SUPPLEMENT – Survey instrument Tell us about you
1. What is your age?
◯ Response choices were each integer from 18 to 85, “N/A,” or “Other”
2. What is your gender?
◯ Response choices were “Male,” “Female,” “Non-binary,” “Other,” and “I choose not to identify”
3. What state is your place of primary practice as a physical therapist?
◯ Response choices included each of the 50 states and “I do not reside in the United States”
4. How many years of experience do you have as a physical therapist?
◯ Response choices included “Less than 1”, and each integer from 1 to 60, “N/A,” and
“Other”
5. What is your highest educational degree?
◯ Bachelors
◯ Masters
◯ Clinical Doctorate (DPT, tDPT, etc)
◯ Academic Doctorate (DSc, EdD, PhD, etc) 6. In what setting are you primarily practicing?
◯ Acute Care Hospital
◯ Health and Wellness Facility
◯ Hospital based outpatient facility or clinic
◯ Industry
◯ Inpatient rehab facility (IRF)
◯ Patient's home/home care
◯ Private outpatient office or group practice
◯ School system (preschool/primary/secondary)
◯ Skilled nursing facility (SNF) / Long term care
◯ Other
7. How many patient visits do you typically have as a physical therapist each week?
◯ Response choices included consecutive integers from 1 to 100, “N/A”, and “Other”
8. What age range(s) of patients do you typically treat? (check all that apply)
◯ < 18
◯ 18 to 64
◯ 65 and older
9. What system(s) are typically the primary focus of your treatment? (check all that apply)
◯ Cardiovascular and pulmonary
◯ Musculoskeletal
◯ Neuromuscular
◯ Integumentary
10. Are you or have you been a clinical instructor for a full-time DPT student at least once in the past year?
◯ Yes
◯ No
11. Do you have any additional education, aside from physical therapy, in health promotion or have you attended at least 10 hours of educational classes with a health promotion focus? Topics might include physical activity promotion, smoking cessation, healthy eating, weight loss, and alcohol consumption.
◯ Yes
◯ No
◯ Unsure
12. Do you have any additional education, aside from physical therapy, in behavior change or have you attended at least 10 hours of educational classes with a behavior
focus? Topics might include theories of behavior change and coaching strategies to facilitate behavior change.
◯ Yes
◯ No
◯ Unsure
Physical activity – any bodily movement produced by skeletal muscles that requires energy expenditure. This can be low intensity activity such as walking or gardening or high intensity activity such as playing a sport.
13. In the past week, on how many days have you done a total of 30 min or more of physical activity, which was enough to raise your breathing rate? This may include sport, exercise and brisk walking or cycling for recreation or to get to and from places but should not include housework or physical activity that may be part of your job.
◯ 0
◯ 1
◯ 2
◯ 3
◯ 4
◯ 5
◯ 6
◯ 7
14. About your own physical activity: How physically active do you think you are currently compared with other Americans of your gender and age? (please tick one)
◯ Much less active
◯ Slightly less active
◯ About the same
◯ Slightly more active
◯ Much more active
15. How many minutes of moderate intensity physical activity, as defined above, is recommended per week for adults to achieve substantial health benefits?
◯ Answers were received via text entry
16. How many minutes of vigorous intensity physical activity, as defined above, is recommended per week for adults to achieve substantial health benefits?
◯ Answers were received via text entry
17. How many days per week is strength training recommended for adults?
◯ Answers were received via text entry
18. Are you aware that there are US physical activity guidelines for adults?
◯ Yes
◯ No
◯ Unsure
19. When indicated, do you formally assess whether a patient or client falls into a risk category for physical inactivity (i.e. do you use any screening tools)?
◯ Never
◯ Rarely
◯ Sometimes
◯ Often
◯ Always
20. When you do formally assess physical inactivity, what screening tools do you utilize? (branching logic was used to display this question if the answer to Q19 was
“Rarely,” “Sometimes,” “Often,” or “Always”
◯ Answers were received via text entry
Health-enhancing physical activity - physical activity for the purpose of maintaining or improving general health rather than for the treatment of a body structure or function 21. In the last month, how often did you encourage your patients to engage in health- enhancing physical activity?
◯ Never
◯ Rarely (one or two times)
◯ Sometimes (three to five times)
◯ Often (most of the patients you treated)
◯ Always (discussed with ALL of your patients for whom it was safe and appropriate)
22. When I consider encouraging my patients to engage in health-enhancing physical activity:
Strongly disagree
Somewhat disagree
Neither agree nor disagree
Somewhat agree
Strongly agree
I know how to deliver this
intervention ◯ ◯ ◯ ◯ ◯
In my work with this
intervention, I know exactly what is expected of me
◯ ◯ ◯ ◯ ◯
I have the skills to deliver
this intervention ◯ ◯ ◯ ◯ ◯
It is my responsibility as a PT to deliver this
intervention
◯ ◯ ◯ ◯ ◯
I am confident that I can
deliver this intervention ◯ ◯ ◯ ◯ ◯
I am confident I can deliver this intervention even when there is little time
◯ ◯ ◯ ◯ ◯
I am confident I can deliver this intervention even when participants are not
motivated
◯ ◯ ◯ ◯ ◯
In my work as a PT, in uncertain times, I usually expect the best
◯ ◯ ◯ ◯ ◯
For me, delivering this
intervention is worthwhile ◯ ◯ ◯ ◯ ◯
If I deliver this intervention, it will help participants to be more physically active
◯ ◯ ◯ ◯ ◯
When I deliver this
intervention, I get financial reimbursement
◯ ◯ ◯ ◯ ◯
I intend to deliver this
intervention in the next three months
◯ ◯ ◯ ◯ ◯
Working on something else on my agenda is a higher priority than this intervention
◯ ◯ ◯ ◯ ◯
This intervention is compatible with daily practice
◯ ◯ ◯ ◯ ◯
Insurance companies provide sufficient support to deliver this intervention
◯ ◯ ◯ ◯ ◯
In the organization at which I work, all necessary
resources are available to deliver the intervention
◯ ◯ ◯ ◯ ◯
Patients receiving this intervention are positive about the intervention
◯ ◯ ◯ ◯ ◯
My work organization provides professionals with training to deliver this intervention
◯ ◯ ◯ ◯ ◯
Professionals with whom I
work deliver this intervention ◯ ◯ ◯ ◯ ◯
When I work with this
intervention, I feel optimistic ◯ ◯ ◯ ◯ ◯
When I work with this intervention, I feel pessimistic
◯ ◯ ◯ ◯ ◯
I have a clear plan regarding how I will deliver this
intervention
◯ ◯ ◯ ◯ ◯
I have a clear plan with regard to delivering this intervention when patients are not motivated
◯ ◯ ◯ ◯ ◯
I have a clear plan with regard to delivering this intervention when there is little time
◯ ◯ ◯ ◯ ◯
Delivering the intervention is
something I do automatically ◯ ◯ ◯ ◯ ◯
Delivering the intervention is
something I seldom forget ◯ ◯ ◯ ◯ ◯
