Adoption Of A Physical Activity Referral Program Across Primary Care Settings In A Major U.s. Health System: Exercise Is Medicine Greenville®

PURPOSE: In 2007, the American College of Sports Medicine highlighted that physical activity (PA) and its benefits should receive greater attention in the health care setting. Exercise is Medicine Greenville® (EIMG®), a PA referral pathway established at Prisma Health in 2016, has been adopted by approximately 60% of the Upstate primary care clinics as of August 2023. However, contextual and organizational factors influencing the adoption of EIMG® have not been formally examined. The purpose of this study was to determine factors impacting the adoption of EIMG® in Prisma Health eligible clinics not yet referring to the program. METHODS: Twenty eligible (e.g., consisting of 2 or more providers; within 15 miles of a PA center) Prisma Health primary care clinics were offered the opportunity to participate in EIMG®. Practice managers were invited to adopt EIMG® via an introductory email. Non-responsive clinics received two follow-up communications before being considered non-adopters. Adopting clinics were then provided with EIMG® program materials (e.g., an introductory video on the EIMG® referral process) to implement the program within their clinic. All practice managers, regardless of adoption status, were asked to participate in a semi-structured interview completed either virtually or in-person. Major themes were revealed through deductive coding and analysis of interviews using Dedoose software. RESULTS: Twelve clinics chose to adopt the EIMG® program and eight clinics were classified as non-adopters (4 declined, 4 non-responsive). Twelve clinic managers (8 adopting, 4 non-adopting) participated in the individual interviews. Facilitators supporting clinic adoption included prior knowledge and familiarity with EIMG®, support from health system administration, and potential benefits for patients. Barriers to adoption included practice managers reporting misplaced invitations, distance to participating PA facilities, and unwillingness to take on another program. CONCLUSIONS: This work highlights different factors influencing adoption of a PA referral pathway in a large health care system. Understanding these factors can help focus the time, energy, and delivery methods used when introducing a new program or initiative in a health system. Research reported in this poster was supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health under award number R56HL157218.