Physical activity (PA) is any movement made by the body’s skeletal muscles that involves an energy expenditure measured by calories. Exercise is a subset of PA that is planned, structured, and repetitious to maintain or improve PA (1). Both adults and children’s health is directly impacted by PA (2). The minimum amount of PA for adults is aerobic activity of 2 h 30 min per week of moderate-intensity or 1 h 15 min of high intensity (3).

According to epidemiological data, physical inactivity raises the occurrence of at least 17 harmful conditions, most of which are chronic diseases or risk factors for chronic diseases (4). Physical inactivity is a global public health concern, affecting most of the world’s population. Exercise is crucial for promoting good health and preventing disease. On the other hand, physical inactivity is a risk factor for various chronic diseases (5). The most common causes of premature death are stress, obesity, and physical inactivity. Sedentary lifestyles double the risk of lipid disorders, obesity, hypertension, diabetes, and cardiovascular disease, thus increasing mortality.

Many factors influence PA for health, including environmental, socio economic, cultural, and lifestyle. For example, individuals of poor socioeconomic positions are likely to have lower PA levels since they have little access to parks and local walkability (6).

Several guidelines for physical activity have been developed to inform people about the minimal quantity of PA that is generally required to establish cardiorespiratory health and improve health (7). The benefits of aerobic and resistance training on cognition and health are mediated by a number of processes, including improved neurogenesis, decreased oxidative stress and inflammation as well as improved cerebral blood flow and oxygen delivery, and favorable hormonal changes (8, 9).

Information on peoples’ awareness and attitudes toward PA is essential to promote practice and identify the PA barriers. This is because awareness dramatically influences an individual’s positive attitude thus, improving the practice.

It has been documented that insufficient knowledge is considered to be a significant contributing factor responsible for PA practice (10). Lack of knowledge about PA guidelines by the healthcare profession student, who should be the most knowledgeable, has previously been noticed as one of the main factors that may contribute to a sedentary lifestyle. Despite the apparent rise in awareness of PA requirements in recent years, it has been reported that demographic differences persist (10). Knowledgeable medical students are more likely to advocate PA and to help in bringing about an increased awareness and thus improve the attitudes of others toward PA. A previous study reported a good knowledge and positive attitudes toward PA among the healthcare profession students (11). The prevalence of PA was 69.9% among healthcare students (12). Another study showed that about 50% of the students were physically active, while 20% relied solely on short walks due to time constraints, limited activity hours, or sedentary habits (13). Several studies have shown that university students are becoming physically inactive (14, 15).

Students’ PA levels are frequently influenced by their academic schedules, social and familial obligations, and lack of leisure time. Few studies have been conducted on the attitude toward PA among university students of Saudi Arabia compared with their global counterparts. Moreover, few studies have assessed awareness and knowledge of PA guidelines, mainly conducted on the general population (16, 17).

A recent study included 507 surveys across 163 countries and territories. Indicated that nearly one third (31%) of the world’s adult population are physically inactive (18). A previous study has shown that more than half of college students need to be more active, and their levels of PA are significantly associated with some demographical characteristics of the students but not their knowledge of the recommended guidelines (19). Based on the preceding facts, and because many students feel pressure when engaging in academic activities, leaving little time for PA, it was essential to assess the current level of physical activity among university students. Despite healthcare profession’s students being future health promoters, limited research has examined the knowledge-attitude-practice relationship in this specific population within the Saudi cultural context. This study aimed to: (1) assess knowledge, attitudes, and practices regarding physical activity among Saudi healthcare students, (2) examine demographic correlates of these variables, and (3) investigate the relationships between knowledge, attitudes, and practice behaviors.

