By: Gina Cortese Shipley, M.S.
It is common knowledge that exercise plays a vital role in healthy living. In recent years, the focus on the adoption of and maintenance of an active lifestyle has grown for a multitude of reasons from preventing chronic disease, to disease management, to lowering of health care spending, to increasing quality and quantity of life, just to name a few. As such, the exercise profession has rapidly evolved in order to meet these growing needs and interests. Despite this, there is still even greater potential for outreach and impact.
With greater attention placed on the profession, there has also been a corresponding increase in the scrutiny of professional qualification standards and a need to accurately identify qualified exercise professionals. All of the above led to the formation of The Coalition for the Registration of Exercise Professionals® (CREP®), a not-for-profit 501(c)(6) corporation dedicated to securing recognition of registered exercise professionals for their distinct roles in medical, health, fitness and sports performance fields. Coalition members are committed to:
In order to achieve the above, CREP has focused its efforts in a few key ways, one of which has been the creation of the U.S. Registry of Exercise Professionals or USREPS. USREPS identifies those professionals who have passed (and who maintain) a competency-based program using an exercise certification exam that has been accredited by the NCCA. It is the intention of CREP to support and further the industry by having USREPS:
As you can see, CREP is truly trying to make a difference in the lives of professionals and the public alike. But USREPS isn't the only way we are making a difference. Check back next month to learn more about our other efforts!
by Torrey Smith, MA, CSCS,*D; CSPS,*D; NSCA-CPT,*D; TSAC-F,*DNational Strength and Conditioning Association (NSCA), Certification Director
The personal training space is crowded with a multitude of educational resources and certifying bodies offering certificates and certifications. Nationally accredited certifications are important for helping trainers and clubs stand out from the crowd by designating these certified fitness professionals as meeting the highest standards of knowledge in the industry.
A Foundation for Success
A strong foundation in evidence-based research, as provided by several nationally accredited certifications, gives personal trainers the knowledge and tools to adapt and evolve to new techniques and equipment, and develop individualized programming to meet client needs and goals. Having the ability to discern the good from the bad when it comes to new programs and the latest technology is critical for a personal trainer to excel.
Imperative to a client's success, and gained through an educational foundation, is a trainer's ability to:
Nationally Accredited Certifications Matter
Accreditation from a national body such as the National Commission for Certifying Agencies (NCCA) is a third party check-and-balance system that ensures an organization's certification processes and examination systems are fair and valid. The NCCA accreditation shows that an organization's program has met the stringent standards of the credentialing community and is both credible and legitimate. Nationally accredited certifications exhibit the highest standards of excellence within the health and fitness industry.
With a wide variety of associations offering certification within the fitness industry, it's important for personal trainers and club owners to align with an organization that best fits their individual style, training philosophy, and career goals.
Commitment to the Profession
For club owners, personal trainers who work to obtain a nationally accredited certification demonstrate a commitment to the profession and excellence. Individuals who are willing to work hard and put in the time to pass a comprehensive exam are likely to carry that work ethic into helping your members achieve their goals. A member who sees success, thanks to the dedication of their trainer, is likely to remain loyal to your facility and spread the word about their success and experience.
by Tom Richards, Director of Corporate Engagement, American Council on Exercise
This year, millions of American adults will visit their doctor for a routine check-up. Two out of three will be overweight or obese. At least four out of five will be less active than the recommendations set forth in the Physical Activity Guidelines for Americans.
In most cases, the doctors will easily recognize the need for their patients to make lifestyle changes. But many of the patients will never hear that message. In fact, fewer than half of all primary care physicians routinely provide their patients with guidance on lifestyle behaviors, such as diet, physical activity or weight control. Other patients, however, may be fortunate enough to have a one-minute conversation with their physicians about the need to make a lifestyle change. Phrases such as "Watch what you're eating," and "Try to get more exercise," will be common. In a small percentage of cases, the conversations may even include specific nutrition guidance and an exercise prescription.
