Background The understanding of attitudes, knowledge, and behaviour related to evidence-based practice (EBP), in particular evidence-based clinical practice guidelines, in primary care physical therapy is limited.

Objectives To investigate self-reported attitudes, knowledge, behaviour, prerequisites, and barriers related to EBP and, in particular, guidelines among physical therapists (PTs) in primary care, and to explore associations of self-reported use of guidelines with these social-cognitive factors.

Methods Cross-sectional survey of PTs (n = 400) in primary care in western Sweden using a web-based, validated questionnaire. Logistic regression analysis was used.

Results The response rate was 67.8%. Most PTs (82%–96%) had positive attitudes toward EBP and guidelines. Thirty-three percent reported being aware of guidelines, 13% knew where to find guidelines, and only 9% reported having easy access to guidelines. Less than half reported using guidelines frequently. The most important barriers to using guidelines were lack of time, poor availability and limited access to guidelines, that they are too general and take too long to read. Positive attitudes to EBP and guidelines, knowledge of where to find guidelines, self-efficacy, easy access, ability to integrate patient preferences, and encouragement of EBP in the workplace were associated with frequent use of guidelines.

Discussion Use of guidelines was not as frequent as could be expected in view of the positive attitudes. Attitudes, knowledge, self-efficacy, easy access, ability to integrate patient preferences, and encouragement of EBP may promote guideline use.

Implications for Guideline Developers/Implementers The identified barriers and determinants can be addressed in the development of guideline implementation strategies.