Exploring the role of healthcare partners in referrals to a community-based exercise program with a healthcare-community partnership designed for people with balance and mobility limitations

To explore how healthcare partners in community-based exercise programs for people with balance and mobility limitations perceive and enact referral in the context of their role. We conducted a descriptive, qualitative study involving semi-structured interviews and reflexive thematic analysis. Twelve healthcare partners from the Together In Movement and Exercise (TIME^TM) program completed interviews. Seven (58%) participants were clinicians and 5 (42%) held non-clinical roles. The most common professional background of participants was physical therapy (<i>n</i> = 9, 75%). Clinicians made direct referrals while non-clinical participants facilitated referral by promoting the program. The main theme was healthcare partners perceive their role in referrals as secondary to their role as educators and trainers. Subthemes were: (1) healthcare partners fulfill educator and trainer roles when conducting formal training of instructors, educating instructors during program visits, and fielding questions; (2) almost all healthcare partners facilitate referral by sharing program information formally and informally; and (3) healthcare partners in clinical practice make direct referrals depending on the clientele. Healthcare partners perceive their roles as educators and trainers as taking precedence over their role in referrals. Findings can be used to guide selection and training of healthcare partners, design of clinical education programs, and research on competencies. Healthcare partners involved in supporting community-based exercise programs with healthcare-community partnerships (CBEP-HCPs) perceive their role in referrals as secondary to their roles in education, training, and overseeing the programCBEP-HCP program implementation may benefit from the inclusion of additional training and resources for supporting healthcare partners in non-clinical and clinical roles for facilitating referralEntry-to-practice healthcare professional education programs, particularly physical therapy programs, should consider including training on boundary-spanning competencies to prepare healthcare professional students for roles like being a healthcare partner Healthcare partners involved in supporting community-based exercise programs with healthcare-community partnerships (CBEP-HCPs) perceive their role in referrals as secondary to their roles in education, training, and overseeing the program CBEP-HCP program implementation may benefit from the inclusion of additional training and resources for supporting healthcare partners in non-clinical and clinical roles for facilitating referral Entry-to-practice healthcare professional education programs, particularly physical therapy programs, should consider including training on boundary-spanning competencies to prepare healthcare professional students for roles like being a healthcare partner

为探究针对平衡与活动能力受限人群的社区锻炼项目中的医疗合作伙伴（healthcare partners）如何从自身角色视角认知并实施转诊行为，本研究开展了一项描述性定性研究，采用半结构化访谈与反思性主题分析方法。来自携手运动（TIME™）项目的12名医疗合作伙伴参与了本次访谈。其中7名（58%）为临床从业人员，5名（42%）担任非临床岗位。参与者最常见的专业背景为物理治疗（n=9，75%）。临床人员可直接开展转诊，而非临床参与者则通过推广该项目来协助转诊。

本研究的核心主题为：医疗合作伙伴认为其在转诊工作中的角色，相较于其作为教育者与培训者的角色处于次要地位。其子主题包括：（1）医疗合作伙伴在开展讲师正式培训、项目巡讲期间对讲师进行指导以及解答疑问时，均履行了教育者与培训者的职责；（2）几乎所有医疗合作伙伴都会通过正式与非正式渠道分享项目信息，以此协助转诊；（3）临床岗位的医疗合作伙伴会根据服务对象情况开展直接转诊。

本研究结果可用于指导医疗合作伙伴的遴选与培训、临床教育项目的设计，以及胜任力相关研究。参与医疗-社区协作模式的社区锻炼项目（CBEP-HCPs）的医疗合作伙伴均认为，其在转诊工作中的角色相较于教育、培训及项目监管职责处于次要地位。CBEP-HCP项目的实施可通过增设额外培训与资源来获益，以协助医疗合作伙伴在非临床与临床岗位中开展转诊协助工作。面向从业准入的医疗专业教育项目（尤其是物理治疗专业项目），应考虑纳入跨边界胜任力相关培训，以培养医疗专业学生胜任医疗合作伙伴等相关岗位。参与医疗-社区协作模式的社区锻炼项目（CBEP-HCPs）的医疗合作伙伴均认为，其在转诊工作中的角色相较于教育、培训及项目监管职责处于次要地位。CBEP-HCP项目的实施可通过增设额外培训与资源来获益，以协助医疗合作伙伴在非临床与临床岗位中开展转诊协助工作。面向从业准入的医疗专业教育项目（尤其是物理治疗专业项目），应考虑纳入跨边界胜任力相关培训，以培养医疗专业学生胜任医疗合作伙伴等相关岗位。