“Exercise is Medicine” in Latin America: training health care professionals in physical activity prescription

Abstract

Health care professionals (HCPs) play an important role promoting healthy habits to patients, yet they lack knowledge, training and self-efficacy to effectively prescribe physical activity (PA). In 2011, the “Exercise is Medicine” Latin American Regional Center developed a one-day (8 hours) in-person course on PA and exercise prescription for HCPs, with theoretical and practical components. Contents include evidence-based health benefits of PA, screening for major risk factors, key behavioral change strategies, basic exercise testing, and prescription and referrals principles. Participants take a multiple-choice evaluation before and after the training. Those who score 80% or higher in the final evaluation receive an international certification endorsed by the American College of Sports Medicine. Since 2013, they also report current PA habits and counselling in clinical practice at the beginning of the course. Sustainability of this initiative, including free enrollment of participants, has been achieved with the support from the industry, scientific societies, and sports and exercise authorities. As of October 2013, 40 courses have been carried out in 15 cities and 7 countries of the region. A total of 1206 HCP have participated (26.4% general practitioners, 47.8% specialists, 20% other HCP), and 625 physicians have been certificated. Participants scored, on average, 20% higher in the final versus the initial evaluation. In total, 379 participants completed the questionnaire, 61.2% of which reported to currently comply with international PA level recommendations. Also, 52.2% and 57.5% reported to always assess or recommend PA in their clinical practice. The overall quality of the course was scored 4.5 out of 5. Participants have shared personal testimonies, stating the positive impact of the training experience on their own personal exercise habits and clinical practice. This course is a promising strategy to help incorporate PA promotion in health care settings. Evaluation of its medium and long-term impact is in progress.