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How Health Clubs Still Serve At-risk Groups Amid Pandemic

IHRSA spoke with four health and fitness centers leading the industry in health and wellness programming. Here's how they're continuing to serve at-risk populations.

For many health club operators, owning a fitness business is a calling to help their communities live healthier, active lives. Many such operators offer specialized programming for people with or at risk for chronic health conditions, older adults, or people living with a disability. This is not just extra programming, but rather a key part of their mission and business.

COVID-19 has turned the world upside down for the entire fitness industry, especially so for clubs whose primary audience consists of groups at higher risk of developing a more severe case of COVID-19. A big question for these facilities: How do we continue to provide vital exercise opportunities for these members while prioritizing their safety both inside or outside the club?

IHRSA spoke with four health and fitness centers leading the industry in health and wellness programming.

Pre-COVID-19 Programs Addressed a Variety of Health Issues

The four clubs offer programs for people with:

  • Parkinson’s disease,
  • cancer,
  • spinal cord injury,
  • intellectual disability, and
  • those who are deconditioned or at risk of chronic disease.
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Atlantic Club, Red Bank, NJ

For example, the Atlantic Club, a medical fitness certified facility, offers p.r.e.p., or Physicians Referred Exercise Program, a 60-day introduction to fitness. The club had 225 doctors referring deconditioned patients and those at-risk for chronic disease into the program and a staff solely dedicated to this population.

Other offerings include:

  • HealthyCare Nutritional Counseling,
  • Exercising with Cancer,
  • Senior Active Aging programs, and
  • Delay the Disease, a program for people with Parkinson’s disease.

Gainesville Health and Fitness Center (GHF) runs “Fit for ALL,” an inclusive training program for people with intellectual disabilities. Before closing due to COVID-19, the program, a collaboration with the local Special Olympics organization, served approximately 50 active athletes with assistance from 65 student volunteers.

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Gainesville Health and Fitness Center, Gainesville, FL

Active Wellness, which operates both corporate sites and community fitness centers in Northern California, also runs p.r.e.p. at many of their community center locations. In addition to p.r.e.p., Active Wellness has several condition-specific programs, including:

  • cancer wellness,
  • cardiac rehabilitation,
  • Boxing for Parkinson’s,
  • diabetes and weight management,
  • fall prevention, and
  • stress management.

Healthtrax, a health club chain in the northeast operating 16 locations, ran a series of programs prior to COVID-19, including:

  • Healthy Steps, a diabetes management and long-term weight loss program integrating registered dietitians and exercise physiologists,
  • a bariatric surgery support group at one center,
  • Phase 1 and Phase 2 Cardiac Rehab administered by a hospital partner,
  • allied health services including nutritional counseling and physical therapy, and
  • p.r.e.p.

Adapting Programs to the Pandemic

Many clubs have taken their services virtual amid widespread club closures, including health programming. Active Wellness, for example, moved all of their programs to virtual offerings, including group classes, personal training, health coaching, and educational workshops. According to Michele Wong, Active Wellness’ vice president of operations, they “have implemented new safety procedures adapted for each location in collaboration with our healthcare partners.”

The Atlantic Club is working on taking their nutritional counseling services online as well as looking at what types of virtual content and services they can develop for the deconditioned or at-risk populations that may not want to come back to the physical club initially. The plan is to launch these services 45-60 days after reopening (as of the writing of this article, New Jersey clubs are still closed).

While GHF has reopened, they were not able to resume their program. Fit for ALL relies on student volunteers from the university—which is closed—to operate. Another challenge is that many of the group homes and local organizations bringing athletes to the program were under a strict stay-at-home order. As of this article’s publish date, GHF plans to resume their program in September, with some partner organizations lifting their restrictions.

They have been working on adapting the program to provide athletes with options for working out at home with their caretakers. According to Noah Hastay, GHF operations manager, these “include both video and written instructions in which the exercises can be regressed and progressed based on each athlete’s individual ability levels. The videos will be done in house with exercises the athletes are familiar with from the class but adapted with at-home equipment.”

Overcoming COVID-19 Related Challenges With Flexibility, Virtual Options

Clubs anticipate challenges around physician confidence and staff bandwidth.

“Bottom line, we are the solution to the pandemic. Stronger immune systems will give folks a better chance to fight off the virus.”

Steve Cappezzone, CEO

Healthtrax Fitness & Wellness

The Atlantic Club notes the need to focus on reopening and safety protocols, and the length of time clubs have been closed and not operating vital programs. With limited capacity in clubs and potential concern from doctors about exercise indoors for some populations, they anticipate a decline in their medical referrals.

Active Wellness acknowledges the challenges with continuing their medical referral programs, but they have focused on working with doctors and patients to meet patients’ needs—no matter where they are.

“We have had to work with these individuals and the physicians who refer them to balance the risk of COVID-19 exposure with the benefits of the program,” Wong says “For some of our participants, this has meant only virtual participation based on their comfort level and physician guidance. This has required a little bit of extra hand-holding, in some cases, to help our members adapt to using technology that may have been unfamiliar to them. What is most important is that no matter how we do it, our goal has been to maintain [the] connection in any way possible.”