The patients will nod along, distressed but not terribly surprised. They will know that their clothes from a few years back are tighter, and that they don't have as much energy as before. Hearing it from their doctors, however, will bring some necessary focus to the issues. As they leave the office, many of the patients will tell themselves it's time to make a change.
But they will arrive at home, or go back to work, and they will likely be immersed in an environment that supports unhealthy eating and sedentary behaviors. For many, willpower will be no match for the cultural environment. Knowledge and a desire for change will not be enough alone to change. Rather, Americans struggling with weight management and poor fitness need support, guidance and expertise on behavior change.
"The breakthrough medicine of the 21st century is behavior change," says Dr. Eddie Phillips, Founder and Director of the Institute of Lifestyle Medicine. Doctors want to help, of course, but they generally lack the time, training and skills necessary to empower their patients to live a healthier, more active lifestyle. That's slowly changing through the great work of organizations like the Institute of Lifestyle Medicine, but it's unlikely that physicians will ever be the key providers of intensive behavior change counseling. The time demands of the profession are simply too great.
The responsibility of providing the breakthrough medicine of the 21st century must ultimately be borne by other health professionals—well-qualified fitness professionals, health coaches, nurses, registered dietitians, medical assistants, physician assistants and others—who have received the proper training and gained the necessary expertise to create sustainable behavior change. These professionals will be the linchpin of a new health care system that supports people in between trips to the doctor—a system that focuses on healthy behaviors and the prevention and mitigation of chronic disease. And so in the future, millions of Americans will leave their doctor visits not just energized to adopt healthier habits, but fully empowered to do so, thanks to the vital support provided by health and fitness professionals.
By Dr. Brian Biagioli NCSF Executive Director
Is nutrition really within the scope of professional practice(s) of exercise professionals? Clearly, role delineation studies identify nutrition and weight management competencies as roughly 10% of an exercise professional's job. So it must have some place within the scope of practice. Additionally, certified fitness trainers, strength coaches and Pilates teachers are constantly asked by their clients to provide information regarding novel dietary strategies, the latest trends in pop-culture (diets), as well as what vitamins and performance-enhancing supplements work (or don't). So what is appropriate behavior?
To start the conversation, it is important to first recognize that the nutrition profession is regulated at the State level. This means two things: 1) no federal laws exist regarding the practice, so it is up to each State to make determinations of practice requirements and scope; and 2) it is up to the practitioner to know and understand the laws in the State where they work to ensure they are compliant and not overreaching.
The Center for Nutrition Advocacy has done a great job of helping professionals better understand the specific laws of each State on their website: http://www.nutritionadvocacy.org/laws-state. The State map of current laws is "clickable" by State and provides summaries and insight into what an exercise professional can and can't do; and the legality varies fairly widely. According to the legend, in red States it is illegal to perform individualized nutritional counseling unless licensed or exempt from licensing by the State. In green States on the other hand, it is legal for anyone to perform individual nutritional counseling. Yellow and orange states have specific requirements, but in all States the ability to provide some level of nutritional education exists. A complete list of States where licensing exists can be found on the website of the Academy of Nutrition and Dietetics at https://www.cdrnet.org/state-licensure.
So this begs the question how does an exercise professional ensure they are not breaking the law? It all comes down to what is said and done, and how it is presented. Most registered dieticians agree that individualized nutrition recommendations are outside the exercise professional's scope of practice. But disseminating information is not. For instance, exercise professionals may come under legal challenge if they write specific diets, particularly for those clients with disease or a special condition; or provide nutritional care plans or modify medical nutrition regimes. But in even the most regulated States, exercise professionals can perform anthropometric assessments, provide information about energy and non-energy yielding nutrients, explain the risks associated with nutrient insufficiency and deficiency, explain caloric values and metabolic concerns of consuming certain foods like processed carbohydrates and alcohol. For the most part, the greatest risk of legal challenge or liability is associated with the descriptive title employed by the professional, the specific prescription of dietary plans, and providing nutritional advice in regulated States.
