A survey of eating styles in eight countries: Examining restrained, emotional, intuitive eating and their correlates.

INTRODUCTION: Restrained, emotional and intuitive eating were examined in relation to each other and as correlates of participants' weight status, body image and self-esteem. In some past research, restrained and emotional eating have been associated with higher weight status and poorer mental health, while intuitive eating is more frequently linked to lower weight status and more positive well-being. However, these eating styles have rarely been examined together and never in a large cross-country sample. METHOD: Six-thousand two-hundred and seventy-two (6272) emerging adults (M age = 21.54 years, SD = 3.13) completed scales from the Three-Factor Eating Questionnaire, the Eating Disorders Examination Questionnaire, the Intuitive Eating Scale-2, the Multidimensional Body Self Relations Questionnaire, the Rosenberg Self-Esteem Scale, and provided weight and height information that was used to calculate body mass index (BMI). Participants resided in Australia, Belgium, Canada, China, Italy, Japan, Spain and the United States and provided information using an online survey. RESULTS: Path analyses for the entire sample revealed significant pathways between higher intuitive eating and higher body satisfaction and self-esteem, and lower BMIs among participants. Higher levels of restrained and emotional eating were associated with lower body satisfaction and self-esteem, and higher BMIs among participants. Minor cross-country differences were evident in these patterns of relations, but intuitive eating emerged as a consistent predictor across countries. CONCLUSION: Overall, findings suggest that efforts should be made to increase intuitive eating among emerging adults and to support individual and macrolevel interventions to decrease restrained and emotional eating behaviours.

Testing of a model for risk factors for eating disorders and higher weight among emerging adults: Baseline evaluation.

Although a range of risk factors have been identified for disordered eating and weight status, the breadth of risk factors have been rarely considered within a single, comprehensive model. The robustness of these findings across countries also remains an open question. The present study sampled 6272 participants aged 18-30 years from eight countries in an attempt to evaluate combined and unique predictors for these two conditions, and to explore possible cross-country differences in these models. Participants completed a range of demographic, biological, behavioral, psychological, and sociocultural measures to test a comprehensive model of the contributions of these predictors for disordered eating and weight-related constructs (binge eating, body mass index, compensatory behaviors, dietary restraint, drive for muscularity, and drive for leanness). Structural invariance testing within a multigroup path analysis framework revealed that a single model across the eight countries provided poor model fit. Freeing of 22% of parameters across countries provided excellent fit and a satisfactory compromise for country-invariant and country-variant parameters in the model. Overall, predictors accounted for between 15% and 60% of variance in the outcome measures, with lowest explained variance for the disordered eating outcomes. Significant unique contributions to prediction were observed for each of the five risk factor variable types and across the eight countries. Thus, the findings show strong support for this model as an explanatory framework of both disordered eating and weight status.

Cross-Country Measurement Invariance and Effects of Sociodemographic Factors on Body Weight and Shape Concern-Related Constructs in Eight Countries.

The aim of this study was to examine the cross-country invariance of five well-established measures of body weight and shape concern-related attitudes and behaviors (i.e., drive for leanness, drive for muscularity, strategies to increase muscle, strategies to lose weight, and weight and shape concerns). A secondary objective was to examine the effects of several sociodemographic factors (age, BMI, socioeconomic status, and gender) on item and latent factor scores of these constructs. A total of 6272 emerging adults (4218 women; Mage = 21.46, SD = 3.11) from Australia, Belgium, Canada, China, Italy, Japan, Spain, and the U.S. completed a self-report online survey as part of a larger study. Overall, support for partial invariance both across countries and in terms of the considered sociodemographic factors was found for reduced versions of the five measures. Significant differences in latent means were found across countries, these being of greater magnitude for drive for leanness and strategies to lose weight. The considered sociodemographic factors (most notably BMI and gender) were associated with the latent mean scores of the assessed constructs. The present study contributes to current literature by providing cross-cultural invariant versions of several measures of relevance in the field of body image.

Psychometric properties of measures of sociocultural influence and internalization of appearance ideals across eight countries.

