What Do Adults Know and Think About the United Kingdom Physical Activity Guidelines, and How Should They be Communicated? A Qualitative Exploration.

Introduction: Currently, there is limited insight into public understanding and opinion of physical activity guidelines (PAG) despite the acknowledged importance of communicating such health-related information. This study aimed to explore adults' understanding and opinions of current UK Chief Medical Officer's PAG (UKCMOPAG) in addition to messaging preferences to inform effective communication of future PAG. Methods: Qualitative semi-structured one-to-one interviews were conducted with 17 adults (52% female, mean age 33.1 years) in Scotland, United Kingdom. The interview schedule included open-ended questions developed to explore understanding and opinion of guidelines, and preferences for communication using the physical activity messaging framework. Data were analysed using framework analysis. Results: Participants were aware that PAG likely existed but could not accurately recall them. Once informed of the UKCMOPAG, they found them unappealing and unclear. They expressed uncertainty about the intended audience and questioned their relevance across different groups. Participants were, however, aware of some benefits of PA and had lived experience of short-term benefits (e.g., improved sleep and mood). As such, there was a preference for communicating UKCMOPAG through positive, relatable messages emphasising everyday benefits. Participants disliked threshold messages, suggesting continuum-based messages with a sliding scale of PA volume/intensity and associated benefits. Lastly, participants indicated that messages should be delivered by trustworthy sources, identified as the National Health Service (NHS). Conclusion: This study is the first qualitative exploration of how the general adult population in Scotland interpret the UKCMOPAG. Findings show that current communication strategies are not aligned to public understanding and opinions of PAG, indicating a need to change communication approaches. Future updates should separate technical guidance from public-facing messages, use relatable language, inclusive examples and ensure delivery by trusted sources. Continuum- and gain-framed messaging highlighting short-term PA benefits may also improve engagement. Further research is needed to evaluate the effectiveness of such audience-centred messages.