A Review of Educational Interventions on Physicians’ Exercise Counseling and Prescription Practices

Abstract

ABSTRACT Context Physicians report various barriers to providing patients with physical activity (PA) counseling and prescriptions. Implementing educational interventions among physicians could be an effective method for the promotion of PA counseling in primary care. Objective The purpose of this study was to review the impact and efficacy of different educational intervention modalities on physicians’ PA promotion outcomes. Design Twenty-one articles were included in this systematic review and were of moderate quality (6.8 ± 3.3 of 14 controlled trials and 6.3 ± 2.3 of 12 uncontrolled trials), assessed via the National Institutes of Health quality assessment tools. Studies ranged in sample size from 9 to 12,945 participants (n = 16,283). Eligibility Criteria For inclusion, studies had to have had interventional experimental design and performed an educational intervention aiming to improve PA counseling or exercise prescription practice, and most of the sample comprised physicians. Study Selection Sources were searched in May 2022 (n = 3422 citations without duplicates) via Scopus, EMBASE, MEDLINE, CINAHL, and Academic Search Premier (Prospero ID: CRD42022331755). Main Outcome Measures Physician PA practice outcomes across studies were categorized in terms of frequency of counseling and prescription, knowledge, and confidence. Results Most studies measuring PA counseling (8 of 13 studies) and prescription practices (8 of 10 studies) exhibited an increased frequency of PA prescription before and after the intervention. Physician confidence surrounding PA increased in most studies (10 of 12 studies), as well as knowledge of PA (6 of 7 studies). Conclusions Studies that were most effective in increasing physician PA promotion outcomes incorporated a practical component (i.e., hands-on) in addition to a theoretical session (i.e., lecture-based) to meet specific goals (e.g., accredited PA guidelines, prescription strategies). This review outlines the strengths and weaknesses of present educational intervention modalities and provides insight into future directions for education models to promote PA counseling and exercise prescription practices among physicians.