The members of the PfA Task Force recognized that many initiatives are already underway to support integration of physical activity into the healthcare setting.
In fact, the leaders of many of these initiatives are members or advisors to the PfA Task Force. The following is a brief overview of some of the most extensive and organized efforts with a vision similar to that of the PfA Task Force. The PfA Task Force is aligned with each of these initiatives and aims to provide critical coordination to help achieve a shared vision.
The DNPAO takes a comprehensive approach to fighting against chronic disease by focusing its efforts in four key areas: epidemiology and surveillance, environmental approaches, healthcare system interventions, and community programs linked to clinical services.
The DNPAO’s Active People, Healthy Nation initiative supports delivering effective community-based physical-activity programs, mobilizing physical-activity partners, creating engaging messaging regarding active lifestyles, training community-based physical-activity leaders and developing technology tools and data-tracking resources.
Centers for Disease Control and Prevention’s Division of Nutrition, Physical Activity, and Obesity (DNPAO)
Diabetes Prevention Program (DPP)
The DPP is a partnership of public and private organizations working to reduce the growing problem of prediabetes and type 2 diabetes. Their efforts aim to make it easier for people with prediabetes to participate in evidence-based, affordable and high-quality lifestyle-change programs to reduce their risk of type 2 diabetes and improve their overall health. In addition to providing a framework for diabetes-prevention efforts, the partner organizations share the following goals:
- Deliver lifestyle-change programs approved by the Centers for Disease Control and Prevention
- Ensure quality and adherence to proven standards
- Train community organizations to run these programs
- Increase referrals to, and participation in, these programs
- Increase coverage by employers and public and private insurers
Exercise is Medicine (EIM)
EIM was developed by the American College of Sports Medicine and the American Medical Association in 2007. Its three aims are to:
- Prompt healthcare providers to assess physical-activity levels of each patient at every clinic visit
- Provide patients with exercise “prescriptions” that can be tailored for their specific needs and disease conditions
- Refer patients to a trusted network of local evidence-based physical-activity programs led by qualified professionals
Every Body Walk!
Every Body Walk! is an initiative of Kaiser Permanente advocating for walking as a major solution to the physical inactivity epidemic. In combination with the Surgeon General’s recent Call to Action to increase walking and walkability in communities, such initiatives lay out the plan to help patients go from a prescription to move more, to actually doing it. In many cases, having a place to walk (and a program to support walking) may be a viable solution.
Health Living Practitioner
The curriculum of the Healthy Living Practitioner certificate program is supported by the American Heart Association (AHA). It is designed to educate health professionals from all disciplines (e.g., medicine, nursing, pharmacy, dentistry, and physical/occupational therapy) on basic principles of healthy living medicine.
HLPs are defined as health professionals who are actively engaged in assessing lifestyle behaviors and subsequently developing and implementing healthy living interventions. HLPs focus on the primordial and primary prevention of chronic diseases as well as secondary prevention in those already diagnosed with a lifestyle-related disease. HLPs are committed to supporting behavior changes toward healthy living and helping to ensure these changes are maintained over the long-term. HLPs participate in a broad range of activities related to the field including individual/patient care, program development and implementation, teaching, research and leadership activities related to healthy living medicine.
Lifestyle Medical Education Collaborative (LMEd)
LMEd offers leadership, guidance and resources to advance the adoption and implementation of lifestyle medicine curricula throughout medical education, as physicians must themselves be educated on the vital role that lifestyle interventions play in preventing, treating and managing disease. Subjects included in these curricula include exercise/physical activity, nutrition, behavior change and self-care.
Million Hearts
This initiative was established by the U.S. Department of Health & Human Services and is co-led by the Centers for Disease Control and Prevention and the Centers for Medicare & Medicaid Services. It focuses partner actions on a small set of priorities selected for their impact on heart disease, stroke and related conditions.
Reaching the following goals will result in 1 million fewer heart attacks in the next five years: 20 percent reduction in sodium intake; 20 percent reduction in tobacco use; 20 percent reduction in physical inactivity; 80 percent performance on the ABCS Clinical Quality Measures; and 70 percent participation in cardiac rehabilitation among eligible patients.
National Coalition for the Promotion of Physical Activity (NCPPA)
NCPPA unites the strengths of public, private and industry efforts to empower all Americans to lead more physically active lifestyles. NCPPA advocates for the following policies and practices in the healthcare sector:
- Provide tax incentives and reimbursement policies that cover health/fitness counseling
- Create linkages between healthcare providers and community resources for physical activity and physical-fitness promotion
- Support exercise prescriptions in healthcare delivery
- Increase professional education and medical school training to healthcare providers to increase their knowledge of physical activity and physical fitness and increase their willingness to write exercise prescriptions
- Integrate quality measures on physical activity/physical fitness into electronic health records
Physical Activity Vital Sign (PAVS)
PAVS calls upon all healthcare systems and providers to routinely assess physical activity at each clinic visit through the medical assistant/licensed vocational nurse asking the following two questions as other vital signs are taken, and then documenting the patient response in the medical record:
• On average, how many days per week do you engage in moderate or greater physical activity (like a brisk walk) lasting at least 10 minutes?
• On those days, how many minutes do you engage in activity at this level?
SHAPE America: 50 Million Strong
This initiative is a call to action for all of America’s health and physical education providers to focus on the common purpose of getting the approximately 50 million students enrolled in
America’s elementary and secondary schools to become physically active, enthusiastic and committed to making healthier lifestyle choices. Today’s youngest students will graduate from high school in 2029. The objective of 50 Million Strong is to ensure that all of America’s youth will be empowered to lead healthy and active lives through effective health and physical education programs by that date.
SilverSneakers
SilverSneakers is a fitness program for seniors that is provided at no cost by more than 60 health plans nationwide. The program includes unlimited access to the more than 13,000 participating gym and fitness center locations in its network.
Step it Up! The Surgeon General’s Call to Action to Promote Walking and Walkable Communities
This program provides strategies that communities can use to support walking, with the goal of driving long-lasting changes to improve the health and healthcare of Americans now and in future generations.
The Call to Action:
- Focuses on promoting optimal health before disease occurs
- Is applicable to the health of people at all ages and stages of life
- Recognizes that everyone should have access to spaces and places that make it safe and easy to walk or wheelchair roll
U.S. National Physical Activity Plan
The Plan aims to help identify ways in which communities and individuals can implement the Physical Activity Guidelines. The Plan consists of a comprehensive set of policies, programs and initiatives that aim to increase physical activity across all sectors, including business and industry; education; healthcare; mass media; community recreation, fitness and parks; sport; public health; faith-based settings; and transportation, land use and community design.
Walk with a Doc
Walk with a Doc is a national grassroots initiative in which doctors and other healthcare providers lead a brief health education session followed by a walk. What started with a movement by Ohio cardiologist Dr. David Sabgir in 2005 after he became frustrated with his inability to effect behavior change, has spread to include 300+ chapters across the U.S. Walk with a Doc has partnered with the National Recreation and Park Association to expand its impact and help build the bridge between clinic and community parks.
Wellness Elevated
The Wellness Elevated Program is housed within the Center for Wellness and Human Performance at Western State Colorado University (WSCU). The program represents a partnership between the Department of Recreation, Exercise, & Sport Science at WSCU and the medical community of the Gunnison Valley. The Wellness Elevated Program offers the following programs:
- Primary prevention program – for patients with cardiac disease risk factors or other health issues
- Phase 2 cardiac rehabilitation program – for patients who have experienced a cardiac event
- Phase 3 cardiac rehabilitation program – for patients who have completed phase 2 cardiac rehabilitation