Assessing Knowledge, Attitudes and Practices of Primary Healthcare Physicians Towards Physical Activity Counseling, Saudi Arabia, Eastern Province Open Access

Abstract

Background:Physical inactivity is a major health issue in Saudi Arabia (SA) and is considered a risk factor for other non-communicable diseases. Being physically active can improve overall health and prevent the risk of non-communicable diseases and their consequences. Primary healthcare (PHC) centers are a suitable place for health promotion and physical activity (PA) counseling, both of which are affected by the knowledge, attitudes, and practices of PHC physicians.

Aims: 1. Assess the knowledge, attitudes, and practices of PHC physicians in SA toward PA through self-reported surveys. 2. Identify barriers to providing PA counseling. 3. Assess physician lifestyle behaviors and the related effects on physicians' PA counseling practices. 4. Develop a set of recommendations for a potential strategy to promote physical activity through PHC centers

Method: This cross-sectional study was conducted in four main cities in Eastern Province, SA (AL-Khobar, Dammam, Qatif, and Safwa). A total of 147 physicians filled out self-reported surveys for use in the assessment of aims.

Results: Overall,61.54% of physicians believed that PA promotion to patients was their responsibility. They felt confident in their ability to provide counseling but believed that they lacked time and adequate referral services for PA and received inadequate training in PA counseling. Among all family and general physicians, the prevalence of PA counseling practice increased if the patient had a chronic disease. Moreover, several factors were associated with physicians' attitudes toward PA counseling and their PA counseling practice, including physician age, gender, specialty, education level, university of graduation, level of knowledge about PA guidelines, general health status, number of adult and pediatric patients seen by physician/day, number of nurses working in PHC centers, and others.

Recommendations: Training the medical staff in PA counseling and empowering the healthcare manpower and infrastructure can help physicians improve their counseling practice. Furthermore, working with the community to develop an electronic referral system for community centers and gyms to promote physical activity could be beneficial. This approach would help decrease physical inactivity in SA and its related health and economic burdens.

Table of Contents

Chapter 1. Introduction

Abbreviations 2

Definitions and Terms

4

The Health Benefits of Physical Activity

8 Role of PHC Centers 11 Conceptual Framework for Physical Activity 12

Problem Statement/Significance

14

The Relevance of the Problem to the Target Population

14 Objective 14 Aims 15

Research Questions

15 Chapter 2. Literature Review 16 Physical Activity and Inactivity in SA 17 Physical Activity Promotion Intervention 24 Physical Activity Counseling 26 Physical Activity Counseling Effectiveness

28

Physical Activity Counseling in Primary Care in SA

30

Global View: Physical Activity Counseling in Primary Care

32

Chapter 3. Methodology & Results

36 Methodology 37 Study Design 37

Study Site and Population

37 Instruments 38

Human Subjects and Ethical Considerations

40 Variables 40

Data Management and Analysis

42 Results 43 Descriptive Analysis 43

Association Analysis

52

Association Between Physician Specialty and the Frequency of Physical Activity Counseling Practice

52

Characteristics Associated with Physicians' Physical Activity Counseling Practice and Attitudes

57

Characteristics Associated with Physicians' Physical Activity Counseling Practice

60

Characteristics Associated with Physician Attitudes Toward Physical Activity Counseling

73

Chapter 4. Discussion

79

Discussion

80 Limitations 87

Recommendations and Future Research

88 References 89 Appendixes 93

About this Master's Thesis

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• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Psychology, Behavioral Health Sciences, Health Care Management
Keyword	Physical Activity Counseling Saudi Arabia Primary Healthcare
Committee Chair / Thesis Advisor	Lobelo, Roberto L, Emory University
Partnering Agencies	Non-US governmental agency (e.g., Minister of Health in Haiti)

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