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.”

Role of Exercise Professionals in Getting People Moving [Podcast Series]

• [:55] Dr. Bantham introduces her guest, Dr. Cedric Bryant

  • Dr. Cedric Bryant, the President and Chief Science Officer at the American Council on Exercise.  With a doctorate in physiology and a master’s in exercise science, Dr. Bryant leads the development of ACE’s evidence-based programming, studies and publications on exercise science and behavior change.

• [1:20] The mission to get people moving

  • “The evidence is pretty overwhelming and clear that if we can get individuals adopting more physically active lifestyles that it can have a profound impact on many of the chronic conditions that really beset our nation...hypertension, diabetes, obesity...all have been shown to be profoundly and positively impacted if we can get individuals moving on a regular basis.”

• [5:08] Physical activity as a “best buy”

  • “It is my belief that we find the time to do those things that we value and enjoy.  We have got to shift the thinking on the part of individuals to help them to understand the real value of being physically active, but more importantly to help them to find those things that really work for them.”

• [9:22] Framing physical activity versus exercise

  • “We know that if people are having a somewhat pleasant experience associated with a given activity, the likelihood of them doing it on a sustained basis goes up exponentially….you’ve got to think of activity like loose change in your pocket.  Every little bit counts.”

• [12:05] Engineering physical activity back into our lifestyles

  • “It is going to take a systems approach to address this epidemic of physical inactivity that we face.” 

• [14:48] Removing barriers to active lifestyles

  • “I think inactivity is almost a learned behavior in a lot of respects and I think it is unfortunate that most of us forget how to play with each passing year...if we could harken back to just the days when it was natural to move, discover, and explore...let’s turn the clock back and have a more childlike approach to how we approach the day.”

• [17:20] The role of exercise professionals in getting people moving

  • “I think we need to have a shift in our thinking and really view healthcare as the ultimate team sport...where exercise professionals can have an impact, I think, is really helping address that physical inactivity related component of overall public/population health.”

• [21:37] Exercise professionals and empathy in bringing about behavior change

  • “As we have started to try to bridge the gap between physical activity, fitness and healthcare, we have gained a greater understanding of the importance of helping our professionals to develop that understanding of the need to be empathetic and the need to be effective communicators...if we are going to have a chance at being trusted and accepted by the healthcare/medical community, it is really being able to display not only the competence from a scientific perspective and knowledge-based perspective, but also being able to display that real competence as it relates to communication and interpersonal skills as well.”

• [24:44] The dual pandemics of COVID and physical inactivity/sedentary behavior

  • “I think there can be a strong and cogent argument made that physical activity should be a highly promoted weapon in the arsenal when fighting these types of pandemics and contagions.”

• [27:43] Optimistic outlook for getting people moving

  • “I have not met more passionate people than individuals in the physical activity, exercise space…[they] derive a tremendous amount of joy seeing other people move and helping other people move safely, enjoyably and effectively.”

Physical Activity As Essential [Podcast Series]

• [:40] Dr. Bantham introduces her guest, Chuck Runyon

  • Chuck Runyon is the CEO and Co-Founder at Self Esteem Brands, which is the parent company of Anytime Fitness, Basecamp Fitness, Waxing the City, and the Bar Method. Anytime Fitness operates 4,000 franchised health & fitness clubs in 50 countries and has been named the #1 franchise and the fastest growing fitness club in the world. 

• [1:10] Physical activity as essential

  • “Physical activity can empower people to new roles, new moves, new mindsets.”

  • “Health is an asset in my life that empowers everything I do.”

  • “Daily physical activity is critical to mental acuity and mindset and to unlock our potential.”

• [3:10] Fitness as one piece of mental and physical health

  • “There is so much evidence linking it to lower risk of depression and stress.”

  • “I wish we focused less on the scale and more on how it mindset and mood and how it empowers so much in your life.”

  • “We want to make sure we are reaching people where they are at..reaching them with nutrition support, physical activity support, we are moving more toward more mental support, and just more lifestyle, more holistic in the coaching we can provide.”

• [5:40] Removing barriers to active lifestyles

  • “I think we can unlock a person’s potential once they are willing to be a bit vulnerable, once they are willing to ask for help.”

  • “What I love about some of the body scanners and wearables is that it democratizes body intelligence, so now we can take biometrics that are highly personal and help someone understand them, and now set some very realistic goals to make fitness achievable.”

  • “Progress equals further engagement.”

• [8:30] Teaching kids to be physically active so they grow up to be active adults

  • “We have to reframe how we are teaching health and make sure that we value physical activity.”

  • “Physical activity and nutrition and health should be part of the core curriculum.”

  • “When people get out of school, they are not equipped to live in an unhealthy world, a world of high calorie cheap meals and sedentary activities...equipping people to be the CEO of their own health.”

• [11:40] The dual pandemics of COVID and physical inactivity/sedentary behavior

  • “The health of the country, pre-COVID, was not good, and when COVID goes away, we are going to be left with a very unhealthy country.”

  • “This thirty day pandemic has shined a spotlight on this 30 year epidemic called obesity and physical inactivity and diabetes and hypertension.”  

  • “That is what we have to fix long-term.  We need to turn the health of this country in the other direction.”

• [14:00] Exercise as better than medicine

  • “An ounce of prevention is worth a pound of cure.  We are not even putting an ounce worth of prevention”

  • “If you look at policies, and funds and incentives for individuals and corporations to be healthy, we don’t have a culture of health”

  • “Everyone is on the hook here, everyone can do a better job to help people, help communities, help our country get to a better place.”

• [17:05] The fitness industry as a partner with healthcare

  • “Doctors can trust that if they refer to a patient to someone with one of these certifications, they are going to get good care.”

  • “The technology is there now where we can start to standardize data, that can be used by the consumer and by the doctor to show that we are in fact making progress.”

  • “We are in the progress game, because if an individual is making progress, they stay engaged in their health and fitness goals.”

• [20:30] Physical activity as essential now more than ever

  • “If I were a lawmaker, I would be fighting like heck to find a way for the gym industry to reopen safely and responsibly under COVID conditions and find a way to get people stronger, get people moving.”

  • “Now more than ever people need to move.”

  • “For us to get through these very trying times, we’ve got to have the emotional strength and mindset to do that, and that starts with physical activity.”

• [22:18] Physical activity in a post-COVID world

  • The optimist in me says yes, this is going to be the perfect time to spark a new conversation to get people healthy and we are going to see a surge coming back to our facilities”

  • “I love the fact that you are trying to bring the medical community closer to the fitness space and closer to communities.  I really think this can be solved through collaboration.  We’ve got to find some adjacent industries to work together.”

  • “I love the digital muscle that this fitness industry has been building”  

• [29:50] Closing the health loop

  • “Maybe as a fitness industry we can do a better job closing the health loop with data..you referred him your him to us, and this is the progress they have made”

  • “You can’t do this alone.  We’ve got to collaborate with smart people, we’ve got to collaborate with other industries.”

  • “The only way to solve personal health, the only way to solve global health is through collaboration.”