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      One-day workshop-based training improves physical activity prescription knowledge in Latin American physicians: a pre-test post-test study

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          Abstract

          Background

          The physical inactivity pandemic and related non-communicable diseases have made it imperative for medical doctors (MDs) to effectively provide lifestyle counseling as part of prevention and treatment plans for patients. A one-day certification workshop was designed to improve MDs PA prescription knowledge, as part of the Exercise is Medicine® (EIM®) global health initiative. The objective was to determine knowledge gain of MDs participating in a standardized, one-day PA prescription workshop performed throughout Latin America (LA).

          Methods

          A 20-question multiple-choice test on PA topics, based on international guidelines, was completed before and after the workshop. Pre and post-test analyses, without a control group, were performed on 1044 MDs after the 8-h workshop that was delivered 41 times across 12 LA countries, from January 2014 to January 2015. Knowledge improvement was determined using the class-average normalized gain and individual relative gain. T-tests with 95% confidence interval levels were conducted to analyze differences between MD specialties.

          Results

          Test scores improved on average from 67 to 82% after the workshop ( p <0.001). The average total individual relative gain was 29% [CI: 26 to 32%]. Relative gain by country ranged from 9.3% [CI: 2 to 16%; Nicaragua] to 73% [CI: 47 to 98%; Dominican Republic]. The mean of the 41 workshops’ class-average normalized gain was 46% [CI: 42 to 51%]. The largest groups of participants were general practitioners (GPs) (33%; n = 348), internal medicine (19%; n = 194), and family medicine (9% n = 92) specialists. Relative gain for GPs was not different than for all grouped primary care specialties (30% vs. 27%, p =0.48). The knowledge gain was higher for the workshop modules on screening/risk stratification and prescription (43% [CI: 39–48%] and 38% [CI: 34–42%], than for the module on PA benefits and risks (26% [CI: 23–28%]).

          Conclusion

          This one-day workshop had a positive impact on the knowledge gain of MD’s on the topic of PA prescription. Although all groups of specialties increased knowledge, GPs and family medicine MDs benefited the most. This short course is an effective continuing education strategy for teaching PA assessment, counseling and prescription to MDs in Latin America, a topic rarely included in the training of MD’s in the region and the world. Further follow-up is needed to ascertain impact on PA counseling practices.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12889-016-3883-2) contains supplementary material, which is available to authorized users.

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          Most cited references26

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          Lack of exercise is a major cause of chronic diseases.

          Chronic diseases are major killers in the modern era. Physical inactivity is a primary cause of most chronic diseases. The initial third of the article considers: activity and prevention definitions; historical evidence showing physical inactivity is detrimental to health and normal organ functional capacities; cause versus treatment; physical activity and inactivity mechanisms differ; gene-environment interaction (including aerobic training adaptations, personalized medicine, and co-twin physical activity); and specificity of adaptations to type of training. Next, physical activity/exercise is examined as primary prevention against 35 chronic conditions [accelerated biological aging/premature death, low cardiorespiratory fitness (VO2max), sarcopenia, metabolic syndrome, obesity, insulin resistance, prediabetes, type 2 diabetes, nonalcoholic fatty liver disease, coronary heart disease, peripheral artery disease, hypertension, stroke, congestive heart failure, endothelial dysfunction, arterial dyslipidemia, hemostasis, deep vein thrombosis, cognitive dysfunction, depression and anxiety, osteoporosis, osteoarthritis, balance, bone fracture/falls, rheumatoid arthritis, colon cancer, breast cancer, endometrial cancer, gestational diabetes, pre-eclampsia, polycystic ovary syndrome, erectile dysfunction, pain, diverticulitis, constipation, and gallbladder diseases]. The article ends with consideration of deterioration of risk factors in longer-term sedentary groups; clinical consequences of inactive childhood/adolescence; and public policy. In summary, the body rapidly maladapts to insufficient physical activity, and if continued, results in substantial decreases in both total and quality years of life. Taken together, conclusive evidence exists that physical inactivity is one important cause of most chronic diseases. In addition, physical activity primarily prevents, or delays, chronic diseases, implying that chronic disease need not be an inevitable outcome during life. © 2012 American Physiological Society. Compr Physiol 2:1143-1211, 2012.
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            Interactive-engagement versus traditional methods: A six-thousand-student survey of mechanics test data for introductory physics courses

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              Exercise is the real polypill.

              The concept of a "polypill" is receiving growing attention to prevent cardiovascular disease. Yet similar if not overall higher benefits are achievable with regular exercise, a drug-free intervention for which our genome has been haped over evolution. Compared with drugs, exercise is available at low cost and relatively free of adverse effects. We summarize epidemiological evidence on the preventive/therapeutic benefits of exercise and on the main biological mediators involved.
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                Author and article information

                Contributors
                mc.arciniegas139@uniandes.edu.co
                +1 (404) 307-4027 , felipelobelo@emory.edu
                ma.jimenez74@uniandes.edu.co
                dc.paez@uniandes.edu.co
                s.cortes53@uniandes.edu.co
                a.de169@uniandes.edu.co
                john.duperly@ama.com.co
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                5 December 2016
                5 December 2016
                2016
                : 16
                : 1224
                Affiliations
                [1 ]Fundación Santa Fe de Bogotá, Bogotá, Colombia
                [2 ]School of Medicine, Universidad de los Andes, Bogotá, Colombia
                [3 ]Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1599 Clifton Rd NE, Atlanta, GA USA
                [4 ]Exercise is Medicine® Global Research and Collaboration Center, Atlanta, GA USA
                [5 ]Department of Economics, University of Leicester, Leicester, UK
                Author information
                http://orcid.org/0000-0003-4185-7193
                Article
                3883
                10.1186/s12889-016-3883-2
                5139105
                27919245
                e96c03af-9802-4e0e-a100-8ed1f98ae1b9
                © The Author(s). 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 26 May 2016
                : 25 November 2016
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100009525, Beverage Institute for Health and Wellness;
                Funded by: FundRef http://dx.doi.org/10.13039/100004325, AstraZeneca;
                Funded by: FundRef http://dx.doi.org/10.13039/100004334, Merck;
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2016

                Public health
                exercise,health behavior,counseling,continued education,lifestyle medicine
                Public health
                exercise, health behavior, counseling, continued education, lifestyle medicine

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