HCPs spoke at length about their experience delivering the Snacktivity intervention, in particular commentary centred on the elements impacting intervention delivery and highlighting specific barriers. Possible refinements to intervention delivery were also offered.

HCPs were asked to follow a checklist of items to be mentioned or discussed with patients during the Snacktivity intervention. There appeared to be a preference for delivering the intervention at the end of the consultation. The checklist provided to the HCPs was considered useful in helping them deliver the intervention.

It was quite good to have the checklist to go through, it was quite straightforward to go through, I think it flowed quite well. (Female dentist—WP3 HCP007)

So maybe just advising people [future HCPs delivering the Snacktivity intervention] just to … to learn the check … go through the checklist before (Male physiotherapist—WP3 HCP008)

However, not everybody found it immediately helpful, and one HCP suggested that it could be reworked into a more user-friendly format, such as being in bullet points.

If it’s supposed to be used for clinicians as a prompt to deliver the intervention as they’re doing it, it is way too complex, there is way too much stuff on there and it’s very difficult to follow, it almost needs to be designed as if it was for a patient… (Male physiotherapist—WP3 HCP001)

Several HCPs altered the checklist to suit their working environment and personal style, and one used the checklist to develop their own ‘crib sheet’, which at least one other HCP used and identified as helpful in learning to deliver the intervention.

But you only had to do it sort of once and then you know you kind of like got the gist of it, which yeah, it … that really helped, that was really good (Female podiatrist—WP2 HCP004)

Because of the COVID-19 national lockdown period in England, some consultations were delivered by HCPs using the telephone, which prompted some reflection on the relative merits of telephone and in-person delivery for health behaviour change interventions such as Snacktivity. One HCP felt that telephone delivery allowed them to maintain control of the flow of conversation and thus deliver the intervention more quickly, although most HCPs preferred in-person delivery, citing benefits. These included reading body language cues better and an increase in trust from trial patients, leading to a possible enhanced commitment to the Snacktivity intervention. Another HCP felt that in-person delivery allowed for greater personalisation of delivery which is important for new healthcare interventions.

So I thought that was a bit more of a … it was much easier to do face to face, and I thought that obviously asking them about what they do day to day already, what their normal job is, what their commute is like, makes it easier to specifically choose a plan for them. (Female dentist—WP3 HCP009)

A few limitations were noted by the HCPs, with one being concerned that time constraints in practice might reduce the effectiveness and impact of the intervention.

So in order to squeeze it in, what I would worry about is making your message less effective and almost thinking, what’s the point of me even mentioning it, if you know what I mean? (Female dentist—WP3 HCP009)

Another HCP highlighted that there may not be the flexibility to allow the Snacktivity intervention to be delivered to all patients.

‘Because you know we’ve got twenty minutes or whatever it is, forty minutes for a new patient, and you wouldn’t be able to do the Snacktivity in that time realistically, you’d be running over’ (Male podiatrist-WP2HPC001)

Some areas for improvement were noted by HCPs. The most frequently discussed barrier to the delivery of the intervention appeared to be the time required. Estimates of how much additional time the Snacktivity intervention added to a consultation ranged from 2 to 15 min.

So, it’s not five minutes. And if you’ve got a twenty-minute appointment of course, then there’s no way you’d be able to do the feet and deliver the intervention, unless you’ve got added time. (Male podiatrist—WP2 HCP001)

However, it was believed that the delivery time was likely to reduce with practice over time.

I just feel that we didn’t have enough practise doing it, obviously if it was a higher recruitment rate, it would have been much, much quicker to do that intervention. (Female dentist—WP3 HCP007)

Several HCPs indicated that intervention delivery was not burdensome.

Yeah, so it wasn’t too difficult to be fair (Male physiotherapist—WP3 HCP011)

This may have been facilitated by the steps some HCPs incorporated to ensure the smooth integration of the Snacktivity intervention within the consultation, with one composing their own approach to raising and discussing the topic of physical activity/Snacktivity.

…So I typed up my whole script and had little parts where I could extend off if I needed to, and I left little sort of pauses in between to check that the patient understood what I was saying. And I got them involved in between, just asking them a few little questions and things like that. (Male podiatrist—WP2 HCP003)