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and has overseen the global development of the initiative over its first decade of existence. From 2007-2017, EIM grew into a "global health" initiative with a presence in more than 40 countries worldwide. The initial five years of the initiative focused on increasing global awareness that "exercise is good medicine". More recently, efforts have shifted toward the strategic implementation of the EIM Solution in healthcare systems.
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can be given out in a number of different formats including exercise prescriptions entered into the electronic health record and provided to the patient in the after-visit summary paperwork or a pad (a format patients are familiar with in receiving prescriptions for medications). The first major exercise prescription program was the Green
Prescription started by the Sport and Recreation New Zealand in 1998.
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Ministry of Health is invited to participate as a part of the
National Center. The National Center is hosted by a national institution (an academic institution, health organization, or other non-profit organization) under the direction of a National Center Director, acting on behalf of the National Center Advisory Board.
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to supportive resources to assist them in engaging in greater physical activity levels. Patients may be referred to existing physical activity resources within a health system (i.e., wellness programs, cardiac rehabilitation programs, physical therapy), self-directed programs (i.e., walking programs,
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The third step of the EIM Solution is to provide eligible patients (i.e., patients who are not completing 150 minutes of moderate to vigorous aerobic activity in a week) with a basic physical activity prescription, depending on the health, fitness level, and preferences of the patient. Prescriptions
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EIM was started by
American College of Sports Medicine President Robert E. Sallis, MD, FACSM in 2007, who has continued to serve as the chair of the EIM initiative since its inception. Under the guidance of Dr. Sallis and the EIM advisory board, Adrian Hutber, PhD, served as the first vice president
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To establish an EIM National Center, national leaders in a country are required to enlist the support of a national primary care organization, a national sports medicine and/or exercise science organization, as well as a leading academic institution. It is also strongly encouraged that the
National
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The second step is to provide brief advice or counseling regarding the importance of regular physical activity, specifically relevant to that patient's medical history and situation. Several physical activity counseling models have been shown to be effective in increasing patient physical activity
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to be included as a standard part of medical treatment and the patient care process. EIM urges healthcare providers to assess the physical activity levels of their patients at every visit, provide physically inactive patients with brief counseling, and 'write' a basic exercise prescription. Before
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The first step, and initiator, of the EIM Solution, is the systematic assessment of every patient's physical activity levels. The
Physical Activity Vital Sign is an evidence- and practice-based tool consisting of two questions to determine whether the patient is meeting the established physical
378:
Sallis, Robert E.; Matuszak, Jason M.; Baggish, Aaron L.; Franklin, Barry A.; Chodzko-Zajko, Wojtek; Fletcher, Barbara J.; Gregory, Andrew; Joy, Elizabeth; Matheson, Gordon (May 2016). "Call to Action on Making
Physical Activity Assessment and Prescription a Medical Standard of Care".
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smartphone apps), or community-based resources. Within the community setting, all physical activity places (i.e., YMCA centers, Jewish
Community Centers, and other community fitness centers), and exercise professionals should be considered for inclusion in a physical activity network.
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The
Exercise is Medicine Solution is the practical implementation of EIM in a health system. The EIM Solution is designed as a simple, brief four-step process that can be carried out in the clinical setting in under five minutes by the entire healthcare team.
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Waterman, Megan R.; Wiecha, John M.; Manne, Jennifer; Tringale, Stephen M.; Costa, Elizabeth; Wiecha, Jean L. (December 2014). "Utilization of a free fitness center-based exercise referral program among women with chronic disease risk factors".
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leaving the clinic setting, inactive patients should also receive a referral to available physical activity resources in the community to assist with becoming more physically active. EIM should be differentiated from
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Gallegos-Carrillo, Katia; García-Peña, Carmen; Salmerón, Jorge; Salgado-de-Snyder, Nelly; Lobelo, Felipe (February 2017). "Brief
Counseling and Exercise Referral Scheme: A Pragmatic Trial in Mexico".
