Enabling Exercise Prescription: Developing a Comprehensive Intervention Strategy for Exercise Counseling and Prescription in Family Medicine.

摘要

Background: The prevalence of physical inactivity among American adults is high. Physical inactivity is a major contributor to morbidity and mortality associated with chronic medical conditions. Exercise counseling and prescription provided by physicians in the office setting has been proposed as a strategy for improving exercise participation among patients. Multi-component office based exercise interventions have shown the most promise toward increasing patient exercise participation. An effective comprehensive intervention strategy for exercise counseling and prescription in Family Medicine is not presently available.;Objective: To develop a comprehensive intervention strategy for exercise counseling and prescription to be used in the Family Medicine outpatient office setting.;Methods: A literature review was undertaken to evaluate the current understanding of exercise and physician office based exercise interventions as they relate to disease prevention and chronic disease management. American Board of Family Medicine certified physicians were interviewed using a semi-structured format to explore their views regarding exercise counseling and prescription. Transcribed interview data was analyzed using abductive analysis.;Results: Exercise counseling and prescription is important and underutilized in Family Medicine. Family Medicine physicians accept the role of being a leader in promoting exercise among their patients. The 5 A's of behavior change were well conceptualized and viewed as a suitable framework for an office based exercise intervention. Physician time constraints and the absence of a standardized process were the most significant barriers to exercise counseling and prescription in the Family Medicine setting.;Conclusion: The literature review and themes derived from interview data analysis provided insight into the development of a comprehensive intervention strategy for exercise counseling and prescription in Family Medicine. The intervention is consistent with the scientific understanding of exercise as it relates to health and chronic disease processes. Its design is representative of current recommendations for interventions aimed at healthy lifestyle behavior modification and is tailored specifically for Family Medicine physicians. This intervention is also proposed as the basis for future research.