Healthcare

Regular physical activity promotes health, prevents disease, and improves quality of life.  Healthcare providers are trusted and effective advocates and educators for physical activity and exercise with their patients. The average U.S. adult sees a primary care provider 2.8 times per year, and all physicians 3 times per year, which presents many opportunities to assess and counsel on physical activity.1 However, patients report receiving physical activity counseling in only 32% of clinical office visits.2 Clinical tools, such as the physical activity vital sign, and programs like Exercise Is Medicine® aim to enhance the efforts of healthcare providers in assessing and promoting regular physical activity.3 Key to those efforts is expanded the education of learners (e.g., medical students and residents) and practicing clinicians. Educating and including advanced practice clinicians and allied health professionals (e.g., physical therapists, dietitians, pharmacists) is crucial as we seek to deliver a consistent, coherent, and comprehensive physical activity message to patients.

In the past decade, incremental improvement has occurred in healthcare sector efforts in physical activity promotion. Healthcare systems like Kaiser Permanente and Intermountain Healthcare have integrated exercise vital signs and physical activity vital signs, respectively, in their electronic health records.4,5 A U.S. medical school has implemented a curriculum aimed at educating medical students about the importance of physical activity.6 Programs such as Walk With A Doc and Exercise Is Medicine® have expanded in the United States and globally.7,8 Among adults ages 65 years and older, the proportion reporting advice from their healthcare provider regarding physical activity increased from 43.7% in 2005, to 51.3% in 2014.9 Likewise, the percentage of children who received advice about exercise increased from 27.5% in 2002, to 37.4% in 2010, representing a 27% increase in 8 years.10

The Healthcare Sector of the National Physical Activity Plan developed strategies and tactics aimed at: 1) prioritizing efforts in health care to promote physical activity, 2) recognizing physical inactivity and insufficient activity as preventable and treatable conditions with health and cost implications, 3) partnering across sectors to improve access to physical activity-related services, particularly for disadvantaged populations with limited access, and 4) expanding education on physical activity in the training of all healthcare professionals.

Successful implementation of the Healthcare Sector plan will require healthcare systems, healthcare providers in practice, and learners, to recognize, embrace, and adopt physical activity promotion as a key strategy to improve population health and reduce the overall financial burden of healthcare to the nation and to individuals. The strategies and tactics in the Healthcare Sector plan can help to achieve those goals. Broad implementation of the physical activity vital sign, in addition to inclusion of physical activity promotion in clinical guidelines (alongside the use of medications, or even before medications), are critically important tactics. Partnering across sectors, along with community partners and health and fitness professionals will be key in linking patients to community resources to support regular physical activity. Finally, advances in the education of ALL healthcare professionals, and especially primary care providers, to support physical activity assessment and counseling is an imperative, along with efforts to encourage healthcare providers themselves to be active role models for their patients, their families, and their communities.

Strategies

Strategy 1
Healthcare systems should increase the priority of physical activity assessment, advice, and promotion. (HC-1) [View Tactics]

Strategy 2
Healthcare systems and professional societies should establish the spectrum of physical inactivity to insufficient physical activity as a treatable and preventable condition with profound health and cost implications. (HC-2) [View Tactics]    

Strategy 3
Healthcare systems should partner with other sectors to promote access to evidence-based physical activity-related services and to reduce health disparities. (HC-3) [View Tactics]

Strategy 4
Universities, post-graduate training programs, and professional societies should include basic physical activity education in the training of all healthcare professionals. (HC-4) [View Tactics]