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IOWA CITY - Imagine if you could pop a pill that would lower the risk of heart disease, diabetes, cancer and other chronic illnesses while improving quality of sleep, strengthening cognitive function, preventing depression and decreasing anxiety.
Well, you can't, according to Lucas Carr, University of Iowa associate professor in the Department of Health and Human Physiology.
'There is no medicine in existence that has all the benefits of this one thing,” he said.
That thing: exercise.
'It's almost an ethical issue,” Carr said. 'With as much as we know about physical activity, for us not to be asking about it and not to find ways to encourage patients to do this is unethical, from a health care standpoint.”
Thus Carr and department colleagues have set out to right this community's moral compass.
Over the summer, they registered the University of Iowa as an 'Exercise is Medicine” campus through the American College of Sports Medicine, which launched the global initiative in 2007 as a push toward integrating physical activity into the health care setting.
For the UI iteration, its Department of Health and Human Physiology opened a 'Community Outreach Lab” in the Field House; crafted a course enabling students to work in the lab and get practical experience; and partnered with health care providers to refer patients to the lab, even embedding exercise-related queries into physical-screening questionnaires.
'Not all clinics have adopted it yet,” Carr said of the two activity-informed questions: How many days a week do you exercise, and how many minutes on average do you exercise a day?
'But our goal is to have that be hospital-wide and to have this systemic approach” to flagging patients below the recommended 150 minutes a week or more of moderate-intensity physical activity.
Here's how it would work: Patients would answer the questions, doctors would give a recommendation and potential referral to the new UI lab, and patients would follow through with a 10-week program.
So far, only family medicine and internal medicine clinics within the UI Hospitals and Clinics system have added the exercise questions to their screening - and that just happened last month. In Carr's outreach to providers about this new student-involved exercise-training opportunity, he's developed a network of 20-some physicians across a range of disciplines who understand that exercise can function as medicine and are aware of the new lab.
'I have been pleased with the number of providers who have agreed to sign up,” he said. 'We are looking to expand that to many more.”
As for the new lab, which is based in the UI Field House, five student-coaches were accepted into the fall's first health-coaching practicum course, through which they served as lab staff. Students are heavily screened and must first successfully complete a health communication and coaching course that gives them a foundation in how to relay health care information to patients.
'We only accept those students who we feel would do well interacting with patients,” Carr said. 'There are some skills that not all students have.”
That first cohort of coaches worked with a total of 13 patients, meeting with them in person for the first visit and then following up regularly on goals and accomplishments over the ensuing seven to 10 weeks, according to Carr.
During that first visit, the student-staffers help patients identify barriers to regular exercise and help them break those down - identifying individual solutions and mapping out exercise plans.
'They are troubleshooting and problem-solving and working through a process to find what's best,” Carr said. 'There is no written script. It's an individualized approach.”
Alison Reichter, a UI lecturer in health and human physiology and certified health coach who is overseeing the lab portion of the university's Exercise is Medicine initiative, said an ideal patient is someone who wants to increase physical activity and just needs support making it happen.
'Someone who needs that accountability piece and help breaking down the large goal of increasing physical activity into smaller, more manageable steps,” she said.
For the student-staff cohort in the upcoming spring semester, eight are enrolled and Carr said the lab is hoping for a swell in patients. Eventually, he'd like to keep the lab running year-round, with summer students participating as well.
'We are trying to give students a really important health care opportunity to work with actual patients and apply the knowledge they are learning,” Carr said. 'I don't know of any other programs in the country that are applying this approach. But to me it seems like a win-win.”
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