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This descriptive exploratory study examined factors related to physical activity counseling practices of adult nurse practitioners (ANPs) nationwide. The purposes of this study were to (a) examine physical activity assessment and counseling practices, (b) identify barriers to physical activity counseling, (c) describe knowledge and confidence in physical activity assessment and counseling, (d) identify personal physical activity practices, and (e) describe use of objective physical fitness measures in the primary care setting.Participants were a randomly selected group of ANPs who are members of the American Academy of Nurse Practitioners.Most ANPs (95%) counsel patients on physical activity at least once a year. As for assessing physical activity, simply asking about it was the most common method (94%). The most common strategy for counseling was discussion (95%). The most common barriers to counseling were lack of time (48%) and preemption by more important concerns (47%). Of fitness measures, the most commonly used was body composition. Cardiorespiratory, strength, flexibility, and balance fitness tests were used infrequently or rarely.NPs can use specific physical fitness measures to help assess, guide, and/or motivate physical activity in their patients.