Patients will have the option to opt-in to this program if they receive a referral from
their primary care physician at the Robert C. Byrd Clinic (RCBC). The referral period
will be one month long, followed by 3 months of wellness facility access (intervention
period). This pilot program will be restricted to adults (18-64 years old) with two or
more diagnosed chronic diseases. Program admittance will be restricted to patients with
diseases that have sufficient evidence for the efficacy of exercise therapy. As patients
will be referred to the program, they will all have physician consent to participate in
supervised physical activity. Standard care will proceed as determined by the primary
care physician, as this program will be adjunctive treatment. As patient recruitment is
contingent on physician referrals, the investigators have established a strong network
with the family care physicians and administration from RCBC, and they are very confident
that this program will be in high demand. Physicians will be reminded of the recruitment
time 1-2 times/month for the 3 months preceding the start date by email, personal
communication, and lunch seminars. Prior to accessing the wellness facility, each patient
will be scheduled for an intake meeting. This intake meeting will be used to collect
patient information (such as vital signs, morphometrics, demographics, physical activity
history and readiness, health history, etc.), and understand patient goals (weight loss,
glucose management, pain relief, blood pressure management, etc.). A patient
questionnaire will be developed for this meeting, and patients will also fill out a
physical activity readiness questionnaire. Motivational interviewing techniques will be
implemented to promote adherence to the program. Individualized goals will be determined
and recorded. Patient preferences such as individual training/coaching vs. group fitness
will also be determined. Following the intake meeting, each patient will be advised on
how they may best reach their goals, and support will be provided by the PI or a trained
medical student for implementation of physical activity. The wellness facility
(Greenbrier Valley Fitness) was specifically chosen as it offers a wide variety of
exercise equipment and activities including strength training, cross training, group
fitness, yoga, and many others. The PI or student research technicians will be present
for questions, coaching, and monitoring at all times when the patient is being active.
Each patient will be provided with personalized exercise therapy that is best suited for
their personal goals and disease states.
An overarching goal is for each patient to achieve 150 minutes per week of moderate to
vigorous physical activity. This benchmark was chosen as it is the current recommendation
from the CDC [1], and has been demonstrated to be therapeutic for all, and curative for
some, of the chronic diseases mentioned above [2,3]. Importantly, some patients may not
make this goal within the allotted time-frame depending on their current fitness and
disease states. In order to assess adherence and attrition, the investigators will have
to assess individuals based on their individualized goals. Any participant that fails to
attend >50% of their scheduled activities, or fails to show up at least once in the last
15 days of the study will count as drop-outs.
Data collected on patients will only occur after their referral to our program, so that
no patient data will be shared between institutions (WVSOM and the Robert C. Byrd Clinic)
and so that the investigators can properly deliver informed consent to patients that are
willing to have their data used for research purposes. GraphPad Prism and excel software
will be used to store and analyze the data, using the descriptive statistics and
computational functions to provide count data and attrition rates. Additional analyses of
factors such as disease prevalence, demographics, age, gender, and appropriate
interactions may also be assessed contingent on the study population.
