The Role of the Fitness Professional in the Clinical Setting.

While fitness professionals have not historically been considered an extension of the health care team, there is a growing movement in health care to provide more complete and effective team-based care and to better integrate clinical and community resources. One way to do this is through physician referrals to community-based fitness professionals who can help patients translate clinician-advised exercise recommendations into individualized and effective exercise programs. Fitness professionals are uniquely qualified to fulfill this role given their training and practical expertise in exercise physiology, exercise program design and implementation, and health behavior change principles.

Making an IMPACT: effect of a school-based pilot intervention.

BACKGROUND: Poor nutrition and inactivity are widespread and contribute to the epidemic problem of childhood obesity. This study examined the effectiveness of a school-based pilot program to improve nutrition and activity in elementary (ES) and high school (HS) students. METHODS: The Improving Meals and Physical Activity in Children and Teens (IMPACT) school-based curriculum used a train-the-trainer model to improve activity and nutrition. Nine students were recruited from one rural North Carolina high school and trained in the IMPACT curriculum and leadership skills. Four 4th grade classes at a neighboring elementary school were randomized to receive the IMPACT curriculum delivered by the HS students over 12 weeks (two classrooms, 38 students) versus the standard curriculum (two classrooms, 37 students). Pre- and post-intervention surveys were used to assess program effectiveness. RESULTS: ES students in the intervention classes reported increased fruit and vegetable intake (+0.85 servings/day compared with controls; p < 0.05) and improved knowledge of the food group in which to eat the most servings (p < 0.01). ES students who participated in the IMPACT curriculum also reported increased intake of calcium-rich foods and grains, though these results were not statistically significant. Similar though nonsignificant improvements in diet behaviors were reported by the HS students who assisted in delivering the 4th grade curriculum. LIMITATIONS: Study limitations include small sample size, risk of cross-contamination, and short program duration. CONCLUSIONS: ES students who participated in the IMPACT curriculum reported improved dietary behaviors and knowledge. School-based curricula such as IMPACT may help improve nutrition among ES students.