Physicians’ intention to provide exercise counseling to patients in Taiwan: an examination based on the Theory of Planned Behavior

Abstract

Abstract Increasingly more clinical guidelines have recommended that physicians provide exercise counseling (EC) to patients to help improve their lifestyle and enhance treatment effects. However, little is known about physicians’ EC intention and associated factors. This study aimed to systematically examine physicians’ EC intention using the Theory of Planned Behavior (TPB). Using the TPB as a theoretical and structural framework, 27 TPB items were developed and factor-analyzed to form five factors (i.e., attitudes toward positive and negative EC outcomes, subjective norms, and perceived control over EC under facilitating and constraining conditions) with satisfactory psychometric properties. Responses from 1,006 physicians (response rate 90.5%) were analyzed using multivariate logistic regression to examine the TPB-based factors associated with greater EC intention. Physicians’ favorable attitudes toward positive EC outcomes (adjusted odds ratio [AOR] 4.03) were most strongly linked to high EC intention, followed by supportive subjective norms (AOR 3.74) and high perceived control under facilitating conditions (AOR 1.64). Specifically, physicians’ EC intention was related to their attitudes toward better treatment effects and gaining respect from patients because of EC, perceived support for EC from patients and senior physicians, and perceived control over EC concerning their behavioral change skills. These findings could inform EC promotion efforts in clinical settings and medical education. EC-related training should be incorporated into medical school curriculum, residency training, and continuing medical education to enhance physicians’ EC-related knowledge and competence, including lifestyle management and behavioral change skills. Attention should also be paid to the role of patients and senior physicians in promoting EC.