Exploration of provider exercise prescriptions and exercise referrals to place or professional: A pilot survey research study

Background: Physical inactivity contributes to roughly $28 billion in annual US health care expenditures, although few US-based providers write exercise prescriptions (EPs). Little research has explored the practice of provider referrals to places for exercise as part of an EP or part of general exercise counseling, despite the known relationship between place and health. The purpose of this pilot study, conducted with Northeast Ohio-based providers, was to assess a new instrument designed to explore provider practices related to EP and referral to place and professional.Methods: The 88-item survey combined standardized and new items to fully address the purpose. Providers were surveyed via paper and online methods. Logistic regression was conducted to explore factors related to referrals to a specific place or exercise professional.Results: Of 166 providers who completed the survey, 14.8% of prescribed exercise to patients and 54.3% referred patients to an exercise professional or specific place. Logistic regression analysis suggested that physicians who prescribed exercise were more likely to provide a referral to professional or place (OR = 6.12, 95% CI = 1.36 – 27.47) while physicians who had accurate knowledge of exercise recommendations were less likely to provide a referral to a professional or place (OR = 0.15, 95% CI = 0.04 – 0.57).Conclusions: A key reason for failure to prescribe place-based exercise referrals was provider unfamiliarity with convenient and safelocations other than health system owned fitness facilities, so provision of exercise location resources for providers potentially willincrease use of EPs.