The aim of the current study was to examine the psychometric properties of two well-established measures of sociocultural influence and internalization of the thin/low body fat ideal and muscular ideal. Data from 6272 emerging adults (68.9 % female), aged 18-30 years from Australia, Belgium, Canada, China, Italy, Japan, Spain, and the U.S. were included in this study. Participants completed measures of pressure from mother, fathers, peers, and media, to both increase muscles and lose weight, as well as internalization of the thin/low body fat ideal and muscular ideal. Overall, support for partial invariance was found across the scales. In addition, group level differences were found between countries as well as along demographic factors including gender, age, body mass index, and socioeconomic status. These findings make an important contribution by identifying these scales as useful tools that will support future cross-country and cross-cultural examinations of explanatory models of the development of body image and eating concerns grounded within sociocultural theories.

Assessing positive body image, body satisfaction, weight bias, and appearance comparison in emerging adults: A cross-validation study across eight countries.

Positive body image refers to individuals' ability to conceptualize their bodies with love, respect, and appreciation. The study of positive body image is relatively new, and instruments used to investigate this multi-faceted construct have received limited use in non-English speaking countries. Thus, the aim of this investigation is to consider four measures that are associated with positive body image across eight different countries. Participants (n = 6272) completed the Body Appreciation Scale-2, the Body Areas Satisfaction Scale, the Physical Appearance Comparison Scale, and the Weight Bias Internalization Scale. Multi-group confirmatory factor analyses (MG-CFAs) and item-response theory (IRT) models were used to examine the measurement invariance of these surveys. Our results generally suggest that positive body image, weight bias, and appearance comparison can be assessed using brief assessments and that these four instruments can be used in different countries, but care should be taken to consider individuals' gender, BMI, and socio-economic position.

A cross-country examination of emotional eating, restrained eating and intuitive eating: Measurement Invariance across eight countries.

This study examined the measurement invariance of three scales that assessed emotional eating, restrained eating, and intuitive eating across eight countries (Australia, Belgium, Canada, China, Italy, Japan, Spain and the United States) in order to determine their suitability for cross-country body image research. A total of 6272 young adults took part in this study. Participants completed an online survey including the Emotional Eating subscale of the Three Factor Eating Questionnaire-Revised 21, the Restraint subscale of the Eating Disorder Examination Questionnaire, and the Reliance on Hunger and Satiety Cues subscale of The Intuitive Eating Scale-2. Multi-group confirmatory factor analysis was used to evaluate potential cross-country differences in functioning of the measures. Partial invariance for all three scales was found, with only minor levels of non-invariance identified. Multiple indicator multiple cause models identified BMI and gender as potential influences on scores for these measures. Sources of invariance across groups are discussed, as well as implications for further substantive research across countries involving these measures.

Measuring perfectionism, impulsivity, self-esteem and social anxiety: Cross-national study in emerging adults from eight countries.

This study assessed the measurement invariance of selected self-report measures of perfectionism, impulsivity, self-esteem and social anxiety in samples of emerging adults from eight different countries. Participants (N = 6272) completed the Multidimensional Perfectionism Scale (MPS), the UPPS-P Impulsive Behavior Scale, the 5-item Rosenberg Self-Esteem Scale (5-item RSES) and the Social Interaction Anxiety Scale (SIAS-6). Multigroup confirmatory factor analysis was run to examine cross-measure equivalence. Evidence for structural invariance was found for all questionnaires, while weak invariance was supported only for the 5-item RSES and the SIAS-6, and a partial weak invariance was found for the MPS and the UPPS-P. No measure achieved strong invariance. Strict invariance was achieved for the 5-item RSES, whereas only a partial strict invariance was supported for the MPS, UPPS-P and SIAS-6. These results suggest that perfectionism, impulsivity, self-esteem, and social anxiety are subjected to linguistic/cultural influence as well as to the effects of socio-demographic variables and can be evaluated by using the selected measures in eight different countries worldwide - but results should be interpreted with caution.

Physical activity participation is associated with higher quality of life scores in men with alcohol use disorders: a study from Uganda.

