Physical activity counseling by primary care physicians: attitudes, knowledge, implementation, and perceived success

Area of Science:

• Public Health
• Preventive Medicine
• General Practice

Background:

• Primary care physicians (PCPs) are crucial for physical activity (PA) counseling due to frequent patient contact.
• Limited understanding exists regarding PCPs' attitudes, knowledge, and perceived success in PA counseling.
• Factors influencing the implementation of PA counseling by PCPs require further investigation.

Purpose of the Study:

• To investigate primary care physicians' (PCPs) attitudes, knowledge, and practices regarding physical activity (PA) counseling.
• To identify factors associated with the implementation of PA counseling strategies in primary care settings.
• To assess the perceived competence and effectiveness of PCPs in promoting physical activity.

Main Methods:

• A large-scale survey of 4074 PCPs was conducted.
• Data collected included physician and practice characteristics, attitudes toward cardiovascular disease (CVD) prevention, and routine CVD prevention measures.
• The study utilized the established 5 A's strategy (Assess, Advise, Agree, Assist, Arrange) for PA counseling.

Main Results:

• A high percentage of PCPs (87.2%) reported high competence in PA counseling.
• However, over half (52.3%) felt their capability to motivate patients for increased PA was 'not good.'
• While most PCPs (90%) routinely employed at least one PA counseling strategy, only 9.5% consistently used all five.

Conclusions:

• The positive attitudes of PCPs towards PA counseling should be reinforced by public health stakeholders.
• Reimbursement for health counseling services by insurance could enable PCPs to dedicate more time to patient-specific health promotion.
• Further support and systemic changes are needed to enhance the effectiveness of PA counseling in primary care.