Physical activity resources and programming for substance use treatment in U.S. residential treatment programs

Regular physical activity (PA) provides many physical and mental health benefits for people with substance use disorders (SUDs); however, multiple barriers exist integrating it into their treatment. This study examined the level of PA programming for adults in substance use residential treatment programs (RTPs) in the United States. Using the Substance Abuse and Mental Health Services Administration's treatment locator, RTPs were identified and categorized by facility type (short-, long-term, or combined). In each state, 25% of RTPs from each facility type were randomly selected. A representative from each RTP was interviewed to identify equipment, time, space, and staff available for PA programming. Of the 193 RTPs interviewed, nearly all valued PA (89.1%) and believed their clients desired its inclusion in their treatment (89.6%). Most RTPs reported having space for PA programming (90.7%), had aerobic (52.9%) and strength training (54.9%) equipment, and included mandatory (57.0%) or optional (87.6%) time in the schedule for PA. Fewer RTPs reported having full- (24.3%) or part-time (56.8%) staff trained to lead PA programming. The most common organizational barriers were a lack of funding/resources (63.7%), space (31.6%), and staffing (11.9%). The most commonly perceived client barriers included a poor mindset/lack of motivation (55.4%), poor physical health (26.4%), client withdrawal/detoxification (14.5%), and general health issues (10.9%). RTPs valued PA and found unique ways to provide space, equipment, and time to offer PA programming. Future research should focus on strategies to overcome client barriers and increase staff qualified to lead PA programming. •Appropriate space, equipment, and time is necessary to promote physical activity.•Many treatment centers provide physical activity programming.•Creative strategies are used to overcome barriers to offering physical activity.•Greater staff training is necessary to enhance physical activity support for clients.