Implementing Individually Tailored Prescription of Physical Activity in Routine Clinical Care

Jul 31

Implementing Individually Tailored Prescription of Physical Activity in Routine Clinical Care

Background

Although the prescription of physical activity in clinical care has been advocated worldwide, in the Netherlands, "Exercise is Medicine" (E = M) is not yet routinely implemented in clinical care.

Methods

A set of implementation strategies was pilot implemented to test its feasibility for use in routine care by clinicians in 2 departments of a university medical center. An extensive learning process evaluation was performed, using structured mixed methods methodology, in accordance with the Reach, Effect, Adoption, Implementation, and Maintenance framework.

Results

From 5 implementation strategies employed (education, E = M tool embedded in the electronic medical records, lifestyle coach situated within the department, overviews of referral options, and project support), the presence of adequate project support was a strong facilitator of the implementation of E = M. Also, the presence of the lifestyle coach within the department seemed essential for referral rate. Although clinicians appreciated the E = M tool, barriers hampered its use in practice.

Conclusions

Specific implementation strategies, tailored to the setting, are effective in facilitating the implementation of E = M with specific regard to education for clinicians on E = M, deployment of a lifestyle coach within a department, and project coordination. Care providers do see a future for lifestyle coaches who are structurally embedded in the hospital, to whom they can easily refer.

Keywords

advice; electronic medical record; lifestyle; patients; pilot.

References

Adrie J Bouma, Joske Nauta, Femke van Nassau, Leonie A Krops, Inge van den Akker-Scheek, Ron L Diercks, Vincent de Groot, Marike van der Leeden, Hans Leutscher, Martin Stevens, Sacha van Twillert, Hans Zwerver, Lucas H V van der Woude, Willem van Mechelen, Evert A L M Verhagen, Helco G van Keeken, Hidde P van der Ploeg, Rienk Dekker; PIE = M Consortium

About The Author

Femke van Nassau is a senior researcher at the Amsterdam UMC, VUmc, specializing in human movement science. Her work at the Department of Public and Occupational Health and the Amsterdam Public Health Research Institute focuses on developing, implementing, and scaling up lifestyle interventions to promote physical activity and reduce sedentary behavior. With a PhD in scaling up school-based obesity prevention programs, she continues to lead innovative health promotion projects across various settings.