BACKGROUND: There is a growing recognition of the importance of encouraging people with alcohol use disorders (AUD) to become more active as an achievable strategy to reduce the disability-associated burden. OBJECTIVE: We investigated whether physical activity and sedentary behaviour in men with AUD contribute to their quality of life (QoL). METHODS: Fifty male Ugandan inpatients with AUD (33.0±10.7 years) completed the World Health Organization Quality of Life Assessment brief version, Simple Physical Activity Questionnaire and the Alcohol Use Disorders Identification Test while waist circumference, body mass index and blood pressure were assessed. Linear multiple regression analysis explored the total variance in QoL explained by all predictor variables. RESULTS: SIMPAQ walking and SIMPAQ exercise explained 46% of the variability in physical QoL, 45% of the variability in psychological QoL, and 40% of the variability in environmental QoL. The SIMPAQ walking score predicted 37% of the variability in social QoL. CONCLUSION: The current findings suggest that higher levels of walking and exercising are associated with a better QoL. Our study therefore provides a platform for future research to investigate the role of physical activity on QoL levels in people with AUD, also in low resourced settings in low-income countries such as Uganda.

Psychological Distress among Patients Attending Physiotherapy: A Survey-Based Investigation of Irish Physiotherapists' Current Practice and Opinions.

Purpose: The primary purpose of this study was to investigate the current practice and opinions of members of the Irish Society of Chartered Physiotherapists (ISCP) with respect to the care of patients in psychological distress. Method: This was a cross-sectional, survey-based investigation of Irish physiotherapists. An electronic survey was sent by email to the ISCP membership. It consisted of closed- and open-ended questions, as well as opinion questions with Likert scale responses. Results: More than 80% of the respondents reported that they encountered patients with psychological distress at least once a week. A lack of education in the area of mental health emerged as a predominant theme. Reflecting on current practice, many discussed the importance of addressing underlying psychological issues before or in tandem with physical issues. Respondents who had engaged in further education in mental health, psychology, or both rated their confidence in recognizing the signs and symptoms of psychological distress higher (p < 0.001). Moreover, a greater proportion of these respondents routinely assessed for psychological distress in their clinical practice (p < 0.001). Conclusion: Physiotherapists regularly encounter patients whom they perceive to have high levels of psychological distress. Irish physiotherapists displayed positive attitudes toward patients' psychological well-being. However, additional education in mental health was a recognized need in the profession.

Objectif : explorer la pratique et les opinions des membres de l'Irish Society of Chartered Physiotherapists (ISCP) à l'égard des soins aux patients en détresse psychologique. Méthodologie : exploration transversale par sondage des physiothérapeutes irlandais. Les membres de l'ISCP ont reçu un sondage électronique par courriel, contenant des questions fermées et ouvertes et des questions d'opinion dont les réponses étaient évaluées sur l'échelle de Likert. Résultats : plus de 80 % des répondants ont déclaré rencontrer des patients en détresse psychologique au moins une fois par semaine. L'un des thèmes prédominants était l'absence de formation en santé mentale. Dans leur réflexion sur leur pratique, les physiothérapeutes étaient nombreux à souligner l'importance d'aborder les problèmes psychologiques sous-jacents avant même les problèmes physiques ou conjointement avec eux. Les répondants qui avaient approfondi leur formation en santé mentale ou en psychologie déclaraient avoir une confiance plus élevée pour reconnaître les signes et symptômes de détresse psychologique (p < 0,001). De plus, une plus forte proportion de ces répondants évaluait régulièrement la détresse psychologique dans leur pratique clinique (p < 0,001). Conclusion : les physiothérapeutes irlandais rencontrent régulièrement des patients chez qui ils perçoivent une grande détresse psychologique. Ils font preuve d'attitudes positives envers le bien-être psychologique des patients, mais précisent qu'une formation supplémentaire en santé mentale constitue un besoin reconnu dans la profession.

Functional exercise capacity in inpatients with alcohol use disorder versus healthy controls: A pilot study.

The purpose of this study was to compare the functional exercise capacity of patients with alcohol use disorders (AUD) with an age-, gender-, and body mass index (BMI)-matched healthy control group. Thirty patients (22 males, 40.4 ± 10.5 years, illness duration = 9.7 ± 9.3 years) and healthy control subjects (22 males, 40.2 ± 10.7 years) participated. Participants performed a 6-min walk test (6MWT) to assess their functional exercise capacity, were asked about musculoskeletal problems and dyspnea, executed a standing broad jump to assess their muscular strength, and completed the International Physical Activity Questionnaire (IPAQ). Patients also filled in the Positive Affect and Negative Affect Schedule (PANAS) and Alcohol Use Disorders Identification Test (AUDIT). Our data show that patients with AUD walked a significantly shorter distance on the 6MWT (649.0 ± 72.9 m vs. 724.4 ± 89.0 m, p = 0.001). In patients with AUD, the variance in standing broad jump score explained 43.6% of the variance in the 6MWT score. The current study demonstrates that impaired muscle strength is negatively associated with functional outcomes in patients with AUD. Exercise interventions should be investigated in order to assess whether they can ameliorate muscle strength and daily life functioning of this vulnerable population.

