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Implementation Facilitation of Exercise is Medicine Greenville

Facilitating Health System Implementation of Physical Activity Screening and Referral to Community-Based Programs: Exercise is Medicine Greenville

Who can join

As published by the study on ClinicalTrials.gov. "Not stated" means the study hasn't said — ask the study team.

Age
No age limits stated
Sex
All sexes
Healthy volunteers
Accepted
Compensation
Not stated

Other requirements are listed under Eligibility below. Only the study team can confirm whether you can join.

What to expect

No one can promise a trial will help you personally — that is what the research is trying to find out.

What participation involves

Not stated in the study description — ask the study team about visits and procedures.

Compensation
Not stated
  • Study-related exams and procedures are typically provided at no cost. This is how many trials work in general — confirm the details for this study with the study team.
  • Participants are monitored closely by the research team throughout the study.
  • Some participants may receive access to an investigational treatment, which is still being studied.
  • Your participation helps researchers learn whether this approach could help future patients.

About this study

In plain language

This study tests ways to help clinics connect patients who are not physically active with community exercise programs. It also looks at the costs and benefits of this approach. It includes participating clinics, their staff, and adults ages 18–80 who qualify for an Exercise is Medicine Greenville (EIMG) referral.

A public health priority exists for the U.S. healthcare sector to integrate physical activity (PA) as a part of the patient care model. This research will provide valuable information on facilitating optimal implementation of a clinic-to-community model that identifies, refers, and enrolls physically inactive patients to community-based PA programs for the prevention and treatment of chronic diseases. Further, this work will provide evidence on the cost-effectiveness of integrating PA in healthcare systems as a population health management strategy.

Compensation is read from the study's own description and may be missing — always confirm with the study team.

Eligibility

Who can join

  • Clinics: Must be a Prisma Health-Upstate family or internal medicine clinic that has used EIMG for at least 6 months.
  • Staff: Must be at least 18 and have worked at the clinic since the study phase began.
  • Staff: Must see at least 25 patients each month, spend more than half their work time at the study clinic, and understand and communicate in English.
  • Patients: Must be ages 18–80 and qualify for an EIMG referral because of high blood pressure, unhealthy blood fat levels, obesity, diabetes, or too little physical activity.
  • Patients: Must have a qualifying healthcare visit at a participating clinic, such as an office visit, video visit, follow-up, or nutrition visit.
  • Activity-tracking group: Must have an EIMG referral and be scheduled for an introduction session at one of the two selected YMCA sites.
  • Interview group: Must have an EIMG referral.

Who can't join

  • Clinics: Cannot join if they do not use EIMG, started it less than 6 months ago, or are more than 15 miles from the nearest YMCA.
  • Staff: Cannot join if under 18, started after the study phase began, see fewer than 25 patients monthly, cannot speak or understand English, or cannot give consent.
  • Patients: Cannot join if under 18 or over 80, or currently referred for physical therapy, occupational therapy, or heart, lung, or cancer rehabilitation.
  • Patients: Certain conditions listed for the visit rule out joining. These include specified heart, lung, kidney, brain, nerve, and blood clot conditions, as well as serious infections.
  • Patients: Other listed reasons include certain fractures, a history of falls, paralysis, spinal cord injury, wheelchair or walking-aid use, a heart stent, oxygen or kidney dialysis use, very high blood pressure, or diabetes with dangerous acid buildup.
  • Patients: Visits involving chemotherapy, radiation, pregnancy care, comfort-focused care, schizophrenia or other psychotic disorders, or thoughts of harming oneself or others also rule out joining. The study team must check the full diagnosis list.
  • Activity-tracking group: Cannot join if unable to give spoken consent, planning travel during tracking, or not allowed to wear a watch at work.
  • Interview group: Cannot join if unable to give spoken consent, unable to speak or understand English, or under 18.

Simplified for readability. The official criteria below are what the study team uses.

