Healthy STEPS: Increasing Exercise Accessibility for Durham Community Members
Interprofessional Student Poster Description: Regular exercise has countless health benefits, but many patients face significant barriers to participation including environmental, motivational, and especially socioeconomic. Although dedicated exercise programs exist in Durham, North Carolina for children and seniors of lower socioeconomic status, there are limited initiatives for adults. The aim of Healthy STEPS is to increase exercise accessibility for Durham community members through partnership with Duke University health professional students.
Providers at the Duke Cardiopulmonary Rehabilitation Clinic and the Duke Outpatient Clinic recruited interested patients. Patients were paired with health professional students from the medical, nursing, physical therapy, occupational therapy or physician assistant programs. Students used motivational interviewing to help their participants create goals for walking that were specific, measurable, achievable, relevant, and time-bound (SMART). Participants were provided exercise equipment and money for transportation. Pairs completed weekly walks and students helped participants adjust goals as their fitness increased.
In 6 months, 6 participants enrolled. The average age was 69. All participants indicated English as their primary language, 2 identified as White and 4 as Black or African American. Upon enrollment, on a scale of 1 (not active at all) to 5 (very active), participants on average rated their current activity level 3 and their goal level 4.5. On a scale of 1 (strongly disagree) to 5 (strongly agree), participants on average rated importance of exercise 5, desire to incorporate more exercise into their life 4.8, knowledge on effective exercise 3.3, and confidence in increasing their exercise 3.7. Common barriers included cost of equipment, availability of gyms and safety of neighborhoods. There was an average of 8 check-ins and 5 walks completed by each pairing.
Based on the initial screening questions, participants valued exercise but faced significant barriers including lack of exercise knowledge and resources. Partnership with students decreased these barriers. Weekly check-ins provided motivational support and helped participants increase their confidence and knowledge. Through equipment provided and walks completed, structural barriers including lack of safe spaces to exercise and cost of equipment were reduced. Important next steps include collecting follow-up data to track improvement and identify ways to further increase accessibility. A future goal is to organize group walks where participants can find support from peers as well as students. This project meets criteria as it is an interprofessional, student-led initiative that identifies, addresses, and provides a solution for factors beyond clinical care that affect the health of Durham community members.
