On Track (City of Kamloops and Interior Health)
On Track is a group exercise program in Kamloops focusing on prevention of cardiovascular disease in middle-aged and older adults. In response to community need, the scope of the program now includes mental health support for participants and also serves those experiencing depression or anxiety. On Track is a 10 to 12-week fitness program involving exercise (walking on the track and weights), nutrition counseling and goal setting for a healthy lifestyle. Part of its focus is to build participants’ confidence in finding safe exercise and reducing cardiovascular and chronic disease risk through lifestyle change.
On Track has been offered since 2008 through the Strategic Health Alliance (SHA), a joint partnership between the City of Kamloops and Interior Health (IH). IH provides a multidisciplinary team (part-time clinical staff) who manage the clinical aspects of the program and the City of Kamloops provides a full-time Program Coordinator (75% of their time is focused on SHA programs), as well as several part-time exercise staff who organize the lifestyle and exercise aspects. The program is offered out of the Tournament Capital Centre (TCC) in Kamloops.
To qualify for the program, participants need to get a referral from their physician and go through a screening process (which is done by the Program Coordinator). Participants pay a $40 fee for the program. If participants cannot afford the program fee, they can receive a subsidy (of up to 80% of the fee) by applying to the City of Kamloops’ Affordable Recreation for Community Health program.
The goal of the Strategic Health Alliance is to promote lifelong health and fitness, and improve the health of people with chronic conditions. In addition to On Track, the SHA has seven programs, two of which are aimed at cardiovascular health, the Vascular Improvement Program (VIP) and And the Beat Goes On (for more information please see Strategic Health Alliance Sector Profile).
The City of Kamloops receives approximately $55,000 from IH each year for all SHA programs. The majority of this budget pays for staffing as well as other costs including marketing, professional development, evaluation, and sustainability. While the contract with IH must be renewed each year, the funding for the program has been fairly stable and allows the programs to be offered at low cost to the participants.
Impact: According to Statistics Canada, cardiovascular disease is the leading cause of death among seniors 85+, and the second leading cause of death among seniors 65-84 and middle-aged adults 45-64. The On Track program successfully contributes to the primary prevention of cardiovascular disease for middle-aged and older adults at risk for cardiovascular disease.
The program is well-attended. On Track usually has between 15-25 participants per session, and the most recent On Track program had 21 participants.
Adding the mental health component to On Track helps to address the depression and anxiety that are often associated with chronic conditions. Pre-and post-test assessments suggest participants’ mental health is improving after going through the program. Between April and June 2016, participants reported an average of 27% improvement in depressive symptoms after participation in the program.
The program builds participants’ confidence with exercising and engaging with community programs. Part of the ways that the program does this is by having trained health professionals available to assist participants should there be a health concern or cardiac incident when they are exercising.
Participants are encouraged to continue exercising after completion of their program, helping to promote ongoing positive health and fitness. There are several program options ideal for participants who have completed a SHA program but may still be concerned about the safety of exercising. These include the two other SHA cardiovascular programs and Keep on Moving, which trains fitness leaders in how to offer safe exercise for people with chronic conditions. Participants are also organizing themselves for ongoing exercise. For example, a recent On Track program graduate started a weekly walking group for program graduates at the Tournament Capital Centre,which is regularly attended by 8-10 people each week.
Strengths and Challenges: On Track is an example of the unique partnership that exists between a municipality and a health authority. They work together to promote health and fitness and improve the health of people with chronic conditions. On Track combines the exercise and recreation resources and expertise of the City of Kamloops with the clinical expertise of IH. The high staff-to-participant ratios allow for specialized attention for the participants. The presence of the multidisciplinary team ensures the safety of the participants and provides reassurance that they are exercising in a safe environment. Due to the specialized population they are working with, considerable time must be invested into training the staff. Most of the work is on a part-time basis which can sometimes make staff retention challenging.
As might be expected with a partnership between two large organizations, ensuring proper communication and coordination is important and also a challenge. To address the challenges, they have created and documented well-defined roles for each partner as well as laid out clear communication structures.The Tournament Capital Centre (TCC), built in 2007 to promote sports tourism in the region, is an important foundation for the On Track program. While not built with the intention of providing programs to seniors and people with chronic conditions, the City recognized the potential TCC could play this role. Parking at the TCC is a challenge, so On Track participants receive special parking passes to ensure they are able to access the program.