Implementing And Evaluating A Physical Activity Referral Pathway Integrated Into A Major Health System: Study Protocol

PURPOSE: The promotion of physical activity (PA) within the U.S. health system has the potential to prevent and treat a multitude of chronic diseases. Despite evidence supporting the integration of PA into primary care, numerous implementation barriers exist. Exercise is Medicine Greenville® (EIMG®) is a clinic-to-community PA referral pathway that connects patients to evidence-informed PA programs. However, the process of seamlessly integrating EIMG® into a health system is under continual improvement. Using a mixed methods approach, this study is examining the adoption, implementation and reach of EIMG® across primary care clinics. METHODS: The study is composed of three phases. In phase I, 20 eligible primary care clinics will be invited to adopt EIMG®. In phase II, adopting clinics will receive an introductory EIMG® video describing the referral process. Individual interviews with adopting and non-adopting practice managers, as well as referred patients, will be conducted. Additionally, clinic staff will be asked to complete an online Organizational Readiness to Change Assessment (ORCA) survey. In phase III, a formal, semi-customized EIMG® onboard training will occur with each adopting clinic, followed by a second round of ORCA surveys and individual interviews with clinic staff and patients. Referral rates of eligible patients will be tracked across phases II and III. RESULTS: Patterns in referral rates during phases II and III will illustrate the depth of onboard training necessary for successful referrals. Qualitative results from the individual interviews will reveal barriers and facilitators to adoption and implementation from the perspective of clinic staff, while the ORCA survey will yield information of the supportive resources and processes necessary to successfully integrate EIMG® into a health system. Patient interviews will identify key barriers and facilitators to referral utilization and program completion. CONCLUSION: The results of this study have the potential to inform the integration of PA referral pathways into other health systems and settings. Findings on onboard training needs, barriers and facilitators to adoption and implementation, and patient perspectives can improve PA referral pathways and increase the connection of patients to supportive PA resources. 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.