Functional exercise capacity is associated with global functioning in patients with alcohol use disorder.

This study explored whether the Global Assessment of Functioning (GAF) score is associated with the functional exercise capacity among inpatients with alcohol use disorders (AUD). 45 (32 men) inpatients (41.1 ±â€¯13.2 years, range = 18-70 years) performed a 6-minute walk test (6 MWT), a standing broad jump (muscle strength) and were assessed with several questionnaires. The GAF-score correlated significantly with the 6 MWT-score (Pearson's r = 0.47, p = 0.002). Variance in illness duration (11.1 ±â€¯11.0 years) explained 27.9% of the GAF-score (50.8 ±â€¯8.0) variance. Variance in GAF and muscle strength (148.3 ±â€¯44.8 cm) explained 50.9% of the 6 MWT-score (638.2 ±â€¯77.6 m) variance. Future research should explore whether improving the functional exercise capacity improves global functioning in this vulnerable population.

A quantitative assessment of the views of mental health professionals on exercise for people with mental illness: perspectives from a low-resource setting.

BACKGROUND: Exercise is nowadays considered as an evidence-based treatment modality in people with mental illness. Nurses and occupational therapists working in low-resourced mental health settings are well-placed to provide exercise advice for people with mental illness. OBJECTIVES: We examined the current exercise prescription practices employed by Ugandan health care professionals when working with people with mental illness, and identified perceived barriers to exercise prescription and exercise participation for people with mental illness. METHODS: In this study, 31 Ugandan health care professionals 20 men; 31.2 ± 7.1 years completed the Exercise in Mental Illness Questionnaire- Health Professionals Version EMIQ-HP. RESULTS: The vast majority of the respondents 29/31, 94% reported they prescribed exercise at least "occasionally" to people with mental illness. Exercise-prescription parameters used were consistent with those recommended for people with mental illness. Regarding barriers to exercise participation, coping with side effects of psychotropic medication at the individual level and reducing stigma at community level should be prioritized. CONCLUSION: A health care reform to enable collaboration with exercise professionals, such as exercise physiologists or physiotherapists, might increase exercise uptake for people with mental illness, thereby improving health outcomes for this vulnerable population.

Development and testing of a model for risk and protective factors for eating disorders and higher weight among emerging adults: A study protocol.

Research has demonstrated that eating disorders (ED) and higher weight have lifetime co-occurrence suggesting that they may be best considered within a common etiological model. Although we know that body dissatisfaction is likely to be a risk factor for both outcomes, other proposed risk and protective factors for each condition have not been adequately explored. The current paper tests a conceptual model that is based on a review of the existing literature from both areas of scholarship. It considers biological, sociocultural, psychological, and behavioral factors that may contribute to both outcomes. The model will be tested in a longitudinal design with an initial sample of 600 emerging adults (aged 18-30) per country in nine different countries (total sample = 5400 participants). Questionnaires will be completed online on two occasions, 12 months apart. The first full phase of the study commenced in July 2018, the same time Body Image was approached to publish this protocol paper (the final revised paper was submitted in September 2019), and data collection will be finalized in December 2019. Multi-group path analysis will identify the biopsychosocial predictors - both cross-sectionally and longitudinally - of both ED and higher weight, and how these vary across countries and gender.

Dietary Intake, Adherence to Mediterranean Diet and Lifestyle-Related Factors in People with Schizophrenia.

The purpose of this study was to examine the dietary intake of both inpatients and outpatients with schizophrenia in the Portuguese population as a potential key contributing factor to the poor physical health profiles, and understand the relationship of diet quality to other lifestyle factors. Participants of this cross-sectional study completed a semi quantitative food frequency questionnaire. Diet quality was determined by adherence to the Mediterranean Diet. In addition participants completed the International Physical Activity Questionnaire-Short-Form and Pittsburgh Sleep Quality Index. Tobacco smoking was assessed through a series of general questions. A total of 100 patients (50% inpatients and 28% female) with schizophrenia were included in the final analysis. Patients reported a high consumption of caffeine, while deficits were evident for fibre and folate intakes, when compared to the European Food Safety Authority recommendations. Both inpatients and outpatients reported poor to moderate diet quality. Smokers reported poorer diet quality when compared to non-smokers (p < 0.001). Dietary intake, and its relationship to other lifestyle components, should be considered for intervention, in order to improve physical health of people living with schizophrenia.

