The goal of this observational- cross sectional study is to investigate the knowledge and practices of physicians in Physical Medicine and Rehabilitation (PM&R), Pediatrics, and Orthopedics regarding pediatric osteoporosis. The main question it aims to answer is:

What are the levels of knowledge and approaches of physicians in PM&R, Pediatrics, and Orthopedics regarding pediatric osteoporosis, and how can a psychometrically valid and reliable data collection tool be developed to measure these?

Participants, including PM&R, Pediatrics, and Orthopedics physicians, will complete an online questionnaire consisting of demographic and clinical practice questions, as well as items measuring their knowledge about pediatric osteoporosis. The study also includes a pilot test with a subset of participants to evaluate the clarity and reliability of the questionnaire.

The aim of this study was to investigate the knowledge and approaches of physicians in Physical Medicine and Rehabilitation (PM&R), Pediatrics, and Orthopedics regarding pediatric osteoporosis. A secondary aim was to develop and evaluate the psychometric properties of a data collection tool designed to measure knowledge and practices related to pediatric osteoporosis.

The Pediatric Osteoporosis Knowledge and Practice Assessment Scale, used as the data collection tool, was developed based on evidence-based guidelines and the International Society for Clinical Densitometry Pediatric Position Statements. The scale consists of a preliminary section assessing demographic data and clinical practices, and a second section measuring knowledge levels. The questions were designed with "true" (1 point), "false," and "I don't know" (0 points) options, similar to the Osteoporosis Knowledge Questionnaire, which is intended for adults. The questions were categorized into general knowledge and diagnosis, risk factors, assessment, and treatment.

Content validity of the scale was ensured by a panel of experts in the field. The scale was distributed online via Google Forms and applied to 321 physicians. A pilot test was conducted with 10 PM&R physicians to evaluate its clarity. To assess reliability, the scale was administered twice to 30 physicians with a one-week interval.

Inclusion Criteria:

• Physicians specializing in Physical Medicine and Rehabilitation (PM&R), Pediatrics, or Orthopedics
• Able to read and understand the language in which the questionnaire is provided,
• Internet access to complete the online survey distributed via Google Forms
• Willing to participate and provide informed consent
• Actively practicing in their respective specialty.
• Involved in the care of patients where knowledge about pediatric osteoporosis is relevant

Exclusion Criteria:

• Surveys with incomplete or inconsistent answers that do not meet the study's data quality standards
• Participants who have been involved in the development or validation of the Pediatric Osteoporosis Knowledge and Practice Assessment Scale

The study population consists of licensed physicians specializing in Physical Medicine and Rehabilitation (PM&R), Pediatrics, and Orthopedics who are actively practicing and involved in the care of patients where knowledge about pediatric osteoporosis is relevant.

Participants are recruited online through professional networks, medical organizations, and personal invitations. The study is conducted using an online survey format to ensure accessibility and convenience for participants. The target population includes both early-career and experienced physicians to comprehensively assess the knowledge and practices across different levels of expertise.