Exercise Promotion in Multiple Sclerosis Through the Patient–Provider Interaction: Development of Practice Models

Abstract
Purpose There is a significant gap between translation of evidence-based benefits of exercise and the adoption of this exercise behavior among persons with multiple sclerosis (MS). Health care providers could be the means by which this translational gap is narrowed, but these individuals require support and resources to effectively promote exercise. The purpose of this study was to develop and evaluate practice models that guide health care providers in delivering exercise promotion in comprehensive MS care. Methods Over a 6-wk period, primary data were collected from health care providers who worked in comprehensive MS care centers across the United States. This study adopted a quality improvement approach, Plan-Do-Study-Act, to evaluate the practice models. We asked health care providers to complete one online survey evaluating the models and thereafter adopted a case study design to evaluate the practice models according to health care provider feedback. Data were collected through one online survey that asked health care providers to rate the practice models, provide reasons for assigning a particular score, and suggest ways to improve the models. Results Health care providers perceived the three practice models as useful resources for promoting exercise within comprehensive MS care, and provided feedback for improving and modifying the models before implementation into practice. Conclusion We are now one step closer toward a tangible, useful resource for promoting exercise in comprehensive MS care and improving the delivery of exercise promotion and consequently overall care among persons with MS within comprehensive care centers.