Free fitness center-based exercise referral program not well utilized, study finds

Eliminating financial barriers to a fitness center as well as providing physician support, a pleasant environment and trained fitness staff did not result in widespread membership activation or consistent attendance among low income, multi-ethnic women with chronic disease risk factors or diagnoses according to a new study from Boston University School of Medicine. The findings, published in Journal of Community Health, is believed to be the first study of its kind to examine patient characteristics associated with utilization of community health center- based exercise referral program.

Currently, fewer than half (47.3 percent) of Americans meet expert recommendations of 150 minutes per week of moderate-intensity exercise or 75 minutes per week of vigorous-intensity exercise. Women are less likely than men to meet guidelines for physical activity. Certain subpopulations are at elevated risk for both inactivity and CMD, including Hispanics, African Americans and those below the poverty level.

Adult female patients of a community health center with an affiliated fitness center, were included in the study if they received a referral to the fitness center from their primary care provider. Demographic and medical information was abstracted from their medical chart and fitness records were abstracted to measure activation of a fitness center membership (creation of an account denoting at least an initial visit) and utilization over time.

The researchers found less than half of the women activated their memberships (40 percent), although Black/African Americans women and those with higher numbers of co-morbidities were more likely to activate. In addition, only a small subset–10 percent of women who activated their memberships (0.4 percent of the total referred sample)–achieved three-month participation levels consistent with cardiometabolic disease (CMD, including heart disease, hypertension, hyperlipidemia, Type 2 diabetes) risk reduction. Nonetheless, average visits per month declined from the beginning to the end of the free 3-month trial membership period.

“Despite providing free access to a fitness center and its staff, the number of women utilizing this service was highly variable,” explained corresponding author John Wiecha, MD, associate professor of family medicine at BUSM. “Our observations are consistent with findings from the United Kingdom, where a recent systematic review found that exercise referral “uptake” (attendance at an initial consultation) by participants varied from 28 to 100 percent and “adherence” (signifying participation in at least 75 percent of all sessions) from 12 to 93 percent,” he added.

According to Wiecha, these findings suggest that program design may benefit from developing activation, initial participation, and retention strategies that address population-specific barriers and integrate credible behavioral change strategies. “Significant public health gains could be realized by increasing physical activity among populations at high risk of chronic disease, and additional research is warranted to develop effective models in the U.S.,” said Wiecha.

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An army (from Latin arma “arms, weapons” via Old French armée, “armed” (feminine)), in the broadest sense, is the land-based military branch, service branch …


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    • Renwoodpeaches
    • May 16, 2014

    Problem is all their gear is made in China! It will all stop working after
    about a week of use.

    • deyvi69
    • May 16, 2014

    0:54 You missed

    • doubletapproductions
    • May 16, 2014

    And we still make everything there! Including this keyboard I’m typing on!

    • David Norris
    • May 16, 2014

    How much projection force does China have? Russia and Cuba got a beating
    from South Africa in the 80’s, all about force projection.

    • howie3601
    • May 16, 2014

    This is pathetic as hell. Chinas stuff is so Outdated.

    • Mick Carson
    • May 16, 2014

    This is what happens when you buy Chinese made products. You will soon see
    these weapons aimed back at you; keep buying Chinese, you stupid people.
    These buffoons have the same technology made by Russia and USA, even Poland
    and other rogue Nations. Which means they will only end up being roasted
    like chickens and nobody wins the war. Maybe they do but it’s a matter of
    who acts quickly and who has more weapons than the others.

    China may be the mightiest because more than half the world buys Chinese
    products, so just imagine the billions of dollars flowing into that
    country. And then… Ka-Booom! your money at work… death to people and

    • Jnevone DSF
    • May 16, 2014

    chi cha chu chu cha chu chi cha con hong chin hu chan gai,, they need to
    invent the subtitle technology that’s happening bcuz what Im watching
    looks like wak ass tech lol

    • jan mendiola
    • May 16, 2014

    fuck chinese assholes stupid country stupid people stupid weapons U.S will
    destroy you gay chinese

    • Tevin Penn
    • May 16, 2014

    Shit we Americans don’t even know what our own Military really has. I’m
    afraid of the U.S turning on its own people, fuck every other country.

