Assessing Physicians' Knowledge, Attitudes, Intentions, Abilities, and Behaviour Toward Physical Activity and...

Background/Objectives: The multiple benefits of physical activity and exercise (PAE) for non-communicable diseases (NCDs) and, thus, for public health underscore the importance of their multidisciplinary implementation in clinical practice. However, there is a lack of validated instruments that comprehensively assess physicians' knowledge, attitudes, intentions, abilities, and behaviour (KAIAB) regarding PAE promotion in NCD management. Methods: This study aimed to develop and validate a new questionnaire to assess physicians' KAIAB towards PAE and to evaluate their KAIAB levels. A two-stage design, including an e-Delphi method and a cross-sectional study, was conducted in Greece from January 2022 to May 2022. Results: In the first stage, after achieving consensus and stability within a purposive sample of 16 physician-experts (response rate 100%), the questionnaire was effectively developed and validated (Content Validity Ratio: 0.5-1) using a two-round e-Delphi method. In the second stage, a cross-sectional study was conducted in two physician populations from 12 medical specialities (response rate: 18.2%) and demonstrated that the new questionnaire had sufficient face validity and high reliability (Cronbach's alpha: 0.805- 0.931). The three original Bloom levels' cut-off points were also used to classify physicians' KAIAB levels in the second stage. KAIAB levels were assessed using median and interquartile range (Mdn/IQR) and were found to be low (13/6), moderate (128/79), high (35/9), moderate (21/8), and moderate (33/8), respectively. Conclusions: The new questionnaire is reliable and valid. It is recommended that the questionnaire be applied in larger studies to further verify its validity and applicability. Additionally, it was found that although physicians reported high intentions and moderately positive attitudes toward PAE promotion, their knowledge in these domains and their exercise prescription practices remained limited. This underscores the need to enhance policies and initiatives in medical education and the healthcare system.