Noncommunicable chronic diseases (NCDs) are a leading cause of death and disability worldwide, including in Brazil. Fortaleza, the largest capital in the northeast, mirrors this trend. The main types of NCDs are cardiovascular diseases (heart attacks and stroke), cancers, chronic respiratory diseases (obstructive pulmonary disease and asthma), and diabetes. The World Health Organization recommends that health professionals focus on health promotion to manage well-being and prevent NCD risk factors like physical inactivity, and smoking, using behavior change theoretical frameworks. While physiotherapists are well-positioned to promote health and mitigate NCDs risks, there is little information on their competencies and barriers in health promotion in Brazil.

To investigate the knowledge, attitudes, practices, and barriers to health promotion among physical therapists in Fortaleza.

A cross-sectional study was conducted using the Brazilian version of the "Knowledge, Attitudes, and Practice" questionnaire, which 30 physical therapists completed. Physical therapists were considered eligible for the study if they were currently practicing and providing services to adults. The questionnaire underwent cross-cultural adaptation following recommended procedures, ensuring appropriate semantic, idiomatic, cultural, and conceptual Equivalence in the final translated version. The ethical review board of the university approved this study and consent was considered implied for the physical therapists who participated. The questionnaire included 26 items designed to identify knowledge, attitudes, and practices related to health promotion. One item was added to the end of the questionnaire, to identify the most frequent barriers to updating clinical practice regarding health promotion. For most items, participants indicated their level of agreement using a 5-point Likert scale. Descriptive statistics and percentages were calculated for the data.

Participants, aged 25 to 47 years (mean: 32.6, SD: 5.8), were predominantly women (63.3%). The most common highest education level was a bachelor’s degree with an additional certificate (52%), and 67% had less than 9 years of clinical experience. Most respondents recognized health promotion as important disease prevention (83.3%) and behavior change (77%). However, over half lacked knowledge of behavior change theories (53%) and felt physical therapists were not well-positioned to meet clients' health promotion needs (57%). All participants agreed that physiotherapists should use appropriate methods and collaborate with stakeholders to enhance health promotion effectiveness (100%). Most reported consistently incorporating health promotion into client care (70%), with a lack of understanding about health promotion and time cited as the primary (62%) and second barriers (50%), respectively.

Physical Therapists from an underprivileged region of Brazil expressed positive attitudes towards health promotion; however, there is a need to develop an educational and supportive organizational infrastructure. This would enhance knowledge and skills of behavioral change theories, ultimately increasing research integration in physical therapy.

Potential strategies may include incorporating behavioral change theories into undergraduate programs in this city.