Increasing Understanding of Referrals from Healthcare Professionals to Community-Based Exercise Programs with Healthcare-Community Partnerships Designed for Older Adults with Balance and Mobility Limitations
Bibliographic record
Abstract
Referrals from healthcare professionals to community-based exercise programs with healthcare-community partnerships (CBEP-HCPs) are important for program sustainability; however, they are inconsistent. Little is known about referrals to CBEP-HCPs, including the referral sources, promotional strategies used to facilitate referral, and the referral practice of healthcare partners (individuals who support programs by prescribing exercise, training and supporting the instructors, monitoring the program, and facilitating referrals). This thesis is comprised of three studies that aimed to: 1) identify the nature, range, and extent of models which guide the development of linkages between healthcare settings and community programs; 2) describe CBEP-HCP providers’ perceptions of the a) type and work setting of healthcare professionals who refer to CBEP-HCPs by community size; b) nature, frequency, and utility of strategies used to promote referral from healthcare professionals to CBEP-HCPs; and c) facilitators and barriers to CBEP-HCP promotion; and 3) explore how healthcare partners in CBEP-HCPs designed for people with balance and mobility limitations understand and enact referrals in the context of their role. Study 1 was a scoping review of healthcare-community linkage models with six models included. Results showed that models most commonly targeted primary care as the healthcare setting and intended users, while there was a paucity of models designed for ambulatory and rehabilitation settings. Almost all models outlined the linkage strategy of coordinating services and referral processes. Study 2 was an interviewer-administered survey of 23 CBEP-HCP providers of 27 programs. Findings revealed that the majority of programs received referrals from hospital-based physical therapists and the majority of healthcare partners were also physical therapists. Study 3 was a descriptive qualitative study employing semi-structured interviews of 12 healthcare partners in a CBEP-HCP. Findings demonstrated that healthcare partners described their role in referrals as secondary to their roles as educators and trainers. They commented that their role with referrals evolved wherein they provided less support as programs became well-established. Thesis findings advance knowledge about referrals by healthcare professionals to CBEP-HCPs. Future research should explore referrals by healthcare professionals other than physical therapists, identify healthcare partner competencies, develop ambulatory and rehabilitation linkage models, and develop interventions to increase referrals.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.042 | 0.130 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.006 | 0.014 |
| Open science | 0.002 | 0.006 |
| Research integrity | 0.002 | 0.004 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".