Societies are willing to enhance their physical activity and are likely to respond to strategies that increase social support to physical activity and improve access to venues where they can exercise. But how can practitioners implement and deliver such strategies in practice?
In the evidence-based Exercise Looks After You (ELAY, El Ejercicio Te Cuida in Spanish) programme, an innovative and cost-effective socio-sanitary strategy developed by the Government of Extremadura, general practitioners refer elderly with metabolic syndrome risk or moderate depression to a sports centre, where professionals periodically assess participants (with fitness, psychosocial, and biological tests) and deliver a structured walk-based programme four days a week. The programme includes the referral to usual exercise advice, four major psychosocial reinforcements to enhance physical activity (primary care counseling, interaction to sports technician, periodical assessment reports, and peers), and easy access to walking venues in urban and rural areas.
A pilot study reported the short-term efficiency of the program (Gusi et al., BMC Public Health, 2008) at 6 months. This evidence led the multidisciplinary effort of several departments to launch a larger project because the departments of Health and Welfare save resources and improve health, but the agents of change and implementation that have to invest resources were allocated at primary care and sports departments (Consejeria de Jovenes y Deporte de la Junta de Extremadura). After the first two years, it was found that 37 sport technicians weekly attend more than 4,000 elderly living in 100 municipalities who changed some pills and consultations for walks and chatting.
Preliminary results showed the cost-effectiveness of the program based on a reduction in primary care consultations and improvements in fitness and health-related quality of life. In addition, this program is highly socially visible throughout local and national media. This practice could encourage the exercise-based public health and preventive strategies for promoting health-related quality of life in elderly.
More details are presented at www.ejerciciotecuida.com. Note: Site is in Spanish.