Some States provide resources that aid is determining what is regulated by law and what is not. For instance, the Ohio Board of Dietetics has a link to scope of practice rules found at http://dietetics.ohio.gov/guidelines/guidelineD1.pdf which is consistent with the requirements in most of the States identified by the legend as red. Exercise professionals who are educating clients to better lifestyle habits and activities that reduce risk for disease should evaluate the tools available from the State to ensure they remain in compliance. That said, disseminating published nutrition recommendations from government agencies including the CDC, NIH and DPHP (https://health.gov/dietaryguidelines/2015/) is very much a part of an exercise professional's job. Americans need help losing weight and reducing the risk for disease and the government wants exercise professionals to help. On the 2015-2020 Dietary Guidelines for American Webpage it states:
"The 2015–2020 Dietary Guidelines is designed to help Americans eat a healthier diet. Intended for policymakers and health professionals, this edition of the Dietary Guidelines outlines how people can improve their overall eating patterns — the complete combination of foods and drinks in their diet."
Chapter 3 of the aforementioned Dietary Guidelines is titled "Everyone Has a Role in Supporting Healthy Eating Patterns". Exercise professionals should be encouraged to get informed and then get to work on the national obesity issues.
By Ray Infante, MA, LMT, Certification Manager - Pilates Method Alliance
February is heart health month, and for many that have experienced the pain attributable to heart disease directly or through social or familial associations, it is the month to share the realities of heart disease with as many people as possible. In February, the fact that heart disease is the leading cause of death in the U.S. is inserted into the public sphere, just after the holidays. Despite the truth of the message, many fortunate enough to not have it impact their lives perceive the issue as one more serious factoid that is "out there," beyond their personal reality.
New year's resolutions are expressions of an individual's desire for change in their life, and in our culture, resolutions are encouraged during the holidays and more specifically as one approaches the 31st of December. Recovery on the 1st is a transitional process, a movement from the blurry festivities of the dawn of the year to a clear vision and the imperative to make good on resolutions. Gym memberships are purchased; diet books, stretch bands, juicers, and any other item potentially related to health and fitness become key searches on Amazon. Everyone seems aware of the benefits of a healthy lifestyle; the messaging into the public sphere has had success, and the fact that healthy lifestyles tend to lead towards a leaner body also helps. People want to look good; one could argue that looking good is a stronger motivator than the fact that heart disease can be avoided by adopting healthy patterns. Does it really matter what the motivator is?
February is also a month for resolution-indifference. Life is complicated and the workout at 6 becomes more and more difficult to attend as weeks pass; there are meetings; children's school functions; there are many tasks related to participating in our society, and, on or about February, these tasks get moved to the top, and fitness starts to become an inconvenience. Who has time to peel the veggies at 7 am?
If someone considering abandoning their healthy new year's resolution was made aware of the fact that a heart attack was in their future and that the attack could be prevented through the adoption of a healthy lifestyle, it would seem likely that the individual would revive their resolution and push complicated life's tasks back down to the bottom of the list where they belong.
Fitness is key in a healthy lifestyle. This has become universally understood in the U.S., yet February comes around, and many exercise professionals struggle to keep the motivation of their clients going. Forget the vanity and focus on the health benefits. Exercise professionals cannot predict the future, but they have at their disposal a tool that reveals the potentiality of harm, as well as the potential for well-being. The tool is research.
