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Provider Acceptance, Training, and Utilization of Place-Based Exercise Prescriptions

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2017, PHD, Kent State University, College of Public Health.
Introduction: Up to 29.5% of U.S. adults are physically inactive. Physical inactivity is associated with excess mortality and morbidity and may contribute an estimated $131 billion in health care expenditures annually. Exercise prescriptions and referrals are an economical solution to physical inactivity, and several health care provider associations and proposed government policy initiatives support adoption of exercise prescriptions. Yet as few as 14% of primary care providers prescribe exercise or make exercise referrals. The purpose of this pilot study is to identify provider characteristics, knowledge, perceived barriers, practices, and needs related to place-based exercise prescription and referral to exercise either at a specific location, or to an exercise professional. Methods: An 88-item questionnaire was developed and administered electronically and in paper format to alumni of a university’s nurse practitioner program and two hospital systems’ networks of primary care physicians and nurse practitioners. Descriptive statistics were generated regarding clinical practices related to patient exercise and providers’ perceived needs related to exercise prescription and referral. Factor analysis was conducted to identify underlying constructs. Bivariate analyses were utilized to identify variables significantly related to exercise prescription and referral. A binomial logistic regression was performed to determine factors related to whether or not providers refer patients to place-based exercise. Results: Responses were received from 166 providers; 61.5% were female, 86.9% were white. Respondents’ specialties were: family medicine (20.6%), internal medicine (27.8%), nurse practitioner (29.4%), and other (22.2%). Overall, 14.8% of providers prescribe exercise to at least some of their patients and 54.3% refer patients to specific exercise locations or professionals. Almost 90% ask about patient exercise, 64.3% document patient exercise, and 20.8% assess exercise by physical fitness and 83.3% by exercise volume. Of the providers who referred to professionals, personal trainers were referred to most frequently (59.2%). Of providers who referred to locations, most (79.0%) referred to hospital owned fitness facilities. Due to limited variability among providers prescribing exercise, correlates of exercise prescription were not assessed. Logistic regression of factors related to exercise referral yielded five significant variables: (1) Asking about exercise, (2) documenting exercise, (3) prescribing exercise, (4) knowledge of Physical Activity Guidelines for Americans, and (5) providers’ perception that patients’ need increased time to exercise. Conclusion: Despite the known health risks of physical inactivity, prescribing exercise to patients is not a common practice among nurse practitioners and primary care providers in this sample. Referral for exercise is also infrequent, occurring in just over 33% of the sample. Provider’s believe that patients lack time to exercise and may need guidance on how to work within patients’ specific schedules and assess convenient locations to refer and prescribe exercise. Improving provider knowledge of recommended activity guidelines may result in improved adoption of physical activity prescription or referral.
Sonia Alemagno (Committee Chair)
Jeffrey Hallam (Committee Member)
Jonathan VanGeest (Committee Member)
154 p.

Recommended Citations

Citations

  • Smock, C. R. (2017). Provider Acceptance, Training, and Utilization of Place-Based Exercise Prescriptions [Doctoral dissertation, Kent State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=kent1492008967709141

    APA Style (7th edition)

  • Smock, Carissa. Provider Acceptance, Training, and Utilization of Place-Based Exercise Prescriptions. 2017. Kent State University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=kent1492008967709141.

    MLA Style (8th edition)

  • Smock, Carissa. "Provider Acceptance, Training, and Utilization of Place-Based Exercise Prescriptions." Doctoral dissertation, Kent State University, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=kent1492008967709141

    Chicago Manual of Style (17th edition)