Increasing physical activity, community cohesion, and self-efficacy among medically underserved patients at an urban public hospital

Background: San Francisco General Hospital and Trauma Center (SFGH) is the safety net provider for San Francisco City and County. Many of SFGH's medically underserved patients are profoundly isolated and lack resources for affordable physical activity classes. Furthermore, few resources exist that are culturally and linguistically accessible for a significant portion of this population. Unhealthy behaviors place many of our patients at risk for a variety of health problems.

Methods: The Community Wellness Program at SFGH provides patient participants with active living classes free of charge, with the aim of increasing self-efficacy, behavior change, and community cohesion. Our group-centered, exercise classes led by professional instructors promote reciprocal determinism, community engagement, healthy eating and active living. Cross-sectional questionnaires from a convenience sample of patient participants at SFGH are conducted quarterly. Our scaled questionnaire assesses domains of patient satisfaction and asks whether the program meets participant needs. A subset of patients are sampled with an expanded questionnaire assessing self-rated health and demographic characteristics.

Results and Discussion: The incorporation of knowledge related to healthy eating and active living provided by our wellness series increases patient participant self-efficacy. Gaining intimate knowledge of the needs, interests, and sensibilities of our medically underserved patients has enabled us to thoughtfully develop more patient-centered wellness programs and services. Increased attendance to our multilingual wellness classes and cultural awareness events demonstrates the compelling need of tailored wellness services for the medically underserved.