A well-known bit of wisdom says that if exercise could be packaged as a pill, every doctor would prescribe it.

A Douglas County coalition has been putting that idea to the test by offering “activity prescriptions” at no cost to patients newly diagnosed with diabetes or prediabetes.

Their goal: reducing some of the barriers to regular physical activity to help people improve their health.

“For patients who are either at risk of developing a chronic condition or managing a chronic condition, we know that physical activity is one of the things they can do that would make a huge improvement in their quality of life,” said Ginny Barnard, Executive Director of LiveWell Douglas County, which administers the program.

Beyond simply prescribing exercise, the Move More Douglas County program — which is funded by a Pathways to a Healthy Kansas grant from Blue Cross and Blue Shield of Kansas (BCBSKS) — provides the funding and support to get patients started on the right foot.

“Pathways is about creating long-term, community-driven solutions to health challenges,” said Virginia Barnes, Director, Blue Health Initiatives at BCBSKS. “We’re proud to support programs like Move More Douglas County that make it easier for people to take control of their health in ways that are sustainable and accessible.”

A prescription for movement

Each prescription offers $75 toward fitness courses or personal training through the Lawrence Parks, Recreation and Culture Department.

In the first year of the program, 38 individuals used one of these activity prescriptions to enroll in a class or personal training.

Ginny aggregates information provided by participants each quarter, including pre- and post-surveys. As incentive, participants are awarded an additional $25 scholarship toward future exercise programs when they complete the post-survey.

Participants have reported:

• Reductions in their A1C, a key marker of whether one’s diabetes is under control;
• Better balance and increased flexibility;
• Improved strength;
• Improved mood; and feeling better in general.

Community collaboration in action

Providers at LMH Health and Heartland Community Health Center in Lawrence are taking part in the program, which is overseen by LiveWell Douglas County, along with the support from Lawrence Parks, Recreation and Culture.

Coalition members meet quarterly to discuss what’s going well and where they see opportunities, and Ginny says Haskell Indian Health Services is in talks to potentially join the program.

Jenn Kessler, CHW-C, Director of Patient Engagement at Heartland Community Health Center, said in 2024, the center saw a 12% increase in patients diagnosed with diabetes and a 15% increase in those diagnosed with hypertension.

“As an integrated care model with wrap-around services that includes a Food is Medicine program, we were excited to provide access to a physical activity resource that would improve quality of life, lifestyle, mental health and overall health,” she said, noting that many of the center’s patients don’t have the financial resources to access fitness services on their own.

“It’s been a great fit,” Taylor Martin, Recreation Facility Operations Supervisor for Lawrence Parks, Recreation and Culture, said of the collaboration. “We’re all very focused on community, wellness and health. It just seemed like a perfect combination.”

Dr. Mark Oertel, of LMH Health’s Lawrence Endocrinology Specialists, is among LMH providers writing activity prescriptions as part of the program.

“The vast majority of people I see can benefit from this program,” he said in an article for LMH Health, noting that some of his patients have experienced such success they’ve returned to ask for another activity prescription.

Breaking down barriers

Taylor said he and his staff work hard to break down what he calls “gym-timidation,” or those nerves one can get when walking into a gym for the first time, not knowing where to start, what to do or if you belong.

Taylor or a colleague meets with recipients of the activity prescriptions to ensure they find a class to fit their abilities and needs.

“The most important thing is just getting people into our facilities and getting them more comfortable with Parks and Rec and seeing what we can offer,” he said, noting that most activity prescription participants have either been new to the facilities or to a formal exercise program.

Popular options have included:

• personal training for one-on-one support, and
• group classes such as senior strength training, adult swim, yoga, tai chi and “jivin’ joints.”

Building a more active lifestyle

Karen Lewis, CHW, Care Cupboard Coordinator at Heartland Community Health Center, brings participants in the center’s Food is Medicine program — all of whom can access the activity prescriptions — to Sports Pavilion Lawrence as a group to meet with Taylor and learn more about the fitness offerings.

“Ninety percent of the participants I work with never really exercised before,” Karen said, “but they’ve used this program and continued some level of activity after the program ended.” 

Karen said several participants have shared positive feedback with her.

One, who has knee issues, found joint-friendly exercises through a trainer at the aquatic center and says they’ve helped her not only physically, but emotionally. Another participant, who worked with a personal trainer, told Karen, “It’s hard work, but I feel so much better after I’m done.”

Finding belonging through fitness

Taylor said that initial introduction helps participants ease into a new routine. The center itself and many of its amenities are free to Douglas County residents, but class offerings have fees.

“I have noticed that once I meet with those groups, I have seen those people come here more often,” he said. “Maybe it just gave them a little push or made them feel more comfortable about entering these facilities.”

He, too, sees positive social and emotional benefits in addition to the physical benefits of exercise.

“We have a lot of retired folks who come out here and they may walk around the track once or twice, but they’re really here to socialize because they might not see anyone else for the rest of the day,” Taylor said.

Staying active for the long-term

With just over a year since its implementation, the activity prescription program is still in its early stages. Coalition members continue to refine and discuss potential enhancements, such as including patients with other chronic conditions, like heart disease, osteoporosis or high blood pressure, where exercise can also support better health outcomes.

Coalition members had discussed establishing an activity prescription program in the past, but Ginny says the Pathways to a Healthy Kansas funding and support were key to translating the ideas into action.

“Without our technical assistance team, through Pathways to a Healthy Kansas, I’m not sure this would have happened,” she said. “It’s like the hidden piece that people don’t see — the agreements of who is doing what. We’ve all committed to continue this work, and I think that’s really a key piece.”

As the program continues to grow, its success offers a model for how communities can turn prescriptions into prevention — and movement into medicine.

Providing pathways to a healthier Kansas

Pathways to a Healthy Kansas is the largest community grant initiative ever funded by BCBSKS, combining community-wide, evidence-based solutions and practices to help Kansas communities improve active living, healthy eating and commercial tobacco prevention. The initiative helps communities address the social determinants of health, or the conditions in which people are born, grow, live, work and age.

Amy Bauer, Senior Corporate Communications Specialist