Community-based physical activity promotion confers broad-spectrum benefits for military Veterans with chronic and complex conditions: Evidence from 4 years of rehabilitation consultant referrals

Abstract: Introduction: Veterans experience a high incidence of chronic and complex health conditions requiring a holistic approach to health and well-being. The Adapted Physical Activity Program (APAP) is a theory-based programme developed to support the physical activity (PA) participation of community-dwelling people with disabilities. Although available to all people with disabilities, of the 214 clients referred between 2015 and 2019, two hundred and three were veterans. This study aimed to understand this unexpected predominance by describing the characteristics of the veterans referred to APAP, including client goals, as well as describing the characteristics of the rehabilitation consultants who made the referrals. Methods: Descriptive statistics were used to describe specific characteristics of the veterans and the rehabilitation consultants. Content analysis was used to analyse client goals. Results: Client data highlighted the complexity of this clinical population. All clients had been diagnosed with more than one health condition, with most experiencing both a physical injury and a mental health diagnosis. Content analysis revealed six overarching client goals, including supporting sustainable PA participation, mental health and well-being, participation in meaningful activities, community and social engagement, management of condition and physical health and fitness. Data from the referring organisations showed that each organisation had multiple health professionals that made repeated referrals to APAP. The most common health profession to make a referral to APAP was occupational therapy. Conclusion: Veterans have a high incidence of chronic and complex health conditions including physical injury and mental illness. Programmes and services that look beyond addressing the diagnosis and treatment of specific conditions to supporting the overall health and well-being of the individual are required. Person-centred, community-based PA programmes such as APAP might offer this solution. Further research is required to assess the efficacy of such programmes with this population.

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