Evaluation of program to reach low-income residents with subsidized memberships to fitness facilities

Introduction. The 2008 Physical Activity Guidelines for Americans recommend 150 minutes of physical activity (PA) per week to reduce chronic disease risk, and fewer Black (50%) and Latino (47%) residents in Boston meet these guidelines than do Boston residents overall (57%). In 2011-12, a PA referral system gave low-income community health center (CHC) patients subsidized memberships to fitness facilities to increase PA opportunities for those in need, with a focus on reaching populations of color. Methods. CHC clinical providers were given information about referring patients to a Wellness Manager, who conducted brief screenings for PA behavior and demographic information and then connected eligible clients with participating fitness facilities. Clients provided PA behavior information again during program renewal 3-12 months later. The paired t-test was used to compare baseline and follow-up PA minutes. Results. Fifteen months into the program, 277 providers in 20 CHCs referred patients to the Wellness Manager. Of the 2,434 approved subsidized memberships, 64% were activated at 24 different facilities. At baseline, 88% of clients were overweight or obese, `82% were Black or Latino, and only 18% met recommended PA guidelines. Of 254 clients with complete PA information at baseline and follow-up, the mean PA minutes per week increased from 72 to 266 (<0.001). Conclusion. This program connected low-income Boston residents of color to fitness facilities; those who remained in the program engaged in more PA than at baseline. Embedding the referral process within CHCs effectively reached this population, and decreasing cost barriers was associated with increased PA.