Many professionals think of research as a laborious undertaking beyond their capacity, but in fact some articles are easy to read, comprehend, and most importantly, share with clients. One such article addresses the benefits of mat Pilates on agility, mobility, and cardiorespiratory fitness in elderly women. In less than 10 pages, a reader learns that Mat Pilates improved the agility and functional mobility in a group of inactive women above sixty years of age! 1 Mat Pilates is an example of an exercise that offers a spectrum of application from marginal exertion to a heavy-breathing workout. It does not require excessive force, heart rate monitors, or any special attire, yet it offers a vehicle for fitness that is accessible to everyone without a tremendous commitment that could be dismissed in February. In a similar article, Tsai conducted a large trial of 88 people ages 20-65y/o practicing mat Pilates over a 12 week period showing significantly improved cardiorespiratory function. Tsai's study clearly shows the benefits of mat Pilates on agility, mobility, and cardiorespiratory fitness2.
The value of fitness needs to be emphasized, explained, and brought home with a smidgen of fear, prior to the onset of resolution-indifference because the motivator does matter; the realities of heart disease are a more compelling reason to stick with health than the notions of a lean body. Exercise professionals must become knowledgeable of the research available, across the fitness landscape. There is research out there that supports the value of all fitness. If the threat of heart disease is repositioned from "out there" to a client's reality, indifference would become a harder choice to make.
It becomes an imperative for the exercise professional to familiarize themselves with as much information on the value of exercise as possible to help their clients keep their new year's resolutions. As professionals, they must put their heart into it because they could potentially save someone's life.
by Richard Cotton, MA, ACSM-CEP National Director of Certification, American College of Sports Medicine (ACSM)
Read last's month's CREP blog to gain insight into the objectives of the following survey results.
The international sample showed that nearly a third (33%) of respondents moved from the country of their birth, but did not move specifically to take a job in the fitness field, but rather moved for other reasons.
When asked to select the highest level of education completed in any field, as well as the highest level of education for preparation to work as an exercise professional from this list:
International Standard Classification of Education (ISCED)
Regardless of the source, we are an educated lot of professionals!
Hours per Week Directly Training Clients
When asked "How many hours per week do you spend directly training clients or patients?" The results were somewhat similar.
Ideas for Providing Services to Those of More Moderate Income
By: Richard Cotton, MA, ACSM-CEPNational Director of Certification, American College of Sports Medicine (ACSM)
The ACSM trend report is an annual survey, now in its tenth year; the survey was completed by more than 2,800 health and fitness professionals worldwide, many certified by ACSM, and was designed to reveal trends in various fitness environments. Forty potential trends are given as choices, and the top 20 were ranked and published by ACSM, including a few new additions to last year's list, one of which rose immediately to the #1 spot.
1. wearable technology
A comparison of these lists is insufficient to make substantive statements on the future of personal training.
In order to more accurately assess and predict the future of personal training, ACSM conducted an additional study.
The objectives of the survey are as follows:
The survey was distributed electronically through Survey Monkey to approximately 30,000 ACSM certified exercise professionals (including international certificants).
While this survey did not provide definitive results regarding the future of personal training, it did provide insight into the education, commitment, creativity and love for the work.
Did gender affect the results?
In "All Data," which was primarily Americans, women made up 63% of the sample; however, internationally, women made up about 45% of the participants. International respondents consisted of ten percent of the total data.
Some more interesting results were found. Read on next month!
Since launching the United States Registry of Exercise Professionals® (USREPS®) in January 2014, the members of CREP have been working hard advancing our mission of gaining recognition of registered exercise professional for their distinct roles in medical, health, fitness, and sports performance fields. In support of furthering the profession, one of our main initiatives has been raising awareness around USREPS®. It has been our hope that the registry serve the industry by: identifying those individuals who have met a uniform standard for their professional qualifications; assisting potential and current employers through credential verification of all validated NCCA-accredited certifications an exercise professional has earned; and serving as an assurance for consumers that registered exercise professionals have been vetted for their qualifications.
We recently checked in with Jeff Monaco, M.S., CSCS, National Fitness Educator at Gold's Gym, to see his thoughts on the state of the profession and how USREPS® has impacted him and his organization.
