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Using the RE-AIM framework to evaluate the implementation of a clinical workflow designed to identify, refer, and connect insufficiently active patients to health coaching
Journal article   Open access   Peer reviewed

Using the RE-AIM framework to evaluate the implementation of a clinical workflow designed to identify, refer, and connect insufficiently active patients to health coaching

Garrett M Steinbrink, Jenna L Springer, Korey A Kennelty, Heather Schacht Reisinger, Britt Marcussen, Katie Imborek, Dale S Bond, Yin Wu and Lucas J Carr
Translational behavioral medicine, Vol.16(1), ibag036
01/07/2026
DOI: 10.1093/tbm/ibag036
PMID: 42418690
Appears in  UI Libraries Support Open Access
url
https://doi.org/10.1093/tbm/ibag036View
Published (Version of record) Open Access

Abstract

Primary care is well-positioned to connect patients to physical activity (PA) interventions but is underutilized. To describe the implementation of a clinical workflow designed to identify, refer, and connect insufficiently active patients to health coaching (HC). From June 2023 to March 2025, a physical inactivity screening and referral workflow was implemented in six primary care clinics within a large university healthcare system. Guided by the RE-AIM framework, descriptive analyses focused on the number and proportion of patients who (i) were screened for inactivity, (ii) were identified as insufficiently active, (iii) expressed interest in HC, (iv) were referred to HC, and (v) were connected to HC. We also assessed provider uptake, evaluated workflow modifications, and computed measures of central tendency and dispersion during the final year. Monthly, a mean (SD) of 1771 (153) patients were screened. Of these, 1013 (102), or 57.1%, were insufficiently active. A median of 288 patients (29%) expressed interest in HC, of which 243 (89%) were referred. A median of 20 patients (10% of those referred) were connected to HC monthly. Among providers with patients requesting a referral, 86% referred. Workflow changes were followed by shifts in metrics, while variability remained low during the final year of evaluation. This workflow identifies and refers many insufficiently active patients to HC. However, there is a gap between patient HC referral and connection to support. Identifying and implementing strategies to overcome barriers and improve patient connection rates is a critical next step.
 Exercise Female Health Promotion - methods Humans Male Mentoring - methods Middle Aged Primary Health Care Referral and Consultation Workflow UIOWA OA Agreement

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