Implementing Individually Tailored Prescription of Physical Activity in Routine Clinical Care: A Process Evaluation of the Physicians Implement Exercise = Medicine Project

• Published in: Journal of physical activity & health Vol. 21; no. 9; p. 916
• Main Authors: Bouma, Adrie J, Nauta, Joske, van Nassau, Femke, Krops, Leonie A, van den Akker-Scheek, Inge, Diercks, Ron L, de Groot, Vincent, van der Leeden, Marike, Leutscher, Hans, Stevens, Martin, van Twillert, Sacha, Zwerver, Hans, van der Woude, Lucas H V, van Mechelen, Willem, Verhagen, Evert A L M, van Keeken, Helco G, van der Ploeg, Hidde P, Dekker, Rienk
• Format: Journal Article
• Language: English
• Published: United States 01-09-2024
• Subjects: Exercise; Female; Humans; Life Style; Male; Netherlands; Pilot Projects; Process Assessment, Health Care; Referral and Consultation; Netherlands; electronic medical record; pilot; advice; patients; lifestyle
• ISSN: 1543-5474
• DOI: 10.1123/jpah.2023-0625

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.
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.
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.
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.