An inadequate level of physical activity in the population is a challenge faced by all of the Nordic countries. The “Nordic network for physical activity, food and health” was established in order to exchange experiences and collaborate to increase knowledge and develop the area of lifestyle on prescription. In Denmark, Finland, Norway and Sweden, various models for prescribing physical activity through the healthcare services have been developed in the past decade. The objective of this report is to describe these different models. By summarising experiences and analysing the advantages and disadvantages of the various models, recommendations can be made for future efforts in the Nordic region - identifying a Nordic "best practice" for the written prescription of physical activity with the possibility of local adaptation.
Materials have been compiled from reports, scientific studies, websites and contacts with experts in the field in each country. Since conditions differ between the countries, the context of the health-promotion work on physical activity is described and a brief historic retrospective is provided regarding the development work done on the prescription of physical activity. Similarities and differences are identified between the countries’ structures of physical activity on prescription and common development issues are identified. A combined analysis leads to recommendations for future efforts in the Nordic region.
The common denominator in the various models for physical activity on prescription is that physicians or other licensed healthcare staff consult with the patient and prepare a written prescription for physical activity. Another common approach is that each country has one or more models that are adapted to local conditions in each region, county council or municipality. Differences between the models primarily concern who issues prescriptions, who has a motivational interview with the patient and follows up the prescribed activities and which patients are eligible. There is a wide variation in how intensive the interventions are, what is done within the healthcare services and in cooperation with other actors in society, and if focus is on promoting physical activity individually or in group activities. Some models use existing structures in society while others have developed new ones. All models have their advantages and disadvantages and different models are uitable for different conditions. The models have been scientifically studied, and all have led to a higher level of physical activity.
It is important that both the activity prescribed and the support provided to cover the patient’s needs are adapted to the individual. In general, healthcare personnel should use two levels of efforts for patients who need to increase their physical activity for preventive or curative purposes. Patients are mainly offered motivational interviews with an individually adapted, written prescription of physical activity that the patient is to conduct on his or her own (daily activity and/or organised activity). Patients who need more help to get started with physical activity are offered exercise groups in the healthcare services as an initial step. An individually adapted, written prescription can then facilitate the transition from structured exercise within the healthcare services to the individual becoming lastingly, independently physically active. However, it is not possible to propose a single model for physical activity on prescription in the Nordic region that suits all patients, prescribers and different local conditions. Work must consequently be adapted based on the current circumstances.
Helsedirekektoratet , 2011. , 70 p.