Factor structure of the German version of the pain attitudes and beliefs scale for physiotherapists.

The Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT) is a questionnaire that is frequently used to measure the treatment orientation of physiotherapists and other healthcare providers toward low back pain (LBP). Previous validation studies of the PABS-PT have reported consistently that exploratory factor analysis (EFA) yielded a two-factor model with the factors "biomedical" and "biopsychosocial." However, there remain concerns regarding the composition of these two factors and the internal consistency of the "biopsychosocial" factor. The objective of this study was to replicate the previous validation study on the German PABS-PT. EFA was implemented to reexamine the underlying structure of the scale, and confirmatory factor analysis (CFA) was used to test the fit of the hypothesized two-factor model. Results of the initial validation study were not replicated. EFA indicated that a two-factor solution is an inadequate representation of the PABS-PT data, and CFA showed insufficient fit of the hypothesized two-factor model to the PABS-PT data. Our results indicate a need for caution when using the PABS-PT to measure physiotherapists' orientation toward LBP, particularly in measuring the magnitude of a biopsychosocial orientation.

Validity and correlates of the International Physical Activity Questionnaire in first-episode psychosis.

AIM: The International Physical Activity Questionnaire (IPAQ) is a self-report tool commonly used in mental healthcare settings to assess physical activity. However, its validity has not yet been investigated in first-episode psychosis (FEP). The aim of this study was to examine the concurrent validity of the IPAQ compared with an objective real-life measure, the Sensewear Armband (SWA), in assessing moderate and vigorous physical activity (MVPA) in people with FEP. A secondary aim was to explore whether there are differences in correlates of the IPAQ vs SWA scores. METHODS: In total, 19 outpatients with FEP (15 men; 24.4 ± 5.1 years) wore an SWA for 5 full consecutive days, subsequently completed the IPAQ, performed a maximal cardiorespiratory fitness test and were assessed with the Positive and Negative Syndrome Scale (PANSS). RESULTS: There was no significant correlation between time spent in MVPA according to the IPAQ and SWA. In contrast with SWA scores, there were no significant associations between IPAQ scores and cardiorespiratory fitness levels. No correlations with PANSS scores were observed in both measures. CONCLUSIONS: The current results suggest that the IPAQ should be used with caution when assessing levels of MVPA in FEP. More accurate methods of measuring physical activity are needed in this population.

Sedentary Behavior and Quality of Life in People with Psychotic Disorders from a Low Income Country: A Study from Uganda.

The current study examined the impact of sedentary behaviour (SB) on quality of life (QoL) in people with psychotic disorders. Thirty-six Ugandan women (mean age = 33.9 ± 8.0 years) and 23 men (37.4 ± 11.8 years) with a DSM 5 diagnosis of psychosis completed the World Health Organization Quality of Life-Brief version and Simple Physical Activity Questionnaire (SIMPAQ). Medication use, physical co-morbidities, weight, height, blood pressure and smoking habits were recorded. Multiple regression analyses were undertaken. Variability in SIMPAQ sedentary and walking scores explained 56% of the variability in psychological QoL, while variability in SIMPAQ walking explained 46% of the variability in physical QoL. Health care professionals should not only consider increasing physical activity but also reducing SB to improve QoL in their patients.

Test-retest reliability and clinical correlates of the Eurofit test battery in people with alcohol use disorders.

