Screening for Physical Activity as a Vital Sign and Social Determinants of Health [Podcast Series]
[:54] Dr. Bantham introduces her guest, Dr. Liz Joy
Dr. Liz Joy, Senior Medical Director of Wellness and Nutrition at Intermountain Healthcare. Dr. Joy is a practicing physician, an adjunct professor of medicine, and the past president of the American College of Sports Medicine.
[1:14] Incorporating physical activity assessment/referral into the clinical workflow
“Really making an effort to really use that SBIRT model. Screening, with a physical activity vital sign, Brief Intervention at the point of care, where the physician is really personalizing information about physical activity to that individual, and then Referral to Treatment. It’s really a referral to resources, and there are many, many resources that are available to people.”
[3:20] The physical activity vital sign as a prompt
“Having a physical activity vital sign does serve as a prompt to collect information about what they are doing and then to inform a discussion and to personalize it. ...having a conversation about how much activity someone is doing or, maybe most importantly, not doing, can really have a benefit in terms of their health outcomes.”
[5:01] Making the time to talk about physical activity
“Our medical assistants actually ask the questions about the physical activity vital sign. And then based on what we are seeing in terms of total minutes per week and self-reported intensity, that creates an opportunity to contextualize the activity in the care of that patient. What do you do if you have just one minute with that patient to talk about physical activity? Or two? Or five? Or maybe ten?”
[7:46] Transitioning counseling about physical activity in the clinical setting to the community setting
“This is where the physical activity vital sign comes into play and is so important. Understanding how little someone is getting can help you counsel them to make small steps toward a bigger change.”
[11:26] Including physical activity as part of social determinants of health and social needs screening
“It really was my work in championing the physical activity vital sign in the electronic health record that led to my work championing screening for unmet social needs in the electronic health record...recognizing that environment plays such a critical role in people’s ability to be safe.”
[16:45] Prioritizing physical activity in screening
“Workflow is critical for the entire care team. You have to clearly define whose job is which. Clinical medicine is a team sport….There are lots of different strategies to give the patient the experience where we care about them as a whole person, and recognizing how their environment affects their lifestyle behaviors and how their environment and their lifestyle behaviors together influence their health. ”
[21:14] Other members of the care team who can facilitate adoption of healthy behaviors outside the clinical setting
“How do we provide more education and skill to our community health worker population around healthy lifestyle behaviors?...There is definitely more that we could be doing within our communities that is around supporting healthy lifestyle in a very culturally appropriate way that I just don’t think we have really prioritized yet.”
[24:32] Interrelationship between COVID-19 and physical inactivity
“I share my strategies with my patients….healthcare providers themselves who are physically active and have figured out how to integrate regular activity into their busy lives are way more likely to talk to their own patients about strategies to integrate physical activity into their lives.”
