Exploring barriers medical residents and established physicians face counselling patients on physical activity by stage of the transtheoretical model

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Hefnawi, Badr
Leung, Lawrence
Tomasone, Jennifer R.
Physical activity , medical education , physical activity couselling , primary care , transtheoretical model
hysical activity (PA) counselling by physicians increases patients' PA levels and improves health outcomes. Physician PA counselling remains low as a result of several barriers which may differ based on a patient's stage within the Transtheoretical Model (TTM) or by physician career status (i.e. between residents and established physicians). A convenience sample of physicians in Ontario (N = 38, n = 24 residents) completed a cross-sectional, online survey assessing perception of barriers to PA counselling based on hypothetical patients' TTM stage of change. Compared with other barriers, physicians agree less with feeling adequately reimbursed, having other professionals intervene, and having adequate resources for PA counselling. Based on responses to each barrier, physicians were more likely to counsel patients in the contemplation, preparation and action stages. Compared with established physicians, residents report less agreeance with being adequately reimbursed and having enough time for PA counselling, and greater agreeance with having other professionals intervene. This study communicates physicians' barriers when counselling patients at different stages of PA behaviour change and the influence of career status on barrier experience. Developing patient-stage- and career-stage-specific medical training, interventions and policy changes may enhance PA counselling among physicians, and ultimately patient PA behaviour and health outcomes.