Design and implementation of a clinic-to-community, physical activity health promotion model for healthcare providers

Porter, Ryan R.; McClelland, Patton; Ewing, A. W. G.; Sonka, Victoria; Trilk, Jennifer L.

doi:10.1016/j.pmedr.2022.101697

Cited by 7 publications

(4 citation statements)

References 18 publications

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“…in Chattanooga (Tennessee) which has shown that an adapted Exercise is Medicine protocol was successful in linking primary care with community PA support. More recently and in line with this study, Porter et al41 reported the results of the implementation of an initiative, called Exercise is Medicine Greenville, connecting patients referred by their health care provider to community partners who provide evidence-based PA programs.…”

mentioning

confidence: 55%

Promotion of Physical Activity by Québec Primary Care Physicians: What Has Changed in the Last Decade?

Laberge,

Gosselin,

Lestage

et al. 2024

Journal of Physical Activity and Health

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Objective: This study aimed to assess the changes in the frequency of physical activity (PA) counseling and in the predictors of primary care PA promotion in Québec primary care physicians (PCPs) between 2010 and 2020. Methods: In 2010, we conducted a survey among Québec PCPs. Questions included: frequency of promoting PA to patients, perceived barriers, needs to improve PA promotion practice, frequency of PCPs’ PA practice, and sociodemographic information. In 2020, we took over the 2010 questionnaire to document the evolution of the PA promotion practice. Results: The proportion of PCPs discussing PA with their patients significantly increased (P < .05) in 2020 for the following health conditions: depression, low back pain, chronic obstructive pulmonary disease, and cancer; it declined (P < .05) for overweight patients, those with metabolic syndrome, and in primary prevention. Collaboration with PA professionals was the major need identified, and it increased in 2020. PCPs’ own practice of PA was a predictor of PA promotion in 2010 (odds ratio = 6.679; P < .001) and in 2020 (odds ratio = 6.679; P < .001). In both 2010 and in 2020, older or more experienced PCPs were more likely to discuss PA with their patients without diagnosed diseases than younger ones or those with less experience. Conclusions: Over the last 10 years, there has been a significant increase in PCPs promoting PA in Québec; however, it has been mainly oriented toward secondary prevention. It is concerning that PA counseling in primary prevention has declined, notably among younger PCPs. The stronger claim for closer collaboration with kinesiologists suggests that PCPs are in favor of an interprofessional strategy, namely collaboration with PA specialists.

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confidence: 55%

Promotion of Physical Activity by Québec Primary Care Physicians: What Has Changed in the Last Decade?

Laberge,

Gosselin,

Lestage

et al. 2024

Journal of Physical Activity and Health

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“…28 This study adds to existing literature such as the EIM Greenville study, which enrolled patients in a 12-week PA programme. 29 In contrast, our implementation efforts offered a high-reach, low-touch approach. While their study found a significant decrease in body weight and SBP in patients enrolled in their PA programme, our study saw an increase in PAVS and BMI and mixed changes in SBP and DBP over time depending on baseline PA category.…”

Section: Discussionmentioning

confidence: 99%

Implementation and evaluation of Exercise is Medicine in primary care clinics within a large academic health system

Dayao,

Duffy,

Cristiano

et al. 2024

Fam Med Com Health

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ObjectiveExercise is Medicine (EIM) is a global initiative encouraging healthcare providers to routinely assess and promote physical activity (PA) among patients. The objective of this study was to evaluate the feasibility, adoption, implementation and effectiveness of EIM from patient, clinician and healthcare staff perspectives using a combination of electronic health record (EHR), survey and interview data.DesignThis study used a combination of the Practical Robust Implementation and Sustainability Model (PRISM) and the Learning Evaluation model to implement EIM. Data captured from the EHR, including Physical Activity Vital Sign (PAVS) scores, and data collected from qualitative surveys and interviews were used to evaluate the programme’s Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM, which is embedded within PRISM) from provider, staff and patient perspectives.SettingFive primary care clinics within a large academic health system.ParticipantsA total of 24 443 patients from all participating clinics had at least one PAVS score during the study period. A total of 17 clinicians completed surveys, and 4 clinicians, 8 medical assistants and 9 patients completed interviews.ResultsImplementation fidelity metrics varied widely between components and across clinics but were generally consistent over time, indicating a high degree of programme maintenance. Fidelity was highest during the first 6 months of the COVID-19 pandemic when most visits were virtual. Mean PAVS scores increased from 57.7 (95% CI: 56 to 59.4) to 95.2 (95% CI: 91.6 to 98.8) min per week at 6 months for patients not meeting PA guidelines at baseline and decreased from 253.84 (95% CI: 252 to 255.7) to 208.3 (95% CI: 204.2 to 212.4) min per week at 6 months for patients meeting PA guidelines at baseline. After EIM implementation, clinician-estimated time spent discussing PA with patients increased for 35% of providers and stayed the same for 53%.ConclusionOverall, this study established EIM’s feasibility, adoption, implementation and maintenance in routine primary care practice within a large academic health system. From a population health perspective, EIM is a model to emulate to help primary care providers efficiently address healthy lifestyle behaviours in routine primary care visits.

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“…These include the use of self-directed resources, such as public sports facilities, bike-sharing programmes, and the use of local parks ( 22 ). Aligning community and healthcare partners to provide a clinic-to-community model may be beneficial for implementing exercise as a core prevention strategy for assisting patients who are at risk for NCDs, to regress, reverse, and minimise the progression of disease ( 74 ).…”

Section: Discussionmentioning

confidence: 99%

Health policy considerations for combining exercise prescription into noncommunicable diseases treatment: a narrative literature review

Tao,

Awan-Scully,

Ash

et al. 2023

Front. Public Health

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ObjectivesIn this review, we aim to highlight the evidence base for the benefits of exercise in relation to the treatment of noncommunicable diseases (NCDs), draw on the Health Triangular Policy Framework to outline the principal facilitators and barriers for implementing exercise in health policy, and make concrete suggestions for action.MethodsLiterature review and framework analysis were conducted to deal with the research questions.ResultsExercise prescription is a safe solution for noncommunicable diseases prevention and treatment that enables physicians to provide and instruct patients how to apply exercise as an important aspect of disease treatment and management. Combining exercise prescription within routine care, in inpatient and outpatient settings, will improve patients’ life quality and fitness levels.ConclusionInserting exercise prescription into the healthcare system would improve population health status and healthy lifestyles. The suggestions outlined in this study need combined efforts from the medical profession, governments, and policymakers to facilitate practice into reality in the healthcare arena.

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Design and implementation of a clinic-to-community, physical activity health promotion model for healthcare providers

Cited by 7 publications

References 18 publications

Promotion of Physical Activity by Québec Primary Care Physicians: What Has Changed in the Last Decade?

Promotion of Physical Activity by Québec Primary Care Physicians: What Has Changed in the Last Decade?

Implementation and evaluation of Exercise is Medicine in primary care clinics within a large academic health system

Health policy considerations for combining exercise prescription into noncommunicable diseases treatment: a narrative literature review

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