gain a true measurement of impact, it is vital that each home nation gathers baseline measurements before implementing any communication activities to capture any increase in knowledge, awareness and application.

Current insight example

In January 2021, DHSC and OHID (formerly Public Health England) conducted an omnibus survey with GPs across the UK which focused on the UK CMOs’ physical activity guidelines. It provided an indicative baseline for this work in the absence of resource to undertake a more robust baseline survey.

Home nations will consider how to commission repeat surveys or similar research at an agreed time interval (on an annual or bi-annual basis) to use as a monitoring mechanism, providing an indication of awareness of the UK CMOs’ physical activity guidelines among GPs. Consideration should also be given to how this approach could be extended beyond GPs to other health professionals. Similar alternative survey options should be explored for the wider workforce in social care, education and the physical activity sector.

It is recognised that evaluative processes will vary across the home nations, therefore the reporting aspect of measuring impact will be nation-specific.

Home nations should consider and plan how to resource and implement, monitor and review the communications framework.

Guidance for professionals, practitioners and policymakers when communicating with the public

It is recognised that professionals, practitioners and policymakers are a key conduit through which messages are conveyed to the public. Although outside the scope of this communications framework, there is emerging evidence on how to develop and evaluate key messages for the public. A study by Williamson and co-authors^{[footnote 3]} aimed to further develop and improve, and gain international expert consensus on, a standardised Physical Activity Messaging Framework (PAMF) and Physical Activity Messaging Checklist (PAMC).

The study sets out best practice principles for developing public messaging. Some generic messages (taken from the UK CMOs’ physical activity guidelines) have been developed over the years, such as:

• everybody active, every day
• the good news is that even small changes can make a big difference over time. As we say in these guidelines: some is good, more is better
• every movement counts
• it is never too late to gain health benefits from taking up physical activity

Although this communications framework document does not focus on the development of public-facing messages, professional and public engagement is intrinsically linked. The study sets out the premise that if the PAMF in appendix 5 and the PAMC in appendix 6 are adopted for use, they could improve physical activity messaging practice by encouraging evidence-based and target population-focused messages with clearly stated aims and consideration of potential working pathways. They could also enhance the physical activity messaging research base by harmonising key messaging terminologies, improving quality of reporting and aiding the collation and synthesis of evidence.

It is likely that each of the 4 home nations will have existing public communications and messaging in circulation that require further alignment to the PAMF and the current UK CMOs’ physical activity guidelines.

It would be beneficial to revisit these messages as a collective and consider refreshing or revising them, in light of the professional-facing engagement, to co-produce a set of meaningful and insight-based messages for use across the UK home nations.

Next steps

This communications framework has been written to provide a guide for those in a position to disseminate the UK CMOs’ physical activity guidelines to professionals, practitioners and system-enablers.

Approved by the UK CMOs, the UK and devolved government policy leads and the home nation public health agencies are asked to respectively apply the framework in the context in which they work, with adequate resource with which to progress.

Similarly, the UK home nations should seek opportunities to work collectively and collaboratively on aspects of implementation where economy of scale can be achieved.

1. Milton K, Bauman AE, Faulkner G and others, 2020. ‘Maximising the impact of global and national physical activity guidelines: the critical role of communication strategies’, British Journal of Sports Medicine, vol. 54, no. 24, pp. 1463–1467. https://doi.org/10.1136/bjsports-2020-102324 (Accessed 3 May 2022). ↩ ↩²

2. Williamson C, Baker G, Mutrie N and others. ‘Get the message? A scoping review of physical activity messaging’, International Journal of Behavioral Nutrition and Physical Activity 17, 51 (2020). https://doi.org/10.1186/s12966-020-00954-3 (Accessed 3 May 2022). ↩

3. Williamson C, Kelly P, Tomasone JR and others. ‘A modified Delphi study to enhance and gain international consensus on the Physical Activity Messaging Framework (PAMF) and Checklist (PAMC)’, International Journal of Behavioral Nutrition and Physical Activity 18, 108 (2021). https://doi.org/10.1186/s12966-021-01182-z (Accessed 3 May 2022). ↩ ↩²

4. Tomasone JR and others. ‘Knowledge translation of the Canadian 24-Hour Movement Guidelines for Adults aged 18–64 years and Adults aged 65 years or older: a collaborative movement guideline knowledge translation process’, Applied Physiology Nutrition and Metabolism. 2020 Oct;45(10 (Suppl. 2)):S103–S124. https://pubmed.ncbi.nlm.nih.gov/33054331 (Accessed 3 May 2022). ↩