Official eligibility criteria

The primary aim of this study is implementation facilitation at the clinic level. The secondary aim of this study is at the patient level. Therefore we have divided our inclusion/exclusion eligibility criteria by primary and secondary aim. 1\. Clinic (primary aim) Inclusion criteria * Currently EIMG-activated Prisma Health-Upstate Primary Care clinic (family or internal medicine) * Adopted EIMG \>= 6 months prior to the beginning of this study Exclusion criteria * Not EIMG-activated * Adopted EIMG \< 6 months prior to the beginning of this study * Greater than 15 miles from the nearest YMCA 1\. Primary care clinic staff (primary aim) Inclusion criteria * At least 18 years of age * Has worked at the Prisma Health-Upstate clinic since the start date of the intervention in the respective wave, i.e., Pre-IF start date for each wave * Has clinical encounters with a minimum of 25 patients per month * Study clinic is their primary clinic (\>50% of their working time) * Able to understand and communicate in English Exclusion criteria * Less than 18 years of age * Work at the Prisma Health-Upstate clinic started after the Pre-IF phase began * Has clinical encounters with \<25 patients per month * Unable to speak or understand English * Adults unable to provide consent 2\. Patient (secondary aim) Inclusion criteria (must meet all of below) * Age \>= 18 and \<= 80 years * Clinically eligible (diagnosis of hypertension, dyslipidemia, obesity, diabetes, or physical inactivity) to receive an EIMG referral * A healthcare visit with an eligible encounter type (evaluation, telemedicine, consult, office visit, e-visit, follow-up, appointment, education, multidisciplinary visit, nutrition, occupational medicine-office visit) * A healthcare visit at a participating clinic Exclusion criteria * Age \< 18 or \> 80 years * Current referral to Physical therapy or occupational therapy * Current referral to cardiac, pulmonary, or oncology rehab * One of the following visit diagnoses listed below: * Alzheimer's disease * Amyotrophic lateral sclerosis * angina or chest pain * congenital stenosis of aortic valve * congenital insufficiency of aortic valve * moderate or severe persistent asthma * typical or atypical atrial flutter * autonomic dysreflexia * acute bronchitis * cerebral infarction * encounter for chemotherapy * chronic kidney disease (stage 3-5) * end stage renal disease * coma * acute chronic obstructive pulmonary disease * unspecified dementia * dependence on renal dialysis * trisomy 21 * pulmonary embolism * venous embolism and thrombosis * history of falling * acute fracture * left ventricular failure * congestive heart failure * hypertensive urgency, emergency or crisis * diabetes with ketoacidosis * chronic respiratory failure * dependence on supplemental oxygen * myocardial infarction * osteoporosis with current fracture * encounter for palliative care * paraplegia or quadriplegia * Parkinson disease * pneumonia * encounter for supervision of pregnancy * encounter for radiation therapy * serious mental illness (schizophrenia, psychotic disorder) * homicidal or suicidal ideations * sepsis * injury of spinal cord * presence of coronary stent * dependence on wheelchair or ambulatory aid For patients completing accelerometry data collection, the additional inclusion/exclusion criteria apply: Inclusion criteria: * Received an EIMG referral and scheduled for orientation * Attending orientation at two pre-determined community PA facilities (these sites were selected due to each being the largest urban and rural YMCA referral sites in the study) Exclusion criteria: * Unable to provide verbal informed consent * Planning on travel or vacation during data collection, as patient PA behavior is anticipated to differ from 'everyday' PA behavior at home * Unable to wear a watch during work hours due to employment restrictions e.g., food service, healthcare, operating heavy machinery/construction, laboratory-based work etc. In addition, for patients completing interviews, the additional inclusion/exclusion criteria apply: Inclusion criteria: \- Received an EIMG referral Exclusion criteria: * Unable to provide verbal informed consent * Unable to speak or understand English * \<18 years of age

Study sites (1)

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