Exercise is Medicine™: A pilot study linking primary care with community physical activity support

Abstract

IntroductionExercise is Medicine™ (EIM) is an approach to clinic-based physical activity (PA) promotion. Study aims were to 1) assess the acceptability of current EIM protocols among healthcare providers (providers) and health and fitness professionals (fitness professionals); and 2) pilot test the resultant modified EIM protocols comparing patients referred to community PA programming with patients exposed to the EIM protocols alone.MethodsDuring 2012–2013 in Chattanooga, Tennessee, USA, 30/80 invited providers and 15/25 invited fitness professionals received training and provided feedback in the use of the EIM protocols. Following EIM use, feedback from providers and fitness professionals about acceptability of EIM protocols resulted in the adaptation of EIM protocols into the electronic health record. Subsequently, 50 providers and 8 fitness professionals participated in the intervention phase of the pilot study. Healthy and/or disease managed adults 18 years and older were enrolled with a sample of patients exposed to both the EIM protocols and community PA programming (EIM +) while another sample was exposed to the EIM protocols only (EIM). All patients were assessed for physical activity and Health-related Quality of Life. Measures were repeated ~ 3 months later for each patient.ResultsEighteen EIM + and 18 EIM participants were studied. The EIM + participants had a greater net increase in total PA (∆truex¯ = + 250 min/week) vs. EIM participants (∆truex¯ = − 38.6 min/week) (p = 0.0002).ConclusionsEIM + participation significantly increased PA levels among participants, suggesting this approach significantly impacts the PA of inactive adults more than just EIM only.

Exercise is medicine in oncology: Engaging clinicians to help patients move through cancer

“…28,29 These trials were informed by earlier successes in changing clinician behavior regarding use of the "5 A's" for effective counseling for smoking cessation (eg, ask, advise, agree, assist, and arrange for follow-up). 30 To date, the EIM approach has been adopted in several primary health care clinics 31 as well as broadly across 3 large health care systems in the United States. [32][33][34][35] To date, very few studies have used elements of EIM in the oncology care setting, 16 but there is ample scope and a need to examine integration into cancer care.…”

Design and Validity of a Choice-Modeling Questionnaire to Analyze the Feasibility of Implementing Physical Activity on Prescription at Primary Health-Care Settings

“…Item 13 asked about how PHC professionals were willing to collaborate in PA promotion through a multidisciplinary PHC team. This was scored as important by the experts, in line with the Exercise is Medicine initiative, which encourages multidisciplinarity [ 8 , 9 ]. Finally, item 19, related to the interest on PAP training courses for PHC professionals, was highly scored by all experts, being an indicator to enhance the efficient PAP implementation in PHC settings in accordance with previous studies [ 23 , 46 , 47 ].…”

“…Health benefits of exercise prescriptions are documented and well-known [ 5 ]. Therefore, several approaches are trying to promote PA on prescription (PAP) in healthcare (HC) settings, as for example, the proposal of the WHO for the European Region 2016–2025 [ 6 ], the worldwide strategy of the American College of Sport Medicine that is the Exercise is Medicine ® initiative [ 7 , 8 , 9 ], and others [ 10 , 11 , 12 ].…”

Physical activity promotion by health practitioners: a distance-learning training component to improve knowledge and counseling

“…With regard to improvements suggested by the professionals, there were calls for a link between the counseling delivered and public, structured physical activity programs, such as physical exercise classes. A pilot study to test the 'Exercise is Medicine' intervention showed that when the counseling for physical exercise was directly linked with referral of patients to a recreation centers, the average effect of increase in moderate-to-vigorousintensity physical activity was larger compared with a group of patients receiving counseling alone after six months of the interventions (Heath et al, 2015). In a national survey involving physicians and nurses working in primary health care in Brazil, Florindo et al (2013) showed that the odds ratio of counseling on physical activity was higher when structured physical activity programs were provided at the primary health care units where the professionals were working.…”