Referrals from Healthcare Professionals to Community-Based Exercise Programs Targeting People with Balance and Mobility Limitations: An Interviewer-Administered Survey

Abstract

Purpose: To describe program representatives’ perceptions of the: (1) type and work setting of healthcare professionals who refer to community-based exercise programs with healthcare-community partnerships (CBEP-HCPs) by community size; (2) nature, frequency, and utility of strategies used to promote referral from healthcare professionals to CBEP-HCPs; and (3) facilitators and barriers to CBEP-HCP promotion. Method: We invited individuals involved with the Together in Movement and Exercise (TIME™) program in 48 centres to participate in a cross-sectional survey. TIME™ is a group, task-oriented CBEP-HCP taught by fitness instructors; healthcare partners promote referrals. Data were summarized using frequencies and percentages. Content analysis was used for open-ended questions. Results: Twenty-three representatives of 27 TIME™ programs (56% response rate) participated. Out of 26 healthcare partners identified, 69% were physical therapists. We report the most common findings: programs received referrals from physical therapists ( n = 16, 70%); programs gave healthcare partners promotional materials (e.g., flyers) to facilitate referrals ( n = 17, 63%); strong relationships with healthcare partners facilitated promotion ( n = 18, 78%); and representatives perceived their lack of credibility challenged promotion ( n = 3, 23%). Conclusions: Physical therapists were the most common referral source. Healthcare partners were instrumental in program promotion. Future research is needed to leverage referrals from physical therapists in settings other than hospitals and to better understand the role of healthcare partners in CBEP-HCPs.

Conditions and strategies influencing sustainability of a community-based exercise program incorporating a healthcare-community partnership for people with balance and mobility limitations in Canada: A collective case study of the Together in Movement and Exercise (TIME™) program

“…The TIME™ program is a task-oriented, group exercise program designed to improve independence in everyday functioning among individuals with balance and mobility limitations (5). Trained fitness instructors, who are supported by healthcare partners [typically physical therapists (35)] and volunteers, deliver the program. The program relies on a partnership between a community organization that hosts the program and provides the resources (e.g., instructors, space, equipment, volunteers) and a healthcare partner (from a local hospital or community practice) who visits classes and serves as a resource for the instructors and supports participant enrollment directly by referring participants, or by creating referral pathways from local sources of participants (5,22,35).…”

“…Trained fitness instructors, who are supported by healthcare partners [typically physical therapists (35)] and volunteers, deliver the program. The program relies on a partnership between a community organization that hosts the program and provides the resources (e.g., instructors, space, equipment, volunteers) and a healthcare partner (from a local hospital or community practice) who visits classes and serves as a resource for the instructors and supports participant enrollment directly by referring participants, or by creating referral pathways from local sources of participants (5,22,35). Other individuals involved in program implementation and delivery include recreation managers who are involved in decisions about whether or not to implement a program in the organization and program coordinators who oversee the program planning and allocation of resources.…”