Meet the EIM Leaders
Jonathon Fowles, PhD, CSEP-CEP
Did my Honours/ Co-op undergraduate degree at the University of Victoria, where did a project in sports medicine that developed into work experience as the Medical Coordinator for the Victoria Commonwealth Games in 1994. Went on to do graduate work in Kinesiology at McMaster University in Neuromuscular Physiology (MSc – 1997), then my PhD at the University of Waterloo in Biochemistry of Exercise (PhD 2001). I started as an assistant professor at Acadia University in July 2001, and became full professor in the School of Kinesiology July 2011.
My work at Acadia University covers the spectrum of exercise for health, with athletes, the elderly and those with chronic disease, specializing in exercise in diabetes prevention and management.
What is your current work position and title?
Chair, Exercise is Medicine Canada National Advisory Council
Scientific Lead, Exercise is Medicine Nova Scotia
Faculty Liaison, Exercise is Medicine on Campus Program at Acadia University
Clifford Shand Chair in Kinesiology
Director of the Centre of Lifestyle Studies
Professor in Kinesiology, Acadia University
How and when did you get involved with EIM?
I was on the Canadian Society for Exercise Physiology Board of Directors in 2011 when EIM came to Canada. Given my background in Diabetes and with Diabetes Canada and with the Heart and Stroke Foundation, I chaired a CSEP working group (i.e. Liaison committee) to help the National Advisory Council develop policies and procedures to set up EIM in Canada. Also from my work in diabetes, I had developed health care provider continuing medical education workshops for Diabetes Canada, which developed the foundation for our 1hr, 4hr, and 8hr EIM ‘Exercise Prescription in Health Care workshops’ that have now been delivered across the country. I became the EIM Canada National Advisory Council Chair in June 2016.
How do you promote EIM through the work that you do?
I promote EIM in everything that I do professionally, as a researcher, and even personally. In my work as the EIM Canada NAC chair, I am always thinking of opportunities for partnerships and promotion of the EIM message within health care and in communities. In my local research and community engagement activities, I have led initiatives to develop collaborative family practice referrals to kinesiologists and have kinesiologists leading exercise programming for older adults and individuals with chronic disease creating a strong ‘Exercise is Medicine’ referral link to community programs. I am also the faculty advisor to the local Acadia University Exercise is medicine on Campus student group, and have helped them to develop a presence on campus promoting the health and community benefits of exercise. In promoting the EIM message, I have been as an advocate to have exercise as part of the curriculum in the Dalhousie Medicine Family medicine program and they recently have incorporated required lectures now (which I deliver) and medical rounds that have exercise as a theme. In my local community I have delivered many community lectures on ‘Exercise is medicine’ and am an avid cyclist, practicing what I preach.
How has EIM influenced the work you do professionally and those you work with (your patients/clients/colleagues)?
My research program recently has focused on evaluating the practice outcomes from the EIM health care provider workshops. Through this role and with my research in knowledge translation, I am on several large multi-disciplinary research projects for innovative health care solutions integrating physical activity as a vital sign and physician prescribed exercise from health care to communities. I have established links in the province between health care teams and fitness facilities and am working with the provincial government to get the physical activity vital sign integrated into all Electronic Medical Records. My research has spilled over to my colleagues who now integrate EIM into their own research. A perfect example is with my colleague who does research with the Canadian Centre for Substance Abuse – they recently developed a collaboration with the Post-Secondary Education Partnership on Alcohol Harms (PEP-AH). We have developed ideas for a research and student engagement campaign using our Exercise is Medicine on Campus groups, to develop Exercise as a factor for positive mental health and potentially preventing potential alcohol harms on university campuses. Our Kinesiology Student Society recently had an entire conference on ‘Exercise is Medicine’ as their theme inviting speakers in to talk about different application for Exercise is Medicine.
Has EIM impacted you personally? If "yes", how so?
Exercise is imbedded into everything I do professionally and personally. With my kids, my family, my friends – I am always thinking of how to help people make physical activity the ‘easy choice’. Most of it is through supporting others in being active and making it the fun option – like asking colleagues to go for a walking meeting. Commuting to work. Playing with your kids outside with a game of soccer or a water fight, instead of being plugged in. It’s a conscious decision that we can all make to make active choices, the right choices, at home, at work, in health care and in leisure.
What are some of the challenges that you have faced in introducing and/or implementing EIM where you work?
The biggest challenge is in funding. Everyone believes that exercise is medicine and that physical activity is good for everyone, but to promote the message, provide the education to health care providers, to develop resources, that costs time and money. Federal and provincial governments are ‘receptive’ to this message, but have yet to take a deep dive into committing to policies and programs to produce and support these initiatives. The interest from the corporate sector is building and I am optimistic – it seems every week I get a call from an organization or company that is interested in partnering with Exercise is Medicine in Canada. This bodes well for the future and for ‘whole of society’ approaches to address the physical inactivity crisis – because if business is starting to get involved more deeply, that means there is interest from society which means that government won’t be far behind (although they always seem to be the last one to the party).
What are some of the sucesses that you have seen implementing EIM into your work?
In my work personally, Exercise is Medicine has developed into my calling card for scholarly work and disseminations as I have noticed greater and greater appetite for the message from medical groups and by other researchers in the knowledge translation/implementation aspects.
I have published several papers on evaluating the impact of education on health care provider behavior and have had several requests for collaboration on research projects and invited presentations to communicate the evidence into practice. This accumulated into my being asked to be the Scientific Lead for an Exercise is Medicine Provincial project – for Nova Scotia in Canada – to develop evaluations, education and practice networks so Nova Scotia could really embrace Exercise is Medicine. Through the success of my prior work developing physical activity resources in Diabetes Care, combined with my efforts to develop national disseminations and evaluations of our Exercise is Medicine program in Canada, I was awarded by the Lawson Foundation (a philanthropic foundation) the 60th Anniversary Award of Excellence. I am using some of the money from that award to further support our EIM workshop program and develop new resources for Exercise Prescription and Referral, including funding a ‘Think Tank’ bringing together exercise experts from health care, fitness, communities and organizations to clarify models for exercise prescription and referral across the continuum of care in Canada.
What advice do you have for early career professionals wanting to promote and develop careers related to EIM?
For Exercise professionals – I believe that the future is bright. The evidence is so strong and the pathways are coming clearer that exercise professionals who understand exercise management in chronic disease, are a needed and valuable component of health care and community wellness. The cost model is clearly showing that this effort must be done now to stave off future catastrophic societal consequences, and those with appropriate training and expertise can help address our aging, physical inactivity and obesity crisis.
For Health care professionals – the times have changed where the old models of illness care aren’t appropriate for most chronic disease seen in medical practice today. The new normal will revolve around ‘lifestyle medicine’ and therefore knowledge and practice around nutrition and PA/exercise, and integrating with exercise professionals through referral networks, will be essential components of future medical practice. The EIM solution is a big part of many ills that affect society today.