713:; Lannin, Natasha; Morris, Meg E. (December 2014). "Motivational interviewing to increase physical activity in people with chronic health conditions: a systematic review and meta-analysis".
918:"An evaluation of the effectiveness and cost effectiveness of the National Exercise Referral Scheme in Wales, UK: a randomised controlled trial of a public health policy initiative"
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Coleman, Karen
Jacqueline; Ngor, Eunis; Reynolds, Kristi; Quinn, Virginia P.; Koebnick, Corinna; Young, Deborah Rohm; Sternfeld, Barbara; Sallis, Robert E. (November 2012).
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Murphy, Simon Mark; Edwards, Rhiannon Tudor; Williams, Nefyn; Raisanen, Larry; Moore, Graham; Linck, Pat; Hounsome, Natalia; Din, Nafees Ud; Moore, Laurence (August 2012).
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Sallis, Robert; Franklin, Barry; Joy, Liz; Ross, Robert; Sabgir, David; Stone, James (January 2015). "Strategies for promoting physical activity in clinical practice".
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Over its first decade of existence, EIM has expanded to include partners in more than 40 countries. The EIM Global Health Network consists of EIM Regional Centers in
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activity guidelines. This tool for assessing patient physical activity levels has been successfully integrated into several healthcare systems including the
766:"Role of Counseling to Promote Adherence in Healthy Lifestyle Medicine: Strategies to Improve Exercise Adherence and Enhance Physical Activity"
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35:
481:"Associations between physical activity and cardiometabolic risk factors assessed in a Southern California health care system, 2010-2012"
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Lobelo, Felipe; Stoutenberg, Mark; Hutber, Adrian (December 2014). "The Exercise is Medicine Global Health Initiative: a 2014 update".
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levels including the "5As" (Ask, Advise, Agree, Assist, Arrange), motivational interviewing, and the use of the transtheoretical model.
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538:"Concurrent Validity of a Self-Reported Physical Activity "Vital Sign" Questionnaire With Adult Primary Care Patients"
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Young, Deborah Rohm; Coleman, Karen J.; Ngor, Eunis; Reynolds, Kristi; Sidell, Margo; Sallis, Robert E. (2014-12-18).
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Carroll, Jennifer K.; Fiscella, Kevin; Epstein, Ronald M.; Sanders, Mechelle R.; Williams, Geoffrey C. (2012-10-30).
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192:(EIM Southeast Asia) that help oversee the expansion and development of the initiative in their respective regions.
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The final, and perhaps most crucial, component of the EIM Solution is ensuring that all eligible patients receive a
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288:"Exercise as medicine - evidence for prescribing exercise as therapy in 26 different chronic diseases"
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O'Halloran, Paul D.; Blackstock, Felicity; Shields, Nora; Holland, Anne; Iles, Ross; Kingsley, Mike;
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Ball, Trever J.; Joy, Elizabeth A.; Gren, Lisa H.; Shaw, Janet M. (2016-02-04).
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Carroll, Jennifer K.; Antognoli, Elizabeth; Flocke, Susan A. (September 2011).
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health systems of Northern and Southern California, as well as in
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Stonerock, Gregory L.; Blumenthal, James A. (March 2017).
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Scandinavian Journal of Medicine & Science in Sports
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The Exercise is Medicine (EIM) initiative calls for
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922:Journal of Epidemiology and Community Health
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249:10.1136/bjsports-2013-093080
98:American Medical Association
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782:10.1016/j.pcad.2016.09.003
542:Preventing Chronic Disease
485:Preventing Chronic Disease
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168:physical activity referral
879:10.1007/s10900-014-9874-2
658:Annals of Family Medicine
934:10.1136/jech-2011-200689
727:10.1177/0269215514536210
612:10.1186/1472-6963-12-374
715:Clinical Rehabilitation
206:Exercise prescription
184:(EIM Latin America),
55:neutral point of view
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497:10.5888/pcd11.140196
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