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Krops L, Bouma A, Van Nassau F, Nauta J, van den Akker-Scheek I, Bossers W, Brügemann J, Buffart L, Diercks R, De Groot V, De Jong J, Kampshoff C, Van der Leeden M, Leutscher H, Navis G, Scholtens S, Stevens M, Swertz M, Van Twillert S, Van der Velde J, Zwerver H, Van der Woude L, Van Mechelen W, Verhagen E, Van Keeken H, Van der Ploeg H, Dekker R
Implementing Individually Tailored Prescription of Physical Activity in Routine Clinical Care: Protocol of the Physicians Implement Exercise = Medicine (PIE=M) Development and Implementation Project
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Implementing individually tailored prescription of physical activity in routine clinical care; rationale for- and design of the Physicians Implement Exercise = Medicine (PIE=M) project
Leonie Krops;
Adrie Bouma;
Femke Van Nassau;
Joske Nauta;
Inge van den Akker-Scheek;
Willem Bossers;
Johan Brügemann;
Laurien Buffart;
Ron Diercks;
Vincent De Groot;
Johan De Jong;
Caroline Kampshoff;
Marike Van der Leeden;
Hans Leutscher;
Gerjan Navis;
Salome Scholtens;
Martin Stevens;
Morris Swertz;
Sacha Van Twillert;
Joeri Van der Velde;
Hans Zwerver;
Lucas Van der Woude;
Willem Van Mechelen;
Evert Verhagen;
Helco Van Keeken;
Hidde Van der Ploeg;
Rienk Dekker
ABSTRACT
Introduction: The prescription of physical activity (PA) in clinical care has been advocated worldwide. This ‘exercise is medicine’ (E=M) can be used to prevent, manage and cure various lifestyle-related chronic diseases. Due to several challenges, E=M is not yet routinely implemented in clinical care. This paper describes the rationale and design of the Physicians Implement Exercise = Medicine (PIE=M) study, which aims to facilitate the implementation of E=M in hospital care.
Methods and analysis: PIE=M consists of three inter-related work packages. First, levels and determinants of PA in different patient and healthy populations will be investigated using existing cohort data. The current implementation status, facilitators and barriers of E=M will also be investigated among clinicians of participating departments from two university medical centers, using a mixed-methods approach. Implementation strategies will be connected to these barriers and facilitators using a systematic implementation mapping approach. Second, a generic E=M-tool will be developed which will provide a tailored PA prescription and referral. Requirements for this tool will be investigated among clinicians and department managers. The tool will be developed using an iterative designing process in which all stakeholders reflect on the design of the E=M-tool. Third, we will pilot-implement the set of implementation strategies, including the E=M-tool, to test its feasibility in routine care of clinicians in two university medical centers. An extensive learning process evaluation will be performed among clinicians, department managers, lifestyle coaches and patients, using a mixed-methods design based on the RE-AIM framework.
Ethics and dissemination: The study design was approved by the medical ethical committees (METc UMCG 2017/517 and Amsterdam UMC 2018/219). Results will be used to further improve the implementation strategies and E=M-tool, to facilitate the implementation of E=M in participating departments and other clinical departments and hospitals.
Citation
Please cite as:
Krops L, Bouma A, Van Nassau F, Nauta J, van den Akker-Scheek I, Bossers W, Brügemann J, Buffart L, Diercks R, De Groot V, De Jong J, Kampshoff C, Van der Leeden M, Leutscher H, Navis G, Scholtens S, Stevens M, Swertz M, Van Twillert S, Van der Velde J, Zwerver H, Van der Woude L, Van Mechelen W, Verhagen E, Van Keeken H, Van der Ploeg H, Dekker R
Implementing Individually Tailored Prescription of Physical Activity in Routine Clinical Care: Protocol of the Physicians Implement Exercise = Medicine (PIE=M) Development and Implementation Project