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Evaluating the Heart Wise Exercise program: a model for safe community exercise programming

Jennifer L. Reed, Jennifer M. Harris, Liz Midence, Elizabeth B. Yee, Sherry L. Grace.

BMC Public Health, Volume16, February 2016.

Promoting physical activity in the primary care setting remains a significant challenge. The Canadian Guidelines for Physical Activity recommend that adults should get at least 150 minutes of moderate to vigorous physical activity per week, in bouts of 10 minutes or more. Despite the overwhelming evidence that regular aerobic exercise is one of the most beneficial things one can do for their health, many barriers stand in the way for patients who may seek to make positive behavioural change.

Increasingly, our patients are living with many chronic diseases including heart disease, diabetes, and chronic obstructive pulmonary disease. Often times, patients with these ailments do not understand how physical activity can be a regular part of their lives, and will often cite their poor overall health as a reason not to be active.

The Heart Wise Exercise Program was started at the University of Ottawa Heart Institute as a way to combat this issue. The program seeks to work with community physical activity providers to designate facilities, programs, and classes where participants can exercise regularly to prevent or limit the negative effects of living with a chronic health condition. Heart Wise Exercise was launched in 2007 in partnership with several local organizations and support from the Ontario Ministry of Health Promotion.

A program or class that displays the Heart Wise Exercise logo satisfies 6 criteria. In 2015, Reed et al. utilized a piloted checklist and audited 45 Heart Wise Exercise programs for the 6 criteria, in addition to administering a survey to a convenience sample of 147 participants:

  • Encourages regular, daily aerobic exercise – 71% of exercise leaders encouraged daily aerobic exercise. Participants reported engaging in an average of 149 minutes of aerobic exercise per week.
  • Encourages and incorporates warm up, cool down, and self-monitoring with all exercise sections – 100% of programs incorporated a warm-up and cool down, and 84% encouraged self-monitoring in class.
  • Allows participants to exercise at a safe level and offers options to modify intensity – 98% of programs offered different options for participants exercise at appropriate intensity levels.
  • Includes participants with chronic health conditions – participants reported living with a variety of chronic health conditions including arthritis, osteoporosis, diabetes, heart disease, and chronic obstructive pulmonary disease.
  • Offers health screening for all participants – 93% of instructors offered health screening for patients.
  • Has a documented emergency plan that is known to all exercise leaders, including the requirement of current CPR certification, phone access to local paramedic services and presence of a defibrillator – 100% of the exercise sites had automated external defibrillators, and 90% of instructors were aware of the documented emergency plan.
  • Furthermore, participants reported being, on average, “somewhat happy” to “very happy” with their Heart Wise Exercise locations, program dates and times, leaders’ knowledge of disease and exercise, cost, and the social aspect of being part of a group.

In all, Heart Wise Exercise Programs are safe and appropriate for your patients with various chronic health conditions. Current participants are highly satisfied with their programs. For more information, please visit:


Sean Mindra MD, CCFP

PGY3 – Sport and Exercise Medicine, University of Ottawa

Advisor: Dr. Taryn Taylor BKin, MSc, MD, CCFP (SEM), Dip Sport Med

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