Models and materials for exercise promotion in comprehensive multiple sclerosis care: completion of the 'exercise in medicine' development process.

Purpose Health care providers have highlighted the need for tools and resources that support promotion of exercise behavior within comprehensive multiple sclerosis (MS) care. This study involved a final quality improvement evaluation of exercise promotion models and materials for inclusion within this setting. Methods and materials Our research team distributed a paper-based survey containing Likert scales, open answer questions, and copies of the models for editing. We distributed this survey among health care providers across the United States. We conducted a novel mixed-methods analysis evaluating quantitative, qualitative, and creative data. Results We received completed surveys from 13 health care providers who strongly rated the clarity and applicability of the models and materials, and reported that no major improvements were necessary. The minor improvements were specific per comprehensive MS care center. The feedback indicated that the "Exercise in Medicine" models and materials are guides such that the processes should be integrated into real world practice by amending roles and responsibilities with the team members and structure per comprehensive MS care center. Conclusion This paper presents finalized models and materials for exercise promotion within comprehensive MS care that are ready to be tested for feasibility and efficacy in a clinical trial.IMPLICATIONS FOR REHABILITATIONHealth care providers require support to promote exercise within the context of comprehensive MS care.The practice models in this article provide guides regarding how to promote exercise in this context.Implementing these exercise promotion guides can reduce the burden of neurologists, and ensure patients receive exercise support from appropriate providers.These guides should be implemented within the context of each individual care center, and not as an explicit step by step guide as each care center is unique.