From Delivery to Adoption of Physical Activity Guidelines: Realist Synthesis
AIM The study documented the attitudes and practices of French general practitioners (GPs) regarding the prescription of physical activity (PA) for obesity management. METHODS A cross-sectional survey of all 254GPs with practices in a city in the south of France was performed, of which 203 (80%) questionnaires were returned. From these, demographic, professional and personal data, beliefs, attitudes, training and barriers to prescribing PA were assessed. RESULTS GPs are very much aware of the importance of PA in the management of obesity, as 94% reportedly prescribed it frequently ('usually' or 'often'). However, only a minority recommended PA levels that were consistent with most guidelines. Even though most of the GPs (71%) reported a lack of training in prescribing PA, only a slight majority (52%) wished to undergo such training. Patients' non-compliance was the main obstacle for 63% of the GPs. Also, although only 1% of the GPs used software and Internet resources, 62% expressed a desire to incorporate these tools in their practices. The personal characteristics of GPs also influenced their attitudes and practices, as reflected by the fact that overweight or obese GPs favoured psychobehavioural management rather than PA (P=0.03). Younger GPs (<45 years) felt less adequately trained than their elders (P=0.01) and were more eager for additional training. CONCLUSION GPs play a central role in preventing the pandemic of obesity and other chronic diseases for which PA is a cornerstone. However, the need to improve GP practices in prescribing PA remains a challenge. Better medical education and the development of adequate Web-based tools should also be prioritized.