National Center Spotlight: EIM Canada

Exercise is Medicine® (EIM) in Nova Scotia, a province in Eastern Canada, was selected to present at the 2018 Annual Meeting of the Nova Scotia Health Authority as one of the 20 most innovative approaches to supporting healthy people, healthy communities – for generations. Here, we take a deeper look at the key strategies undertaken by EIM Canada to gain this prestigious distinction.

BACKGROUND

The EIM Nova Scotia provincial initiative was conducted between 2015-2018 with two primary goals:

1. To assess the current state of physical activity counseling and exercise prescription by health care providers in Nova Scotia; and
2. To support physical activity training for physicians and health professionals that will encourage Nova Scotians to be more active.

PROJECT PHASES

• From 2015-16 a provincial survey of primary health care providers assessed current practices, confidence, barriers and facilitators to physical activity counseling and exercise prescription by health care providers.
• In 2017, provincial workshops across Nova Scotia trained front-line health care providers in physical activity counseling, exercise prescription, and created local physical activity networks to receive patient referrals.
• Between 2015 and 2018, community engagement meetings and presentations were held with stakeholder groups (community health teams and boards, provincial government/organizations/associations/advocacy groups) across Nova Scotia to promote EIM and gather information on best practice to support exercise prescription and referral of patients from health care providers to the local community.

KEY FINDINGS

1. Many health care providers in Nova Scotia reported moderate knowledge and confidence for physical activity counseling, but low confidence to prescribe exercise to clients to increase their current physical activity levels. 
2. Current educational practices on physical activity for health care professionals is inadequate; 82% of respondents desired more education particularly on patient motivation and exercise for disease management.
3. Feedback from several settings indicates that more support is needed, in both clinical practices and in communities, to facilitate physical activity recommendations with patients that have greater barriers to engaging in physical activity.

SUCCESSES

• Awareness. EIM efforts in Nova Scotia raised the profile and increased awareness of the importance for physical activity in disease management across the province.
• Collaborations. The initiative resulted in a highly successful collaboration between Acadia University and the Nova Scotia Health Authority, with endorsements from the Chief Medical Officer of Health and Doctors Nova Scotia.
• Physical activity knowledge translation. This project yielded eight EIM workshops, five conference presentations, two webinars and 20+ presentations to stakeholder groups. Scholarly outputs (to date) include seven abstracts at local, regional, national and international conferences and two academic papers.
• Changing practice. The comprehensive packaging of best evidence and practical tools/strategies, applied across multiple sectors, changed attitudes and behaviors of health care providers, decision makers and community members. ‘Local networks’ were established linking physicians and other health care providers with community facilities, programs and professionals. These cross-disciplinary efforts increased support for physical activity and are leading to the development of a new health care model.

CONCLUSIONS

There is an opportunity to engage Nova Scotians in shared accountability for health by integrating physical activity promotion into health management. An investment in strategies to integrate EIM into health care and communities is one of the best evidence-based strategies that can support people to be ‘active for life’ and build a more active, vibrant, and healthy Nova Scotia.