Exercise has the potential to prevent or treat most chronic diseases, yet nearly 80% of Americans do not meet the US Guidelines for Physical Activity (PAGAC 2018). To address this issue, multiple calls have been made to integrate exercise into standard clinical care (NPAPA 2016, Schmitz et al 2019). Unfortunately, the success of these initiatives remains low in large part because of poor physician utilization (Adusumalli et al 2021). While physicians are generally willing to refer patients to exercise, systemic barriers impede adoption of physician exercise referrals into regular clinical practice (Clark et al 2017). This gap between what physicians know they should do and what they actually do in practice (the “know-do” gap) is obstructing the potential for patients to realize the benefits of exercise medicine. It is time to move beyond the evidence to demonstrate the benefits of exercise; we need to know how to translate the evidence into practice. Effective strategies to promote widespread adoption of exercise into clinical practice need to be investigated to achieve optimal patient care.
The field of implementation science provides methodology to systematically explore the “know-do” gap in exercise medicine and develop strategies to effectively translate research into practice. The session at the EIM World Congress 2022 entitled: “Implementation Science 101: Practice Strategies to Close the Research-to-Practice Gap in Exercise Medicine” explored the potential of implementation science to enhance the translation of exercise medicine research. Key principles of implementation science were introduced, and panelists shared examples of how those principles were used to promote uptake of exercise medicine across three diverse clinical settings. Attendees learned the difference between implementation and effectiveness research and became familiar with strategies and resources that incorporate implementation science principles. To learn more about the developing field of implementation science and physical activity, join the listserv for EIM's Research Learning Collaborative.
Most physicians recognize the importance of connecting patients to evidence-based exercise programs; however, successful integration of exercise into medicine is rare. Even widely available programs with clear patient benefits, such as cardiac rehab, are poorly utilized. While physicians regularly report barriers to adopting exercise referral into practice (e.g., lack of time and ineffective referral systems) solutions to overcome these issues are not well understood and rarely addressed when introducing new programming. As a result, physicians continue to struggle to successfully integrate exercise into their standard medical practice.
If exercise medicine is going to become standard practice in healthcare, it is essential to think beyond what the program will be and also consider what physicians need to feasibly adopt the program into routine practice. This requires recognition of the value of implementation research and planning.
Mary A. Kennedy, Ph.D., ACSM-EP: Dr. Kennedy is a Postdoctoral Research Fellow in Implementation Science at Edith Cowan University in Western Australia and a member of the EIM Moving Through Cancer Task Force and Education Committee.