"Adapted physical activity as a tool for integrated care."
Authors: Mostade Céline , Goosse Audrey , Muselle Hélène , Magotteaux Vincianne 
Published: January 2024

Introduction- background and problem statement: Chronilux is one of twelve local pilot projects in Belgium who since 2018 started to test different strategies for implementing integrated care for the chronically ill. One of its missions was to develop adapted physical activity (APA) via ChroniActiv' modules responding to the needs of a particularly large population of chronically ill people in the area.

Objective: To pilot the APA in the care path of the chronically ill as a lever towards integrated care.

Description Of Policy Context: ChroniActiv' module is a structured path that involves collaboration between the participant and different professionals. A holistic approach that includes a medical consultation, an individual physical fitness assessment with a physiotherapist or occupational therapist and the realisation of twelve group sessions of APA. The module ends with a physical fitness assessment, whose results are then analysed with the participant and its physician.

Target Population: Chronically ill or people with risk factor(s) for whom getting back into motion is one of the therapeutic objectives.

Highlights, Innovation: A community-based approach that enabled chronically ill people to invest in a care plan in a non-medical collective environment but secured by health professionals.

ChroniActiv' enabled participants to be active in their transition to a healthier and more active lifestyle.

Sharing experiences between the actors involved brought the inclusion in the care plan of additional health professionals such as dieticians and psychologists. As a result, complementary tools were offered (via group or individual workshops) to help the participant to live better with his disease in his everyday life.

Networking with local authorities facilitated the implementation of the modules. These collaborations allowed equitable access to the whole population in terms of financial, communicational and geographical aspects. The creation of an extended communication allowed all field professionals (pharmacists, home care workers, Mutualities...) to inform and direct the citizen towards a ChroniActiv' module.

Impact, Outcomes: ChroniActiv' modules facilitated the integration of care through the interprofessional collaboration. For professionals, this dynamic opened to a more integrated perspective of care.

The physical fitness assessment (n=157) showed an improvement in physical skills. The evaluation questionnaires highlighted, in particular, an improvement in well-being, the creation of social links, a gain in freedom and independence in daily life, a better self-esteem…

The participant entered a virtuous circle of health that tends towards better primary, secondary and tertiary prevention.

Comments On Transferability And Conclusion: The integration of ChroniActiv' into the care pathway is a wise intervention that leads towards the quintuple aim:

The population health is improved through getting back into motion of the participants and the common vision of their providers;

Efficiency is ensured by better prevention;

The well-being of professionals is enhanced by increased opportunities for action, better collaboration, a common vision and positive feedback from participants;

Improvement of the participant's experience as evidenced by the evaluation (well-being, autonomy...);

Financial and geographical equity is possible through the created networks.