Bridging the Gap in Physical Activity Promotion for Prediabetes and Type 2 Diabetes: A COM-B Study of Primary Care Healthcare Professionals

Aims To identify determinants of Physical activity (PA) promotion among healthcare professionals (HCPs) caring for patients with prediabetes (PD) and and type 2 diabetes mellitus (T2DM), using the Capability, Opportunity, Motivation–Behavior (COM-B) model. Methods A cross-sectional online survey was conducted among 84 HCPs involved in diabetes care. The questionnaire assessed PA-promotion practices, knowledge of PA recommendations, personal PA levels, and COM-B model constructs. Descriptive, univariate, and multivariate analyses were performed. Results Of the 84 participants, 56% reported promoting PA most of the time, while only 29.7% correctly identified PA recommendations. Mean COM-B scores on a six-point Likert scale (1–6) were 4.00 for capability, 4.66 for motivation, and 3.24 for opportunity. HCPs who frequently promoted PA had significantly higher scores across all COM-B domains compared to non-promoters ( p < 0.05). In multivariate analysis, motivation emerged as the strongest predictor of PA promotion behavior (F = 19.7), while perceived opportunity remained comparatively low. Conclusions PA-promotion in primary care for patients with PD and T2DM remains suboptimal despite relatively high perceived capability and motivation among HCPs. Limited opportunity- reflecting time constraints, organizational barriers, and lack of structured support may hinder implementation. Interventions targeting both motivation and system-level opportunities may enhance PA promotion and improve diabetes management in primary care settings.