I understand that you recently went through a process of ensuring your employees had valid credentials. Please explain what your purpose of this was (what was your motivation/the importance of it/why was there a need for this)?
When I as hired on as the National Fitness Educator for Gold's Gym, one of my first orders of business was to ensure that all members of our Fitness Team met the minimum requirements to deliver safe and effective exercise programs for apparently healthy individuals that were members of our gyms. This meant that I needed to ensure that every team member held a valid personal training and/or group fitness certification from a recognized certifying agency. The purpose behind this review was to make sure we were living up to the promise we give our members that every one of our Fitness Team members is nationally certified in their specific discipline. The importance was to ensure our team members had the qualifications necessary to design safe and effective exercise programs for our members. There was a need for this because our company has over 1,200 Personal Trainers and over 4,000 Group Exercise Instructors. With that many Fitness Team members, and turnover in both departments, it is very difficult to keep track of every certification. How exactly did you go about this (what was your criteria, what actions did you take, tools did you use to assist, the process)?
The first step in reviewing our Fitness Team's certification was to establish a baseline requirement for all team members. The baseline requirement we set was that every personal trainer hired by Gold's Gym must have at least one NCCA accredited personal training certification, and it must be current. The second step was to gather the certification information from every single Personal Trainer on staff. That meant gathering the certifications for over 1,200 Personal Trainers. After all the certification information was gathered, I had to verify each Personal Trainer's certifications. To verify the certifications, I utilized several tools including the certifying agency's website, calling the certifying agency directly, and using USREPS®. What I liked about using USREPS® is that it provided all the certifications from member organizations for the individual I was looking up. Instead of having to contact multiple certifying agencies for one individual, I was provided information on all the certifications held. That dramatically cut down the time needed to verify several certifications for one individual. What has been the impact/outcome that has resulted from going through this process? How has this affected the way you do business?
In my opinion, the Fitness Industry holds itself back by not holding itself to a much higher standard of education and credentials for its professionals. There is an enormous need in our country for highly qualified fitness professionals. Fitness professionals that can work alongside other allied health care professionals to provide the knowledge and expertise to combat our Nation's health crisis. I applaud organizations such as USREPS®, and the member organizations, that are working diligently to increase the standards of our industry. The impact for Gold's Gym has been that we have increased our hiring standards for Personal Trainers and Group Exercise Instructors. We have implemented a tier structure for our personal trainers that allows them to increase their income by continuing their education and obtaining additional approved certifications. As the most recognized name in Fitness, we want to do our part to ensure that we are providing highly qualified fitness professionals for our members, and the community. What are your plans to continue ensuring your employees carry valid credentials (including non-expired)?
We are now more diligent with verifying the credentials of every applicant before they are hired. Additionally, we continuously review our Personal Trainers' and Group Fitness Instructors' certifications weekly to ensure compliance. How would you like to see the fitness industry grow/change?
I would love to see the fitness industry become more regulated in a sense. I believe fitness professionals should be required to have at least an associate's degree in exercise science with a national board exam required for licensure. Nobody seems to question those requirements for Athletic Trainers, Registered Dietitians, Medical Technicians, etc., however, there is always a huge push back from the fitness industry when states try to regulate fitness professionals. Do you see USREPS as a part of supporting that?
I see USREPS as a large part of increasing the standards and requirements to become a fitness professional, and I would like to see them take a stronger stand in this area. We want to thank Mr. Monaco for his time in providing his insight and feedback and commend him and Gold's Gym for their incredible work. For more information on USREPS®, check us out at usreps.org. Contact us at [email protected], if you have any feedback you would like to share. We would love to hear from you!
By Maddie Fromm, American Council on Exercise
The Coalition for the Registration of Exercise Professionals (CREP), along with several other key organizations representing the fitness sector in the U.S., recently signed on to the Marseille Declaration. This marked the global launch of the Marseille Declaration as well as the launch of the Universal Fitness Innovation & Transformation (UFIT) USA Taskforce.