This study provides key insights into the knowledge, attitudes, and practices of PA among healthcare undergraduates in Saudi Arabia. The overall knowledge score of 68.97% indicates a relatively moderate awareness of PA. While knowledge scores averaged 81% in the U.S., the current awareness in Saudi Arabia of 68.97% represented a moderate rate that requires targeted educational interventions (20, 21). Moreover, another study has shown that most (67.6%) of people in the United States were aware of PA recommendations (16). Knowledge of critical PA was moderate (75%) and varied between various demographical characteristics in Australia (22). The average knowledge score of the students on physical activity in Nepal was 71.3% (23).

The knowledge scores exhibited significant variation based on region. Various factors could cause this disparity, most of which are related to regional differences in educational systems and cultures similar to what has been reported as reported before (24). The study showed that male students demonstrated slightly higher knowledge scores than female ones. Similarly, previous research has shown similar results with no gender difference in knowledge (25). The average knowledge score of participants of different ages slightly increased in older students. Similarly, previous study results showed good knowledge among older people (26). In contrast, another study shows that older adults possessed poorer PA knowledge than their younger counterparts (27). The participants from the medicine colleges have the lowest knowledge score on PA, while the applied health sciences colleges have a high knowledge. These discrepancies might be caused by variations in the curriculum’s emphasis, availability of resources for health education, or the dominant beliefs and practices in specific academic or geographical contexts.

The average attitude score was 47.93%. Males showed a slightly more positive attitude than females. Women’s participation in sports substantially correlated with socioeconomic class, health-relevant attitudes, including internal and external locus of control, and health markers. Another study reported an average positive attitude score toward physical activities of 64.3% among undergraduate medical students in Nepal (24). A previous study has shown that medical students’ attitudes regarding PA were positive and did not differ from those of male and female students (28). The study found that the average attitude score of participants increased among 18–20 aged students. The results show that the average attitude score of participants in different regions varied slightly. The average attitude score of participants across the study majors was statistically significant. Medicine students have higher attitude scores in PA, while nursing students have lower scores.

The study shows a worrying trend in PA habits, with a sizable fraction reporting no intense exercise and a minority regularly engaging in vigorous-intensity activities. This trend is consistent with earlier research showing startlingly low PA levels among college students (29). About 62% of participants in a study on female university students failed to achieve the WHO standard of 75 min per week of strenuous activity, and 70% of participants failed to meet the WHO recommended of 150 min per week of moderate activity (16).

Walking is the most popular type of exercise, which is essential since it is accessible and low-impact, making it a viable option for many participants. Across all participants, the average practice was 51.9%. A sizeable fraction of 14.04% acknowledged never exercising, compared to 3.9% reported before (30). There was a statistically significant difference in practice by gender, with men exhibiting somewhat more than women. The current study also revealed that women were less likely than men to exercise. A prior study found a substantial difference between males and females in total physical activity and vigorous-intensity physical exercise (20).

Another study determined that 68.4% of men and 48.4% of women university students reported practicing PA (2, 31). Gender inequalities can be explained by a variety of reasons, including weariness and exhaustion, a lack of social support, culturally imposed gender norms and behavioral expectations that favor women staying at home, and limited facilities for women’s sports. Similarly, research has noticed that boys from several countries participate in more PA than females, likely contributing to their better PA assessment scores (32). Also, another study shows that boys have more substantial incentives to participate in PA, whereas girls exhibit more obstacles (33). The two most often cited barriers were time constraints and a lack of encouragement from teachers, classmates, and families. The main barriers that prevent students from participating in PA most frequently are a lack of time and poor facilities (20).

Illness and injuries were less reported by the participants. However, implementing customized fitness programs, and integrating subjective and objective training load evaluations could all help to lower injury rates, increase recruit preparedness (34). The absence of companionship and insufficient time contributed to university students’ avoidance of PA (24). The study represents a high percentage of PA practice among all age groups. The age group over 23 exhibited the highest proportion, accounting for 54.98%. The nursing department students demonstrated a higher level of proficiency (52.55%) compared to the medicine students, who showed a lower level of proficiency (50.69%). The study showed that the students who were in perfect present fitness (71.45%) or had an average weight (56.07%) were more physically active. Conversely, those who were obese (32.34%) or unfit to the current standard of fitness (13.46%) were less likely to engage in PA. Being overweight during childhood and adolescence is a typical cause of a sedentary lifestyle among students (35). It is important to note that Saudi Arabian institutions’ particular cultural and environmental settings may present unique obstacles and opportunities for promoting physical exercise.

