title: Using a qualitative approach for understanding hospital-affiliated integrated clinical and fitness facilities: characteristics and members' experiences.
abstract: BACKGROUND
  With health care shifting away from the traditional sick care model, many hospitals are integrating fitness facilities and programs into their clinical services in order to support health promotion and disease prevention at the community level. Through a series of focus groups, the present study assessed characteristics of hospital-affiliated integrated facilities located in Northeast Ohio, United States and members' experiences with respect to these facilities.
  
  
  METHODS
  Adult members were invited to participate in a focus group using a recruitment flyer. A total of 6 focus groups were conducted in 2013, each lasting one hour, ranging from 5 to 12 participants per group. The responses and discussions were recorded and transcribed verbatim, then analyzed independently by research team members. Major themes were identified after consensus was reached.
  
  
  RESULTS
  The participants' average age was 57, with 56.8% currently under a doctor's care. Four major themes associated with integrated facilities and members' experiences emerged across the six focus groups: 1) facility/program, 2) social atmosphere, 3) provider, and 4) member. Within each theme, several sub-themes were also identified. A key feature of integrated facilities is the availability of clinical and fitness services "under one roof". Many participants remarked that they initially attended physical therapy, becoming members of the fitness facility afterwards, or vice versa. The participants had favorable views of and experiences with the superior physical environment and atmosphere, personal attention, tailored programs, and knowledgeable, friendly, and attentive staff. In particular, participants favored the emphasis on preventive care and the promotion of holistic health and wellness.
  
  
  CONCLUSIONS
  These results support the integration of wellness promotion and programming with traditional medical care and call for the further evaluation of such a model with regard to participants' health outcomes.
authors.affiliation: The Department of Social and Behavioral Sciences, Kent State University, Kent, OH, USA. jyang23@kent.edu.|The Research Institute at Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA. jyang23@kent.edu.
authors.forename: Jingzhen
authors.initials: J
authors.lastname: Yang
authors.affiliation: The Department of Social and Behavioral Sciences, Kent State University, Kent, OH, USA. dkingsb2@kent.edu.
authors.forename: Diana
authors.initials: D
authors.lastname: Kingsbury
authors.affiliation: The Department of Social and Behavioral Sciences, Kent State University, Kent, OH, USA. mnicho22@kent.edu.
authors.forename: Matthew
authors.initials: M
authors.lastname: Nichols
authors.affiliation: The Department of Social and Behavioral Sciences, Kent State University, Kent, OH, USA. kmann5@kent.edu.
authors.forename: Kristin
authors.initials: K
authors.lastname: Grimm
authors.affiliation: The Department of Health Sciences, Kent State University, 142 Nixson Hall, Kent, OH, 44242, USA. kding@kent.edu.
authors.forename: Kele
authors.initials: K
authors.lastname: Ding
authors.affiliation: The Department of Social and Behavioral Sciences, Kent State University, Kent, OH, USA. jhallam1@kent.edu.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Hallam
mesh_terms: D000368:Aged; D019033:Delivery of Health Care, Integrated; D005260:Female; D017144:Focus Groups; D006293:Health Promotion; D006801:Humans; D008297:Male; D008875:Middle Aged; D009820:Ohio; D010044:Outpatient Clinics, Hospital; D017060:Patient Satisfaction; D036301:Qualitative Research; D014481:United States