Clinician-Patient Communication About Physical Activity in an Underserved Population

Clinician: “Exercising three times a week… that's what you had set as a goal last year in March. How is that going?… How much are you thinking you are exercising… once a week? Once a month?”

Clinician: “Do you do any sort of exercise?… Anything in particular?”

Clinician: “You have to do at least half an hour of some kind of motion before it is considered beneficial to you… It does help to control your blood pressure… it helps control your diabetes… helps strengthen your bones, makes you less likely to fall… prevents osteoporosis.”

Clinician: “Try to exercise for three or four times a week. What is walking, what is riding a bike for a good half an hour at a time…cause that will also help.”

Clinician: “What else is good for you is… getting out and getting to do things that you like to do, getting some exercise. . . . getting your body going will help you a little bit as well. (in relation to depression) If you do this power walk 5 days a week for a half an hour where you're sweating, eat a little healthier, more fruits and vegetables and water, less of the bad stuff, you will lose that weight.”Patient: “I'm working on it.”

Clinician: “You did the water flexibility fitness [class]? I'd love to see you go back.”

Patient: “Is it still going on?”

Clinician: “Yep, and it'll continue.”

Patient: “What day is it? Mondays and Wednesdays?”

Clinician: “Yeah, Mondays and Wednesdays.”

Patient: “I'm going back. I don't care if my blood pressure's high or not. I just want to go, cuz see Dr. X stopped me from going. I was kinda tired; I was kinda glad I had an excuse not to go. But, you know, I was going - getting up and going, and it was in my schedule. I was going.”

Clinician: “I know.”

Clinician: “I found out about this place that does sort of like cardiac rehab. They do a little bit more intensive follow-up for the weight loss and diabetes and for your heart. They prescribe exercise for those three reasons. You do well when I see you frequently. When we don't lose contact, I think you do well. When you have someone on your case, you do a little bit better.”

Clinician: “I think you would be a good candidate because you are doing well with [local exercise program] and I know when you get excited when you do this. . . . this weight loss. So I think you'd be a good candidate for this. So can I refer you there?”