Prescription for Activity Task Force, Funded by ACE, Could Bridge Community and Clinic Gap
Have you ever imagined a world in which healthcare providers treating individuals who are at risk chronic conditions like diabetes write prescriptions not only for a trip to the pharmacy, but also for a visit to someone trained and qualified to deliver physical-activity interventions?
What if every healthcare consumer at risk for chronic conditions had an assigned preventive-care “team” that included someone well qualified to deliver behavior counseling including science-based physical activity?
What if healthcare consumers could receive the physical-activity counseling prescribed to them at a place that’s actually convenient for them, like their work, at home or in their yard? Or in parks, community centers, fitness facilities, places of worship or even, say, barber shops and hair salons?
What if a healthcare consumer’s progress in a prescribed physical-activity intervention could be entered by the qualified provider directly into that consumer’s electronic health records via a secure smartphone app?
What if healthcare consumers knew such interventions were reimbursable by health insurance or otherwise funded in some nontraditional way for purposes of equipping them to prevent or self-manage chronic disease?
What if healthcare as we know it today became so evolved that it were as much about prevention as treating illness, and a cornerstone of that was community-based representatives of the clinic whose job it is to help community members adopt and maintain healthier lifestyles?
This is all very different than what Americans expect from the healthcare system today, but if a new task force of national experts and thought leaders has its way, it could some day be a reality. The all-new Prescription for Activity Task Force has begun examining what it would take for a significant number of healthcare consumers in the U.S. to be prescribed or incentivized to pursue physical activity-based behavior-change interventions. The Task Force’s vision is that behavior interventions, with a strong emphasis on physical activity, are readily accessible, delivered by trusted members of the patient-centered team, reimbursable by payers and integrated in patient records. This project is funded by the American Council on Exercise (ACE).
For people who are trained and well-qualified to deliver physical activity-based behavior-change interventions and have a passion for working with individuals and families who are in desperate need of physical activity, the future could be very bright.
What the Science Says
Leading recommending authorities increasingly say that physical activity-based behavior-change interventions should be among healthcare’s key strategies to treat and prevent chronic, preventable disease. For example:
- The National Physical Activity Plan states, “Given the well-established benefits of structured exercise regimens and regular physical activity, numerous studies have shown that brief healthcare provider counseling during an office visit can play a critical role in patients adopting varied preventive lifestyle interventions.”
- In December 2015, a viewpoint in the Journal of the American Medical Association entitled “Making Physical Activity Counseling a Priority in Clinical Practice” makes the case that physical-activity interventions as part of healthcare are not only a good idea but are also cost-effective and productive.
- A paper published by the American Heart Association in late 2015 entitled “The National Physical Activity Plan: A Call to Action from the American Heart Association” argues for the substantial evidence supporting the benefits of regular physical activity to prevent a wide variety of disease conditions and to enhance quality of life.
Experts want physical activity-based behavior-change interventions to become an integral extension of clinical care for preventive care. The evidence shows that such interventions work—they are happening today in isolated pockets of innovation around the country, thanks to programs like Exercise Is Medicine. The results are very encouraging. But there has been no clear, agreed upon path for how to scale those pockets of innovation so they become system wide. The Prescription for Activity Task Force was formed in an effort to change that.
Task Force Objectives
The Task Force will spend 2016 and early 2017 assembling a change map that spells out the step-by-step specifics of how the healthcare system must evolve over the coming decades so the recommendations of leading authorities come to life. That change map will articulate precise, measurable outcomes that the healthcare system must achieve by certain dates and in very specific cause-and-effect sequences in order to make the stated vision a reality. This will then require strategic planning for how all those outcomes are achieved and how those sequences are sparked. It is an ambitious undertaking.
“This is exactly the right convening at the right time,” says Robert Sallis, M.D., FACSM, Co-Director, Sports Medicine Fellowship, Kaiser Permanente and member of the Task Force. “There is broad agreement that increased physical-activity counseling is a promising strategy to achieve the triple aim of improved quality, better experience and lower cost of care. This group intends to figure out how to make that a reality.”
The all-volunteer Task Force is an impressive, esteemed group. Among its more than 30 members are executives from allied health and health-advocacy organizations, senior VP-level leaders at health insurance plan providers, world-renowned physicians, the nation’s most sought-after voices on preventive care, and more.
“Leading preventive-care and community-health experts have called for widespread physical-activity counseling, particularly for those with, or at risk for, chronic conditions,” said Cedric X. Bryant, Ph.D., FACSM, chief science officer for ACE. “This group will aim to identify how to evolve the healthcare system to one in which physical activity-based behavior-change counseling is available and widely utilized by all healthcare consumers seeking to prevent or manage disease.”
The task force met in Dallas/Ft. Worth in May and will reconvene in mid-September in Denver.
Implications for Health and Fitness Professionals
For the vision of the Task Force to become a reality, much about how healthcare works today would need to evolve. But that’s not all. In communities across the country, there would need to be a growing army of individuals who are well-qualified and trained to deliver physical activity-based behavior-change interventions as an extension of the clinic. It would require all manner of people in communities to be trained and skilled as behavior-change counselors, including, for example,
- People who are already healthcare providers today in clinical settings, such as nurses, physician assistants, medical assistants and physical therapists
- Professionals who already are considered care providers even if they aren’t always found in the clinic, such as dietitians, nutritionists and athletic trainers
- Individuals who aren’t remotely considered “health providers” today but are trusted in their communities and could be recruited, trained and prepared to deliver such interventions—people such as social workers, clergy members, workplace managers and teachers
And certainly it should be well-qualified health and fitness professionals and coaches and others who already work in our communities today, individuals who are experienced at delivering the message of healthier lifestyle and would love nothing more than to help vastly more people get and stay moving. That’s not just an opinion held by ACE. In 2014, the U.S. Preventive Services Task Force named properly trained health and fitness professionals—such as those ACE educates, certifies and represents—among the professions qualified to deliver behavior counseling in the community as part of the healthcare system for those with multiple risk factors for cardiovascular disease (the leading cause of death in the U.S.).