The Marseille Declaration represents a global social change movement and is supported by the United Nations Educational, Scientific and Cultural Organization (UNESCO) and promoted by the UNESCO Chair and its signatories. It is meant to bring together fitness industry leaders (and all those serving, operating and shaping the sector) to increase opportunities to engage with people with disabilities. It is a means to encourage these leaders to advocate, innovate and transform practices to enable the full and effective participation of people with disabilities in the fitness sector.
Originally introduced in Marseille, France, in 2015, UFIT is a social change movement aiming to increase fitness opportunities for people with disabilities by building capacity in health and fitness clubs and making access to high quality fitness experiences the norm for all individuals. The UFIT project calls on the fitness industry to be more inclusive of people with disabilities in their operations and asks people with disabilities to explore all that fitness clubs have to offer. CREP is proud to play a part in facilitating this movement in the U.S.
The goals of the UFIT USA Task Force include the following:
For more information on UFIT, visit www.justdoufit.com.For more information on ACE, visit https://www.acefitness.org/.
by Brian Biagioli, NCSF
Reputable organizations that support clinical and applied exercise professions have made significant strides in improving competency standards and the technical capabilities of practitioners over the past three decades. Maturity in the standard-setting division of the health and fitness industry has positioned specific professions for distinct roles within the allied health sector. The charge toward raising the bar and earning recognition for qualified exercise professionals has been the primary mission of the Coalition for Registration of Exercise Professionals® (CREP®). The multi-organization members of CREP® all provide certification programs accredited by the NCCA, consistent with those aligned professions of the allied health fields including physicians, nurses, registered dietitians, and athletic trainers. This is significant for career-oriented professionals as the allied health landscape provides a growing number of future opportunities for those pursuing health-related careers.
The first step in the process of elevating the exercise professions is establishing a recognized distinction of competency. CREP® has done this by creating the largest register of exercise professionals in the world. Consumers and employers can trust that those individuals listed in the United States Registry of Exercise Professionals® (USREPS®) have been vetted against a uniform and recognized standard, are required to comply with ethic and professional practice guidelines, and are in good-standing with their professional credential requirements. No other mechanism in the United States meets this level of consumer protection for employing an exercise professional.
Consistent with governmentally regulated professions, CREP® members require passing a competency-based examination in order to be eligible for registration. The term "Registered Exercise Professional" is the new distinction in the health and fitness industry to identify an individual who is appropriately qualified to provide services related to their specific role acknowledged within the registry. This follows best practices of other leading allied health professions. USREPS® is a member of the International Confederation for Registers of Exercise Professionals® (ICREPs®), a multi-continent association of registers from around the world. Based on the documented, internationally-recognized competency standards for registered exercise professionals, those listed in in USREPS® have the opportunity for portability of their credentials to registers in other countries.
The credentialing process is not the only bar that has been raised within the fitness industry. In further alignment with compatible allied health fields, the competency requirements of professions on the register is supported by programs in secondary education. College and university exercise science programs are expected to use the role delineation data from job task analyses of the registered professions to help set curriculum for specific roles if they seek program accreditation through the Commission on Accreditation of Allied Health Education Programs (CAAHEP). The Committee on Accreditation for Exercise Sciences (CoAES) is the body that evaluates alignment based on the identified tasks required of the roles associated with exercise science programs. CAAHEP program accreditation ensures that students have covered the learning domains necessary for success on competency-based exams from NCCA accredited certification programs. While a college education may not be a pre-requisite for certain roles on the registry, it further aids in the distinction and recognition for those that require a certificate, 2, or 4 year degrees as part of the competency requirements.
CREP strongly encourages stakeholders at all levels to become educated in the manner professionals earn qualifications so they may be eligible for the United States Registry of Exercise Professionals®. For more information on member organizations, academic programs, employment, and consumer protection please go to USREPS.org.