Taking into consideration the high burden of non-communicable diseases in Romania, The National Institute of Public Health (NIPH) under the Ministry of Health in Romania joined the EUPAP project to pilot the Swedish best practice model for physical activity on prescription (PAP). The focus is on the following diagnoses in the implementation process: diabetes; osteoporosis; hypertension; overweight and obesity; anxiety; depression and cancer. The aim is to offer an individualized prescription/counselling of physical activity for preventive and treatment purposes and a follow-up of the patient. At the end of the project, the goal is to evaluate the results and conclude if PAP is suitable for the local context, and if it can be used within the health services for prevention and treatment.
The National Institute of Public Health (NIPH) under the Ministry of Health is the coordinating institution for the first implementation of the Physical Activity on Prescription (PAP) in Romania. The Institute provides technical assistance, including the provision of data, expertise and training, on public health and related matters to the Ministry of Health and its local structures, the county Public Health Directorates.
The National Centre for Health Status Evaluation and Health Promotion (NCHSEHP), under the NIPH, is responsible for the surveillance of population health and well-being, of lifestyle factors, and coordinates the National Programme for Health Status Evaluation, Health Promotion and Health Education.
The NIPH, with the support of the coordinator of the community nurses, from the Public Health Directorate of the Sibiu County, succeeded to involve 20 community nurses to pilot PA counselling according to the Swedish method.
The Regional Centre of Public Health from Sibiu (part of the NIPH organizational structure), under the coordination of the National Centres from NIPH, was also involved due to its strong connections at local level with the family doctors’ practices, within a local healthy lifestyle program for the elderly population. Two family doctors’ practices from Sibiu were involved in the project. The Sibiu Regional Public Health Centre conducted the local training for the community nurses, in which the General practitioners (GPs) involved in the implementation participated. The regional centre was involved within the project to support the implementation process by facilitating access to the gym for patients referred by GPs, in accordance with the Swedish model.
GPs (two from Sibiu and two from Arad) have received training to become prescribers in the EUPAP project. Furthermore, persons involved in the coordination of the local implementation process, two doctors from Sibiu Public Health Centre and one doctor from the Public Health Directorate of the Sibiu County (coordinator of the community nurses) attended the Swedish PAP training.
The NIPH developed methodologies for the implementation process, in order to support the GPs and community nurses.
In addition - prior to the implementation, the FYSS-short - Physical Activity in the Prevention and Treatment of Disease, and the Prescription-form were translated. The Prescription-form was adapted to the local context.