Presentation (CTI)

OBJECTIVES: Knowledge, attitude, and practice (KAP) surveys in healthcare professionals (HCPs) rely on self‑report and may not reflect real‑time treatment choices. Integrating experimental vignettes can standardize clinical scenarios, vary key attributes, and more realistically assess how HCPs translate knowledge and attitudes into decisions. This study evaluates a combined KAP-vignette framework for profiling obesity‑related knowledge, attitudes, and practices among HCPs, modelling treatment decisions under standardized scenarios, and quantifying intention-behaviour gaps.
METHODS: We conducted a cross‑sectional online study among HCPs managing adults with obesity in India, Thailand, and Vietnam. A structured KAP survey assessed guideline awareness, perceptions of obesity as a chronic disease, and attitudes and practices regarding pharmacotherapy. An embedded factorial vignette experiment presented randomized cases varying by BMI, comorbidities, previous weight‑loss attempts and out‑of‑pocket costs. For each vignette, HCPs selected treatment strategies (lifestyle alone, pharmacotherapy, or surgery). Mixed‑effects regression examined how vignette attributes and KAP scores influenced choices, and concordance between self‑reported and vignette‑based decisions was assessed.
RESULTS: Among 312 respondents, mean obesity knowledge scores were 7.8/10 (SD 1.4), and 82% agreed obesity is a chronic disease, yet 29% reported initiating pharmacotherapy. Higher BMI (class II/III) and ≥2 comorbidities increased GLP‑1 selection (adjusted odds ratio [aOR] 2.15; 95% CI 1.62-2.86), whereas high cost reduced use (aOR 0.54; 95% CI 0.39-0.74). HCPs with high knowledge (≥8/10) but negative pharmacotherapy attitudes initiated GLP‑1 in 46% of eligible vignettes versus 63% with more positive attitudes (p = 0.012). Concordance between self‑reported practices and vignette‑based decisions was 58%, with under‑treatment notable in patients <40 years and those without comorbidities.
CONCLUSIONS: Embedding experimental vignettes within a KAP survey yielded more actionable insights than KAP alone and can inform targeted education and policy levers to reduce intention-behaviour gaps.