title: [Action Plan to Improve the Utilization of Stationary Bikes in a Health Promotion Exercise Program].
abstract: OBJECTIVE
  Research has shown that exercise helps reduce the risk and the severity of metabolic syndrome. Since 2009, KMHK hospital has implemented a primary-prevention health promotion program that targets individuals who are at elevated risk of metabolic syndrome. The program engages participants in an exercise protocol that asks them to exercise regularly on a stationary bike three times a week for six months. The utilization rate of the stationary bikes averaged 75% in 2010, but reduced to 34.7% in 2011, with an average withdrawal rate of 24.3%. Therefore, an action team was assembled in order to enhance the effectiveness of the program.
  
  
  OBJECTIVE
  This project used two primary strategies to increase the utilization of stationary bikes. These strategies included: increasing referrals and decreasing withdrawals.
  
  
  METHODS
  Surveys of participants who, respectfully, failed to complete and successfully completed the exercise protocol were conducted to identify the factors associated with non-completion / completion. The enrollment policies, the equipment, and the environment were inspected comprehensively. After identifying the causes and effects, several interventions were implemented. These interventions included: installing insulation curtains to block direct sunlight, upgrading the stationary bikes to newer models, creating an environment more conducive to exercise, promoting the referral policies, marketing the health promotion program, and securing family support.
  
  
  RESULTS
  After three months, the utilization rate of stationary bikes increased to 77.8%, representing an improvement rate of 124%. Furthermore, the number of case referrals significantly increased and the withdrawal rate decreased to 4.8%. Finally, longer-term follow up indicates that the utilization rate and the withdrawal rate have continued to improve.
  
  
  CONCLUSIONS
  The program implemented in the present study successfully enrolled more participants in the exercise protocol, as evidenced by the increased utilization of stationary bikes and by the lower withdrawal rate. Meanwhile, the risk factors for metabolic syndrome among the participants improved dramatically, which in turn achieved the goal of primary prevention and demonstrated program effectiveness.
authors.affiliation: Department of Nursing, Kaohsiung Municipal Hsiao-Kang Hospital, Taiwan, ROC.
authors.forename: Yu-Yen
authors.initials: YY
authors.lastname: Huang
authors.affiliation: Department of Nursing, Kaohsiung Municipal Hsiao-Kang Hospital, Taiwan, ROC.
authors.forename: Hsiu-Yuen
authors.initials: HY
authors.lastname: Chen
authors.affiliation: Department of Nursing, Kaohsiung Municipal Hsiao-Kang Hospital, Taiwan, ROC.
authors.forename: Chia-Chien
authors.initials: CC
authors.lastname: Wu
authors.affiliation: Department of Nursing, Kaohsiung Municipal Hsiao-Kang Hospital, Taiwan, ROC. ymchen@kmu.edu.tw.
authors.forename: Yao-Mei
authors.initials: YM
authors.lastname: Chen
mesh_terms: D001642:Bicycling; D015444:Exercise; D006293:Health Promotion; D006801:Humans; D024821:Metabolic Syndrome / Q000517:prevention & control*
keywords: exercise program; health promotion; metabolic syndrome; quality improvement project