    • Tenzin Nyendak
    • May 16, 2014

    No matter how China rise the power but still it has to down one day like
    Great Britain which invaded India,now look to Russia how they down USSR.
    Therefore, China will be remain one day like Britain because of illegal
    invaded TIBETAN land …When Tibet will be free, China will be loose the
    world power !!!

    • louis berry
    • May 16, 2014

    A high percentage of white men are gay because they are way too open
    minded! Even the marines are now accepting faggots to enroll in the
    marines. No wonder they lost the 2 wars in iraq and Afghanistan! Chinese
    people are all heterosexual except a few! that would explain the 1billion+
    citizens that lived in china! Most gay guys are white and they’re
    responsible for most Std’s that currently exist! Fuck white racist addict

    • kurikong katul
    • May 16, 2014

    new stolen tech

    • david zohan
    • May 17, 2014


    Lol and who would shown the Chinese how to build them? from a country who
    didn’t even have a military 65 years ago and then to the one of the most
    powerful and advanced in the world withing 60 years I don’t think so have a
    long think about what you are saying, the Chines make copies of other
    countries equipment though have different technology.

    Chinese military equipment is still 3rd world development in technology, an
    example Russia had to suply China with jets so they can build there J10
    aircraft and are having difficulty in building an advanced radar for the
    new development J20 stealth fighter they plan to build.

    also China are asking France and Isreal to help them on the development of
    the J20 electronic sytem and Radar development though China has been
    refused and now sucking up to Russia ass to beg them to build for that
    China haven’t got the technically know how, now you telling people China
    have EMP weapons lol, sorry buddy you are a dick head.

    Russia only allow to give out so much technology China has to learn how to
    build themselves.

    • Mike Cimerian
    • May 17, 2014

    1:04 Smurfs!

    • aldrin carlos
    • May 17, 2014

    substandards also

    • big Jazzer
    • May 17, 2014

    I really enjoy reading the comments, there are so many military experts who
    know everything there is to know about everything!! Personally I wouldn’t
    know one tank from another but it just seems logical that a country that
    spends so much on defence would know what to spend it on and not invest
    in ‘old outdated shit’ and if you look at Chinese infrastructure such as
    their train systems they leave most other countries standing and as someone
    who worked in the emergency services their response times and methods in
    dealing with disasters is amazing. Anyway perhaps some of the military
    gurus that write comments should send their CV to the Chinese Government
    and become their military advisors; I am sure it would be highly

    • Sonny Nguyen
    • May 17, 2014

    Haha…China stop show off ….China just copy good , but quality it’s so

    • aster waldo
    • May 17, 2014


    • briamuth1
    • May 17, 2014

    See how this military will be used in: “Dragon Storm: China invades Taiwan”
    by T.J. McFadden. Available worldwide through amazon kindle or the kindle
    app at:

    • Dan Jakmel
    • May 17, 2014

    China has Russia technology which means Iran has it India has it.. Not

    • Redi2ride
    • May 17, 2014

    The Chinese GOV. Owns Costco! They make a ton of money off USA They own our
    San Diego Naval base! lol! They probably own my butt too! ……….Dang
    that’s not funny ……

    • Mark Vanover
    • May 17, 2014

    China the only thing I’m watching is ur stupid and out dated military USA
    was eat you for breakfast

    • Eric SeVeeJ
    • May 17, 2014

    1:05 bunch of middle school nerd hackers?

    • John Kempter
    • May 17, 2014

    Eggrolls or gtfo.

    • lesley poole
    • May 17, 2014

    hair stay on head thicker longer all over face clear no marks as to showing
    with hologram work older men in there 70s years and looking
    after German black women and who bottle me and white sex worker who had
    face lift ok face clear and arm ok lesley make it crime mind control as the
    china man said still young don’t touch a skin neck ok and show
    hair the other ok Lesley age they looked after the German my gold on there
    necks Germans black men OK and white whores they got ok i love all races
    but not brought up to be Germans in 21st century and see other hurt fuck up
    as to one area and all there skin neck firm in stpauls ok they even set up
    some races as well black men and women and try to make out a bout the past
    as they did with voice control look at ajaxs is white women in her 60 mouth
    ok and skin neck arms 

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