The CHANGE program, Exercise intervention in primary care
Doug Klein MD MSc CCFP Khursheed Jeejeebhoy MD PhD Angelo Tremblay PhD […] David M. Mutch PhD
Canadian Family Physician • Le Médecin de famille canadien | Vol 63: JULY • JUILLET 2017
Abstract
Problem addressed
Primary care settings require a feasible program for integrating lifestyle interventions, which
can reverse metabolic abnormalities, for patients in practice.
Objective of program
To integrate a lifestyle intervention program into existing primary care clinics with an
interprofessional approach that includes dietitians and kinesiologists.
Program description
Canadian Health Advanced by Nutrition and Graded Exercise (CHANGE) provides a
personalized approach to nutrition and exercise modification focusing on patients with metabolic syndrome. With
CHANGE, exercise intervention is individualized (ie, tailored to individual preferences) and graded (ie, intensity is built
up slowly over time); supervision and implementation of the program is conducted in a collaborative fashion between
the family physician and the kinesiologist. Patients undergo an initial fitness assessment that determines their baseline
aerobic, strength, and flexibility scores, and the same assessment is performed at 3 months and at 12 months.
Conclusion
The CHANGE program demonstrates how
interprofessional primary care teams can support patients
with metabolic syndrome in achieving their health goals. By
including dietitians and kinesiologists in primary care settings
to work alongside family doctors, many barriers to lifestyle
interventions can be overcome. The team’s collaborative
understanding of the patient combined with the patient’s own
sense of urgency for change creates the opportunity for the
formation of new healthy lifestyle habits. Although results are
preliminary, CHANGE appears to be a feasible, implementable,
and effective program.