People with alcohol use disorder (AUD) are at an increased risk for cardiovascular diseases (CVD). Physical fitness is a predictor of CVD and premature mortality. Currently, no existing measures of physical fitness used in the general population have been tested for validity and reliability in this vulnerable population. Therefore, we examined the reproducibility, feasibility and correlates of the Eurofit test battery in this population. From 32 men (age = 40.8 ±â€¯13.8years; illness duration = 10.2 ±â€¯10.3years; body mass index, BMI = 24.8 ±â€¯3.8) and 13 women (age = 41.9 ±â€¯12.1years; illness duration = 13.7 ±â€¯13.1years; BMI = 26.3 ±â€¯4.9) with AUD two trials of the Eurofit test, administered within one week, were analyzed. All patients also completed the International Physical Activity Questionnaire, the Positive Affect and Negative Affect Scale and Alcohol Use Disorders Identification Test. All Eurofit items showed good reproducibility with intraclass correlation coefficients ranging from 0.82 for the flamingo balance test to 0.97 for the standing broad jump and handgrip strength tests. Better performance on Eurofit test items was associated with younger age, a shorter illness duration, a lower BMI and higher physical activity levels. The current study demonstrates that the Eurofit test can be recommended as a reliable test for evaluating the physical fitness of inpatients with alcohol use disorder.

Physical fitness and physical activity levels in people with alcohol use disorder versus matched healthy controls: A pilot study.

Low physical fitness and physical inactivity have been recognized as prominent behavioral risk factors for cardiovascular diseases and an independent risk factor for all-cause mortality. To date, no studies have ystematically assessed physical fitness and physical activity in patients with alcohol use disorders (AUD) vs. a healthy comparison group. The aim of this cross-sectional study was to assess and compare the physical fitness and physical activity levels in patients with AUD against healthy controls. Thirty inpatients with AUD (22 males, 40.4 ± 10.5 years, illness duration = 9.7 ± 9.3 years) and 30 age-, gender- and body mass index (BMI)-matched healthy controls were included. All participants performed the Eurofit test battery and the International Physical Activity Questionnaire. Patients also completed the Positive Affect and Negative Affect Scale (PANAS) and Alcohol Use Disorders Identification Test (AUDIT). The PANAS positive and negative scores were 30.1 ± 7.5 and 27.6 ± 8.2; the AUDIT score was 27.3 ± 7.0. Patients with AUD had a reduced whole body balance (flamingo balance test: 12.1 ± 5.1 vs. 8.7 ± 3.9 attempts; p = 0.005), speed of limb movement (plate tapping: 13.3 ± 2.7 vs. 11.6 ± 2.2 s, p = 0.007), explosive leg muscle strength (standing broad jump: 151.8 ± 34.9 vs. 174.2 ± 33.7 cm; p = 0.01), abdominal muscular endurance (sit-ups: 15.9 ± 5.7 vs. 19.8 ± 7.1; p = 0.02), and running speed (shuttle run: 25.4 ± 4.5 vs. 23.1 ± 4.0 s). Patients with AUD were also significantly less physically active than healthy controls (1020.9 ± 578.8 vs. 1738.7 ± 713.3 MET-minutes/week; p < 0.001). Backward regression analyses demonstrated that older age and higher BMI explained lower physical fitness levels, whereas longer illness duration and impaired explosive muscle strength explained lower total physical activity levels. The current findings suggest that lower physical fitness and physical activity are emerging as prominent modifiable risk factors in patients with AUD. Future research should explore the benefits of specific rehabilitation interventions aimed at increasing physical activity and physical fitness in this vulnerable group.

Barriers, attitudes, confidence, and knowledge of nurses regarding metabolic health screening and intervention in people with mental illness: a pilot study from Uganda.

BACKGROUND: People with mental illness are at an increased risk for developing cardio-metabolic disorders. Routine screening following pharmacotherapy is however unacceptably low in sub-Saharan African countries with less than 1% adequately screened. It is unknown whether this is due to a lack of adequate competences. OBJECTIVES: The aim of this pilot study was to assess the barriers, attitudes, confidence, and knowledge of nurses regarding metabolic health, prevention and treatment in Uganda. METHODS: Twenty-eight nurses (39% female, 30.9±6.9 years) completed the Metabolic - Barriers, Confidence, Attitudes and Knowledge Questionnaire and the physical activity prescription rate item of the Exercise in Mental Illness Questionnaire. RESULTS: More than 75% had a positive attitude towards metabolic screening and intervention and more than 50% were confident in providing smoking cessation advice, and physical activity and nutritional counseling. However, 57% stated that their heavy workload prevented them from doing health screening and promotion activities. There was a negative correlation (ρ=-0.54, P=0.003) between the frequency of physical activity prescription and the perception of the inability of patients to change. CONCLUSION: The present findings suggest that nurses are generally supportive of metabolic health screening and intervention but their high workload prevents them from implementing metabolic health interventions.