Opposition and opportunity: Reported challenges and changes to practice within the context of the exercise is medicine canada initiative


Exercise is Medicine Canada (EIMC) is a national initiative aimed at increasing the number of health care providers (HCPs) assessing, counseling and prescribing exercise as part of routine health care visits. The purpose of this paper is to examine HCP's biggest perceived challenges in promoting exercise, how they intended to overcome these challenges, and to determine whether physicians followed through on proposed changes to their practice following an EIMC training workshop. As part of a larger EIMC evaluation, data from 181 HCPs (52% physicians) was drawn from questionnaires administered at training workshops. This data generated 249 challenge-statements and 75 statements about how HCPs planned to overcome these challenges. The most common challenges reported were patients' lack of interest (28% of total responses), lack of time (18%) and HCPs' lack of knowledge (12%). To overcome these challenges, HCPs reported that they would discuss exercise with more patients (55%), and increase use of exercise-related resources (32%). Data from 47 physicians generated 93 statements regarding proposed changes to practice immediately following the workshop. Primary responses included actively prescribe specific exercises (27%) and discuss in more depth (26%). At follow-up 2-3 months later, 88 statements were generated, with 46% reflective of at least one of the proposed changes, and 40% reflecting changes that were different than originally proposed. These findings suggest that despite challenges HCPs are looking to overcome these hurdles, and that the changes made reflect both the training received, as well as ways in which physicians are managing their clinical reality.

Acknowledgments: Supported by the Lawson Foundation