Physical Therapists' Knowledge, Skills, Beliefs, and Organizations Impact Physical Activity Promotion: A Systematic Review and Meta-Analysis

Objective The purpose of this study was to characterize factors that influence physical therapists' physical activity (PA) promotion practices and map these factors to the Theoretical Domains Framework (TDF) to inform future implementation efforts. Methods Six databases (MEDLINE, EMBASE, Scopus, CINAHL, PsychInfo, and Web of Science) were searched from inception to March 11, 2021. Studies were included if they reported physical therapists' PA promotion practices and factors influencing these practices. Study quality was assessed with a modified Newcastle-Ottawa Scale and the Critical Appraisal Skills Programme checklist. Studies were excluded if they did not separate physical therapist PA promotion practices and influencing factors from other health professionals. Results The search yielded 12,835 references and 27 included studies. Twenty studies were included in a meta-analysis of proportions, whereas 15 studies were included in a meta-analysis of correlations. Very-low to moderate-quality evidence suggests that factors at the individual and organizational levels have very small to moderate associations with PA promotion practices. Conclusion Efforts to improve PA promotion by physical therapists should consider incorporating combinations of individual and organizational factors. Limitations to the body of evidence highlight the need for future research. Impact With PA projected to decrease in the general population by an additional 20% by 2050, PA promotion is urgently needed to maximize physical therapists' impact on the health of society. This study identifies factors that may prove useful for guiding the development of strategies to encourage greater engagement in PA promotion by physical therapists.