Meanwhile, for GHF, the biggest challenge was around making virtual programming work for the different groups they serve. Hastay says, “We work with people with intellectual disabilities, physical disabilities, and/or cognitive disabilities, so this can be challenging to have content that is applicable to all.”

For Healthtrax, consumer fear and government regulations have been the biggest challenge. Healthtrax CEO Steve Capezzone says, “Obviously, people with pre-existing conditions are not comfortable coming back yet, but they are also encouraged to stay home due to the various state regulations.”

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Keeping Your Highest Risk Members Safe & Reassured

All four clubs emphasized cleaning and safety protocols. These include:

  • Enhanced cleaning and sanitization. As Atlantic Club COO Kevin McHugh put it, the club is “surgery center level of sanitization as well as social distanced.”
  • Social distancing of at least six feet between participants at all times.
  • Temperature checks and COVID-19 symptom screening for staff and members.
  • Employee and member mask-wearing (except when exercising).
  • Adding ionization systems to their HVAC system.

In planning to resume the Fit for ALL program, Hastay and GHF focused on cleaning, avoiding cross-contamination, and implementing a mask policy. He says, “We will ensure all equipment is disinfected and sanitized before and after use. Rather than moving through stations, athletes will stay in one spot and use the same equipment throughout the whole workout to prevent cross-contamination. Athletes and volunteers will be pre-screened before returning and before each class for the foreseeable future. All volunteers will wear a mask the entire time, and athletes will wear masks when not performing exercises.”

When The Atlantic Club reopens, they will offer a particular time of day for seniors to provide them with specialized programs and have added additional sanitizing before and after these hours to reduce their risk. McHugh says, “It is not about if our Club is SAFE… it is the risk concerns of this population, whether from chronic disease or age. We have protocols that far exceed our guidelines.”

Active Wellness also implemented temperature checks and screenings.

“We have added additional sanitation stations and enhanced cleaning measures, social distancing signage, a new member code of conduct, and issued PPE to all of our staff,” Wong says. “We have also had to rely on on-line scheduling for every service, event, and appointment to ensure we are ready to service our members when they arrive and maintain safe participation levels.

“In some cases, we have moved programs outdoors, where space is available, and equipment around in facilities to create more space. Where we have not been able to move equipment, we have placed signage on equipment and unplugged equipment to ensure adequate space between each piece of equipment in use.”

Capezzone also talked about the importance of communicating with members regularly. He says, “We are very safe, although many members and patients are holding off returning. We are working hard to keep them informed about all the new standards and encourage them to participate in our virtual classes if they’re not yet ready to come back to the center.”

Addressing Member Concerns

“To ensure our members feel safe, we have shared our commitment to be transparent about any confirmed cases of COVID-19 among our staff or members.”

Michele Wong, Vice President of Operations

Active Wellness, San Francisco, CA

The Atlantic Club and Healthtrax have both leveraged video to help reassure members the club is safe—and show them just how safe.

“We have developed videos that we have sent to our members that show them how we have socially distanced our equipment and created three distinct fitness studios; Cardio Studio, Technogym Selectorized Studio, as well as a new Free weight Studio,” says McHugh. “We developed a Group Cycling and Group Exercise Video that shows social distancing, our new use of space...and recently completed a Sanitization and Cleaning Video that showcases how we are SAFE and clean and incorporate non-toxic products that are chemical-free and kill all pathogens.”

According to Capezzone, “[Healthtrax] has produced videos of our facilities and posted them on our website. We are doing a ton of member communication and updates to keep them informed.

“Bottom line, we are the solution to the pandemic. Stronger immune systems will give folks a better chance to fight off the virus,” he added.

The Atlantic Club is also leveraging more virtual options in the club. They have added a virtual Group Cycling Studio and launched in-club, virtual classes with a new sound system in all of their studios as well as two, 75-inch screens for the virtual class schedule.

GHF members also have concerns about the effects of an inactive lifestyle. “High-risk members definitely have fears of returning; however, many have more fear of not coming and what a sedentary lifestyle can do their overall health,” says Hastay.

Wong at Active Wellness discussed the importance of reassuring members through transparency. “To ensure our members feel safe, we have shared our commitment to be transparent about any confirmed cases of COVID-19 among our staff or members.”

“We fortunately have not had to communicate such a situation, but we know it is a possibility even with every precautionary measure in place,” Wong says. “We do not want our members to wonder if there has been an exposure. We hope they can rest assured that no news on this front is good news.”

Author avatar

Alexandra Black Larcom @ihrsagetactive

Alexandra Black Larcom, MPH, RD, LDN, is the Senior Manager of Health Promotion & Health Policy for IHRSA. She spends her days working on resources and projects that help IHRSA clubs offer effective health programs in their communities, and convincing lawmakers that policies promoting exercise are an excellent idea. Outside the office you'll most likely find Alex at the gym, running on the Charles River, or, in the fall, by a TV cheering on the Florida Gators.