Implementation Facilitation of Exercise is Medicine Greenville

Prior treatment

• Adopted EIMG \< 6 months prior to the beginning of this study
• Current referral to Physical therapy or occupational therapy

Other illness

• Clinically eligible (diagnosis of hypertension, dyslipidemia, obesity, diabetes, or physical inactivity) to receive an EIMG referral
• Current referral to cardiac, pulmonary, or oncology rehab
• One of the following visit diagnoses listed below:
  • Alzheimer's disease
  • Amyotrophic lateral sclerosis
  • angina or chest pain
  • congenital stenosis of aortic valve
  • congenital insufficiency of aortic valve
  • moderate or severe persistent asthma
  • typical or atypical atrial flutter
  • autonomic dysreflexia
  • acute bronchitis
  • cerebral infarction
  • encounter for chemotherapy
  • chronic kidney disease (stage 3-5)
  • end stage renal disease
  • coma
  • acute chronic obstructive pulmonary disease
  • unspecified dementia
  • dependence on renal dialysis
  • trisomy 21
  • pulmonary embolism
  • venous embolism and thrombosis
  • history of falling
  • acute fracture
  • left ventricular failure
  • congestive heart failure
  • hypertensive urgency, emergency or crisis
  • diabetes with ketoacidosis
  • chronic respiratory failure
  • dependence on supplemental oxygen
  • myocardial infarction
  • osteoporosis with current fracture
  • encounter for palliative care
  • paraplegia or quadriplegia
  • Parkinson disease
  • pneumonia
  • encounter for supervision of pregnancy
  • encounter for radiation therapy
  • serious mental illness (schizophrenia, psychotic disorder)
  • homicidal or suicidal ideations
  • sepsis
  • injury of spinal cord
  • presence of coronary stent
  • dependence on wheelchair or ambulatory aid
  • For patients completing accelerometry data collection, the additional inclusion/exclusion criteria apply:

Lab values

• Unable to wear a watch during work hours due to employment restrictions e.g., food service, healthcare, operating heavy machinery/construction, laboratory-based work etc.
  • In addition, for patients completing interviews, the additional inclusion/exclusion criteria apply:

Age

• At least 18 years of age
• Less than 18 years of age
• Age \>= 18 and \<= 80 years
• Age \< 18 or \> 80 years
• \<18 years of age

Other

• Not EIMG-activated
• Greater than 15 miles from the nearest YMCA
  • 1\. Primary care clinic staff (primary aim) Inclusion criteria
• Has worked at the Prisma Health-Upstate clinic since the start date of the intervention in the respective wave, i.e., Pre-IF start date for each wave
• Has clinical encounters with a minimum of 25 patients per month
• Study clinic is their primary clinic (\>50% of their working time)
• Able to understand and communicate in English
• Work at the Prisma Health-Upstate clinic started after the Pre-IF phase began
• Has clinical encounters with \<25 patients per month
• Unable to speak or understand English
• Adults unable to provide consent
  • 2\. Patient (secondary aim) Inclusion criteria (must meet all of below)
• A healthcare visit with an eligible encounter type (evaluation, telemedicine, consult, office visit, e-visit, follow-up, appointment, education, multidisciplinary visit, nutrition, occupational medicine-office visit)
• A healthcare visit at a participating clinic
• Unable to provide verbal informed consent
• Planning on travel or vacation during data collection, as patient PA behavior is anticipated to differ from 'everyday' PA behavior at home
• Unable to provide verbal informed consent
• Unable to speak or understand English

• Received an EIMG referral and scheduled for orientation
• Attending orientation at two pre-determined community PA facilities (these sites were selected due to each being the largest urban and rural YMCA referral sites in the study)
• \- Received an EIMG referral

Criteria the registry did not label

• The primary aim of this study is implementation facilitation at the clinic level. The secondary aim of this study is at the patient level. Therefore we have divided our inclusion/exclusion eligibility criteria by primary and secondary aim.
• 1\. Clinic (primary aim) Inclusion criteria
• Currently EIMG-activated Prisma Health-Upstate Primary Care clinic (family or internal medicine)
• Adopted EIMG \>= 6 months prior to the beginning of this study