The observed differences in knowledge, attitude, and practice among subgroups emphasize how crucial it is to customize treatments to meet specific student populations’ needs and obstacles.

For example, students from different academic majors or areas with lower knowledge scores could benefit from more intensive health education programs. People with low socioeconomic positions probably engage in less physical exercise since fewer parks and walkable neighborhoods exist in their communities (6).

There was a significant relationship between the mean practice score and both knowledge and attitude scores. These findings were in contrast to those previously determined, which showed that there was no correlation between the amount of knowledge regarding PA and its practice (36). We found no correlation between knowledge and attitude.

The Theory of Planned Behavior that links beliefs to behavior, may provide a good model to explain the relationship between the healthcare profession’s students’ knowledge, attitude, and practice of PA (38). According to the theory, individual’s behavior is influenced by intention, which in turn is governed by attitude, perception of social pressure (subjective norms), and belief in their ability to perform a specific behavior (perceived behavioral control). In this study, the moderate level of PA attitude (47.93%) together with its significant correlation with practice may suggests that the students’ intentions could be hindered by their perceptions of social expectations or their own ability to be engaged in physical activates. The reported barriers, such as lack of time and or interest, may constrain the translation of positive knowledge into consistent action thus lowering their ability to practice PA.

This miscorrelation between attitude and knowledge is consistent with other research (30, 35). Interestingly, the study found no links between participants’ attitudes toward physical exercise and demographic variables. This conclusion contradicts some earlier research (27, 35) that found opinions differing depending on demographic variables. It is crucial to remember that attitudes are complicated concepts that are impacted by a wide range of variables. Therefore, the study’s lack of significant correlations could be unique to the environment and population it looked at.

Overall, the study’s findings highlight the urgent need for focused interventions and approaches to close the knowledge–behavior gap and remove the PA obstacles that college students in healthcare professions programs face. Some possible approaches are to incorporate opportunities for PA into the curriculum to encourage students to engage in recreational activities on campus and to provide easily accessible and reasonably priced exercise facilities that meet their various needs and preferences. Furthermore, programs focusing on time management abilities and social support systems may enable students to prioritize physical exercise above academic obligations. Despite the good knowledge and positive attitudes toward.

PA, its prevalence was estimated to be 51.90% in this study and, 69.9% by another study among healthcare students in Saudi Arabia (13, 37). A previous study revealed that 55.7% of the students performed vigorous-intensity sports, fitness, or recreational activities (36). Overall, 58.0% of the students we physically inactive, and only 13.4% performed vigorous physical activity, 14.8% moderate-intensity PA, and 29.9% walking activities (36). A study in Saudi Arabia showed that the most common type of PA among healthcare students was walking (51.7%), followed by bodybuilding (25%) and running at 24.4% (10). The top reported barrier to PA among inactive students was time limitations (51.3%).

Our limitations are typical to the other studies using a cross-sectional design and self-reported data. The results may not be as broadly applicable as we used a heterogeneous purposive sample technique. Confounding variables that are not measured.

This study highlights a moderate PA knowledge and practices among healthcare students in Saudi Arabia, with notable disparities across gender, age, and academic majors. Targeted interventions, including curriculum integration and improved access to facilities, are essential to bring a higher knowledge–behavior and practice levels and promote healthier lifestyles. The disparity between participants’ reported PA attitude and knowledge levels is one of the study’s noteworthy results. Universities could incorporate PA modules into existing health courses and create on-campus programs emphasizing time management skills to help students balance academics and exercise. Future research using a longitudinal study design and intervention trials are needed for better understanding of the suboptimal level of the university students’ practice of PA despite the good knowledge.