Bridging the gap between knowledge, attitudes, and practice regarding physical activity and exercise among Greek medical oncologists.

Abstract

e23141 Background: Physical activity and exercise (PAE) are core components of evidence-based cancer care. However, evidence on how PAE recommendations are translated into routine oncology practice remains limited. This nationwide study, one of the very few such studies in Europe, aimed to examine knowledge, attitudes, and behavior toward PAE among Greek medical oncologists. Methods: A nationwide, web-based, cross-sectional survey was conducted among specialist and trainee medical oncologists practicing in Greece. All eligible oncologists (N = 606) were invited to participate. A validated questionnaire assessed oncologists’ subjective and objective knowledge, attitudes, self-perceived abilities, behavior (KAAB), barriers and facilitators to PAE promotion. A modified version of Bloom’s three-level cut-off points was used to classify physicians’ KAAB levels toward PAE. The study was ethics-approved and registered (ClinicalTrials.gov NCT06981143). Results: A total of 162 medical oncologists participated (response rate 26.7%). Mean KAAB scores (± SD) were 16.18 ± 4.23 for subjective knowledge and 12.43 ± 4.77 for objective knowledge (both classified as low), 125.33 ± 14.83 for attitudes (classified as moderate), 18.12 ± 4.87 for self-perceived abilities (classified as low), and 27.96 ± 7.15 for behavior (classified as low). Internal consistency of the questionnaire scales was high, with Cronbach’s alpha coefficients ranging from 0.855 to 0.913. Overall, perceived facilitators to PAE promotion were limited, whereas perceived barriers were of moderate intensity. The most frequently reported barriers included lack of formal training, limited consultation time, absence of structured referral pathways, and limited availability of exercise professionals. In correlation analyses, subjective knowledge (ρ = 0.631, p < .001) and self-perceived abilities (ρ = 0.760, p < .001) were strongly associated with PAE-related behavior. These two variables were also strongly correlated with each other (ρ = .630, p < .001). Spearman’s correlation analysis indicated no association between barriers and overall behavior (ρ = .004, p = .956), whereas facilitators related to PAE counseling and prescription were moderately and significantly positively associated with behavior (ρ = .491, p < .001). Conclusions: The results of this study indicate a significant gap between generally favorable attitudes toward PAE and its systematic clinical implementation. They further suggest that limited subjective knowledge and, more importantly, low self-perceived clinical ability hinder implementation, whereas facilitators play a crucial enabling role in PAE promotion. Based on these findings, interventions focusing on education, organizational support, and structured referral pathways may be particularly effective in promoting PAE among cancer patients.