Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Jul 28, 2025
Date Accepted: Oct 20, 2025
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Behavioral Profiles and Sociodemographic Predictors of Planetary Health Diet Engagement among Healthcare Professionals: Implications for Public Health Promotion
ABSTRACT
Background:
The Planetary Health Diet (PHD) promotes dietary habits that are beneficial to human health and environmental sustainability, two closely related goals of modern public health. Healthcare professionals are expected to lead by example and use their position to encourage their patients and communities to adopt healthier and more sustainable behaviors. However, little is known about their knowledge, attitudes, and behaviors (KAB) related to the PHD, which limits the ability to design targeted interventions for this key population.
Objective:
To analyze KAB profiles related to the PHD among French healthcare professionals and assess associations with individual characteristics.
Methods:
This cross-sectional study was conducted from April to June 2024 among healthcare professionals. Participants were recruited using a non-probabilistic, convenience sampling method. Inclusion criteria were to be 18 years of age or older, fluent in French and working as a healthcare professional at Hospices Civils de Lyon. Data were collected through an online questionnaire including sociodemographic and geographic variables, KAB items related to the PHD, and dietary intake. Adherence to the PHD was calculated using a validated scoring system. KAB items were analyzed using k-means clustering analysis to identify distinct profiles. Associations with sociodemographic and geographic variables were explored using chi-square tests and ANOVA.
Results:
Among 1104 respondents (84.0% women and 79.8% aged between 30 and 59 years), three KAB clusters were identified: Cluster 1 ("Knowledge–Attitude Gap ", 43.6%) had higher knowledge but attitude lags; behavior better than attitude; Cluster 2 ("High intent-Low action", 35.7%) had strong knowledge and attitude, but low behavior; Cluster 3 ("Behavior-Driven Alignment", 26.2%) acts despite weak knowledge and attitude—behaviorally aligned but low awareness. PHD adherence was significantly associated with being female, having a vegetarian/flexitarian diet, and reporting environmental concern (all p<0.01).
Conclusions:
Distinct KAB profiles among healthcare professionals suggest differing levels of engagement regarding the PHD. Interventions promoting sustainable diets in healthcare should be tailored to each profile—addressing knowledge gaps, reinforcing attitudes, or targeting behavior change—to foster professionals' alignment with planetary health goals.
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