Successful Implementation of
Exercise is Medicine at the Worksite
™
Lynn JS, C Winters, J Urda, L Marriner, C Fengl, and S Buckenheimer
Department of Exercise & Rehabilitative Sciences, Slippery Rock University, Slippery Rock, PA
Abstract
Summary of Program
Program Impact
Organization: Slippery Rock University (SRU) offers a variety of undergraduate and graduate programs for about 8,850 students. Approximately 950 faculty, staff,
and administration are employed at SRU. SRU has a relatively new wellness commission which provides a variety of health and wellness initiatives.
1. Develop a relationship with health care provider(s)
Summary of the Primary Program: Utilizing the Exercise is Medicine™ model, employees and students are referred by their Personal Care Physician or the Student
Health Center. Once referred, a qualified exercise professional provides motivational interviewing, comprehensive pre/post fitness assessments, and individualized
exercise prescription, focused on creating SMART goals to initiate behavior change and improve self-efficacy.
• The health care providers at the student health center were educated about the
Exercise is Medicine™ ideologies. They agreed to embed “physical activity” into
their electronic medical record so that students who were being seen for non-urgent
conditions were screened for their volume of physical activity as a 6th vital sign.
• Students not accumulating 150 minutes of physical activity per week were given
the option of receiving a brochure on fun ways to exercise or being referred to
the one-on-one exercise program.
• Local physicians were contacted about the program and are encouraged to refer their
patients to the program.
• For a corporate wellness program, contacts would be made with health care providers
caring for the employees.
1. During the 6-week analysis period, 90% of student health center office visits included
“Exercise” screening/counseling
2. Of the patients who did not accumulate 150 minutes of physical activity per week, 10%
accepted the referral to the program
3. Twenty participants (age = 24.6 ± 12.6; 4 males, 16 females) with no regular exercise
program completed the program
4. 100% of participants completed at least 12 prescribed sessions, and 85% of the sessions
were completed within the 6-week time period
5. 100% of participants reported increased exercise self efficacy
6. 100% of participants had a detailed plan to continue exercise at the end of the program
7. 100% of the participants changed behavior by increasing physical activity
8. Qualitative feedback from participants and exercise professionals is below
Explanation of the evaluation plan: Adherence to the exercise program, pre/post fitness assessment outcomes, self-efficacy, and behavior change were measured over
a 6-week period.
Summary of the program impact: Twenty participants (age = 24.6 ± 12.6; 4 males, 16 females) with no regular exercise program completed the intervention.
Participant compliance was 85% within 6-weeks. One hundred percent of participants reported feeling more confident about exercising regularly, and 100% had a plan
in place to continue to exercise. The program was successful to increase physical activity, self-efficacy, and positive behavior change. Additionally, participants
established a plan to continue a regular exercise program.
Background
Exercise is Medicine (EIM)™ is a global initiative created by the American College of Sports
Medicine (ACSM), the American Medical Association (AMA), and numerous global
partners with interests in health and wellness.
The goals of EIM include:
• Making exercise an important part of the accepted medical paradigm
• Bridging the gap between clinicians and exercise specialists to increase physical activity
• Making physical activity and exercise an integral part of the individual’s daily routine to
help prevent and manage disease
Research evidence supports the premise that the success rate of health behavior change
programs is higher when the physician is involved.
Organization
Slippery Rock University includes numerous buildings situated on a 660-acre campus in a
rural area 80 km north of Pittsburgh, PA. The university offers over 60 undergraduate and 20
graduate programs to 8,850 students. Students have access to a student health center which
employs nurse practitioners, nurses, and a medical doctor.
The university has an 82,000 foot comprehensive recreation center which is available to all
students from 6:00am to 11:00pm. In addition to the facility, the recreation team offers group
fitness classes, intramural sports, outdoor adventures, and aquatic programs.
The Exercise Science Program at SRU prepares students to work one-on-one with clients or
patients in a variety of settings. The curriculum includes intensive training in wellness
coaching, motivational interviewing, and exercise prescription for healthy and special
populations. In the penultimate semester, students have a class in which they are assigned a
client for whom they must conduct assessments, shape wellness/fitness goals, create goal
driven comprehensive exercise prescriptions, and guide the program twice per week for 12
weeks. The final semester includes a 12-week (480 hour) internship.
2. Establish the venue or facility for physical activity interventions
• In the present case, the program has full access to the on-campus recreation center.
Students do not pay extra to use the facilities, but referrals from off-campus physicians
must purchase a membership.
• A corporate site with a fitness facility has a built in venue, but local fitness facilities or
university facilities could be approached to host the exercise program.
Effective Strategies Cited by the Exercise Professionals:
3. Provide qualified exercise professionals to accept the referrals and run program
• Build the relationship first, then take care of the exercise prescription.
• Motivational interviewing and wellness coaching are keys to success. The plan must
be the participant’s, not yours.
• Link participants to their own social support network when possible (friends, family)
• It’s not all about the gym. Participant meetings were at the art gallery, the cafeteria,
and outside on the walking path
•
Statements from Participants:
Exercise Science students at the end of the curriculum provided the one-on-one
exercise/wellness programming and reported to faculty.
• Interns collected referrals and contacted the patients/participants
• Participants completed an initial wellness questionnaire including health history
and physical activity history and interests related to wellness
• Initial visit included wellness coaching and motivational interviewing to
establish a plan
• Individualized programs were undertaken for 6 weeks, meeting twice per week
• The exercise professional focused on building a relationship with the participant
• A variety of motivational techniques and communication efforts were used
including text messages and shared lunches at the cafeteria to discuss healthy
eating opportunities
• Pre and post fitness assessments were encouraged
• A questionnaire was completed at the end of six weeks which included questions
about plans to continue exercise and a program evaluation
Evaluation Plan
1. The number of patient screenings was quantified to examine the ability of the health care
providers to conduct screenings during office visits
2. Participant compliance was analyzed for the 6-week program
3. A comparison of participant exercise self efficacy at the beginning and end of the program
was made
4. Changes in volume of physical activity from pre-program to the end of the program were
evaluated
5. Observation and anecdotal reports from participants and exercise professionals were
carefully documented to qualitative review
• “It acts as stress relief and allows me to set goals and develop holistically.”
• “The program has given me all the tools I need to stay active and healthy when I’m
done.”
• “EIM has motivated me to be physically active again after stopping for a long time.”
• “I lost 5 pounds…I have more confidence in myself…I loved working with my
trainer.”
• “EIM program is not just for people who are overweight or unhealthy, it’s for
everyone.”
• “The trainers are knowledgeable, helpful, and professional and make the most out of
the experience. I love EIM.”
Examples of texts between participants
and the exercise professional