Favourable finance options, providing physician support, trained staff and a pleasant environment did not improve membership activation or consistent attendance among low-income, multi-ethnic women with chronic disease risk factors or diagnoses, reveals a new study from Boston University School of Medicine. The findings, published in Journal of Community Health, is believed to be the first study of its kind to examine patient characteristics associated with utilization of community health center- based exercise referral program.
Currently, fewer than half (47.3 percent) of Americans meet expert recommendations of 150 minutes per week of moderate-intensity exercise or 75 minutes per week of vigorous-intensity exercise. Women are less likely than men to meet guidelines for physical activity. Certain subpopulations are at elevated risk for both inactivity and CMD, including Hispanics, African Americans and those below the poverty level.
Adult female patients of a community health center with an affiliated fitness center, were included in the study if they received a referral to the fitness center from their primary care provider. Demographic and medical information was abstracted from their medical chart and fitness records were abstracted to measure activation of a fitness center membership (creation of an account denoting at least an initial visit) and utilization over time.
"Despite providing free access to a fitness center and its staff, the number of women utilizing this service was highly variable," explained corresponding author John Wiecha, MD, associate professor of family medicine at BUSM. "Our observations are consistent with findings from the United Kingdom, where a recent systematic review found that exercise referral "uptake" (attendance at an initial consultation) by participants varied from 28 to 100 percent and "adherence" (signifying participation in at least 75 percent of all sessions) from 12 to 93 percent," he added.
According to Wiecha, these findings suggest that program design may benefit from developing activation, initial participation, and retention strategies that address population-specific barriers and integrate credible behavioral change strategies. "Significant public health gains could be realized by increasing physical activity among populations at high risk of chronic disease, and additional research is warranted to develop effective models in the U.S.," said Wiecha.