Stakeholders identify barriers to community physical-activity guidance for older adults with MCI

Researchers conducted semi-structured interviews from October to December 2025 with 33 older adults with mild cognitive impairment (MCI), caregivers, community healthcare professionals and community workers across one residential community and two community health service centers in Shenyang, China. Using the Consolidated Framework for Implementation Research 2.0, they analyzed interview data through a combination of deductive and inductive content analysis focused on future implementation of the physical-activity guideline PAG-CD.

Across 19 framework constructs, the researchers identified 24 barriers and 25 facilitators. Barriers included poor fit between standardized recommendations and individual needs, limited staffing and professional resources, heavy workloads, short-term collaboration between organizations, unclear accountability, safety-liability concerns, and inadequate feedback and documentation. Facilitators included confidence in the guideline developers and evidence base, stratifying recommendations by function and simplifying content, family support, trust in community clinicians, and digital communication or video support.

The authors propose adapting guidance to functional status and exercise-related risks, establishing sustained collaboration with clearly assigned roles, and providing implementer training, risk-management procedures and low-burden feedback systems. These findings describe perceived implementation conditions in a small number of settings in one Chinese city; the study assessed the pre-implementation phase, not the guideline’s effects or the effectiveness of the proposed strategies.