TY - JOUR
T1 - Implementing Individually Tailored Prescription of Physical Activity in Routine Clinical Care
T2 - A Process Evaluation of the Physicians Implement Exercise = Medicine Project
AU - PIE = M Consortium
AU - Bouma, Adrie J
AU - Nauta, Joske
AU - van Nassau, Femke
AU - Krops, Leonie A
AU - van den Akker-Scheek, Inge
AU - Diercks, Ron L
AU - de Groot, Vincent
AU - van der Leeden, Marike
AU - Leutscher, Hans
AU - Stevens, Martin
AU - van Twillert, Sacha
AU - Zwerver, Hans
AU - van der Woude, Lucas H V
AU - van Mechelen, Willem
AU - Verhagen, Evert A L M
AU - van Keeken, Helco G
AU - van der Ploeg, Hidde P
AU - Dekker, Rienk
PY - 2024
Y1 - 2024
N2 - 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.
AB - 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.
U2 - 10.1123/jpah.2023-0625
DO - 10.1123/jpah.2023-0625
M3 - Article
C2 - 39084613
SN - 2080-9999
VL - 21
SP - 916
EP - 927
JO - Journal of Physical Activity and Health
JF - Journal of Physical Activity and Health
IS - 9
ER -