A Web-Based Survey of Residents' Views on Advocating with Patients for a Healthy Built Environment in Canada

Purpose. To determine family medicine residents' perceived knowledge and attitudes towards the built environment and their responsibility for health advocacy and to identify their perceived educational needs and barriers to patient education and advocacy. Methods. A web-based survey was conducted in Canada with University of Toronto family medicine residents. Data were analyzed descriptively. Results. 93% agreed or strongly agreed that built environment significantly impacts health. 64% thought educating patients on built environment is effective disease prevention; 52% considered this a role of family physicians. 78% reported that advocacy for built environment is effective disease prevention; 56% perceived this to be the family physician's role. 59% reported being knowledgeable to discuss how a patient's environment may affect his/her health; 35% reported being knowledgeable to participate in community discussions on built environment. 78% thought education would help with integration into practice. Inadequate time (92%), knowledge (73%), and remuneration (54%) were barriers. Conclusions. While residents perceived value in education and advocacy as disease prevention strategies and acknowledged the importance of a healthy built environment, they did not consider advocacy towards this the family physician's role. Barrier reduction and medical education may contribute to improved advocacy, ultimately improving physical activity levels and patient health outcomes.