title: Utilization of a free fitness center-based exercise referral program among women with chronic disease risk factors.
abstract: Physical activity (PA) reduces the risk for a number of chronic diseases including heart disease, hypertension, hyperlipidemia, and diabetes mellitus type 2. However, most Americans do not meet expert recommendations for exercise, and minorities and low-income persons are the most inactive. Community-based approaches to promoting PA include primary care exercise referral programs. This study examines patient characteristics associated with utilization of a community health center-based exercise referral program. Adult female patients of a community health center with an affiliated fitness center, in Boston, MA, were included in the study if they received a referral to the fitness center from their primary care provider. Demographic and medical information was abstracted from the medical chart, and fitness records were abstracted to measure activation of a fitness center membership (creation of an account denoting at least an initial visit) and utilization over time. Overall, 503 (40%) of the 1,254 referred women in the study sample activated their membership. Black women were almost 60% more likely to activate their membership (adjusted OR 1.6, 95% CI 1.2-2.2), and women with higher co-morbidity counts were almost 45% more likely to activate (adjusted OR 1.4, 95% CI 1.0-2.0). Once activated, a minority of women participated at levels likely to improve cardiometabolic fitness. Of the 503 activations, 96 (19%) had no participation, 359 (71%) had low participation, and only 48 (10%) had high participation. No independent predictors of participation were identified. These findings suggest that program design may benefit from developing activation, initial participation, and retention strategies that address population-specific barriers.
authors.affiliation: Department of Family Medicine, University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: Megan R
authors.initials: MR
authors.lastname: Waterman
authors.forename: John M
authors.initials: JM
authors.lastname: Wiecha
authors.forename: Jennifer
authors.initials: J
authors.lastname: Manne
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Tringale
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Costa
authors.forename: Jean L
authors.initials: JL
authors.lastname: Wiecha
mesh_terms: D000328:Adult; D002908:Chronic Disease; D003153:Community Health Services; D015444:Exercise; D005260:Female; D020446:Fitness Centers / Q000191:economics / Q000706:statistics & numerical data*; D015438:Health Behavior; D006801:Humans; D008875:Middle Aged; D010349:Patient Compliance; D012017:Referral and Consultation; D012307:Risk Factors
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