A Pragmatic Application of the RE-AIM Framework for Evaluating the Implementation of Physical Activity as a Standard of Care in Health Systems

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This figure shows a flowchart of the clinical phase of the EIM Solution. Step 1: Physical activity assessment (via the Physical Activity Vital Sign). Step 2: Brief counseling and/or physical activity prescription. Step 3: Referral to an EIM network or intervention advisor. These 3 steps lead to EIM networks (programs, places, professionals). An alternative or indirect pathway from Step 3 to EIM networks is to meet with an intervention advisor (connecting patients to EIM networks).

Figure 1.
The clinical phase of the EIM Solution. Steps 1 through 3 of the EIM Solution take place primarily in the clinic setting and involve patients having their physical activity levels assessed, receiving brief counseling from a member of the health care team and/or receiving a semi-customized physical activity prescription, and receiving a referral to EIM network of physical activity resources. In some health systems, patients may also interact with, or be referred to, an intervention advisor. The role of the intervention advisor could include behavior change counseling and connecting the patient to the EIM network of physical activity resources. Dashed lines indicate an indirect or alternative pathway. The gray box indicates the community phase of the EIM Solution. Abbreviation: EIM, Exercise is Medicine.

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This image shows a flowchart of the community phase of the EIM Solution. Referral from the health care system can link patients from health care systems to a supportive network of physical activity programs, places, and professionals. Box 1: Self-Directed Resources: Resources in which patients can engage independently, such as walking programs, home-based programs, DVD and web-based programs, and mobile apps. Box 2: Internal EIM Networks: Resources that exist within a health system, including physical therapy, wellness programs, cardiac rehabilitation, certified exercise physiologists. Box 3: External EIM Networks: existing, community-based resources, including self-directed programs, local community centers/gyms, and credentialed exercise professionals.

Figure 2.
The “community” phase of the EIM Solution. The fourth step of the EIM Solution involves the linkage of patients from health care systems to a supportive network of physical activity programs, places, and professionals. These EIM networks may be developed by using existing programs and professionals internally within a health system or externally in the community setting or connecting patients to resources for self-directed management. The dashed lines indicate alternative pathways. Abbreviation: EIM, Exercise is Medicine.

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