Lace Up and Learn: The Power of Community Walking Programs

When primary care is delivered in 15-minute doses, there is little time to go beyond acute issues and routine screenings. However, family doctors are finding other ways to support patients on their path to better health and well-being.

“I don't think we're doing our community justice with the health education that we have currently,” says Ali Butt, a fourth-year University of Toronto medical student based in Mississauga.

“If I’m talking with a patient, it’s not uncommon for them to be surprised that drinking alcohol is linked to dementia and cognitive impairment, or that moderate physical activity means you shouldn’t be able to hold a conversation. I created Walk with a Future Doc to help change that.”

Affiliated with the global non-profit Walk with a Doc, the Mississauga program aims to use movement and conversation to promote community health.

The monthly walks are led by medical students, residents and other clinicians, with each walk focusing on a specific theme, such as mental health and sleep hygiene, as well as seasonal affective disorder. Each begins with a 10-minute educational talk before the walk gets underway.

Since launching in 2022, the program has welcomed more than 100 community members and connected them with 14 different clinicians.

“It’s part education, part physical activity, part social connection,” says Butt, who plans to specialize in family medicine after completing medical school. “To me, this is what community medicine is about.”

For some participants, the exercise might be the prescription in itself.

At Mount Sinai Academic Family Health Team, Dr. Sabrina Kolker leads a walking program for individuals recently diagnosed with type 2 diabetes. Walking offers a low-impact, accessible form of exercise that helps regulate glucose levels, reduce insulin resistance and promote cardiovascular health.

"During residency, I did a research project on prescribing exercise for people with type 2 diabetes, and one thing that stuck with me was how uncomfortable clinicians are talking about exercise,” says Dr. Kolker, a family doctor and two-time Olympian who competed for Team Canada in women’s rowing.

“Many of us know our own exercise habits are less than ideal, and, as a result, don’t feel confident having that conversation with our patients.”

Her research led to a pilot program where participants meet every other week for a 20-minute “lace up and learn” talk from a diabetes expert, followed by a walk.

“The education sessions are useful, but it’s the conversations that happen on the walk that have the most impact,” says Dr. Kolker, an assistant professor in the Department of Family and Community Medicine at U of T.

“As a clinician, it gives you the time to get to go so much deeper, to understand how their diabetes fits into the fabric of their lives, what other support they might need and how to help them through what can be a very challenging diagnosis. Plus, you have the peer support component.”

Dr. Nikola Despotovic and Dr. Alex Mouratidis helped lead the pilot as second-year family medicine residents. For them, the program was mutually beneficial.

“It can be frustrating to have just a few minutes with a newly diagnosed patient to try and get across all this important information and then not see them again for a few months,” says Dr. Mouratidis.

Dr. Despotovic adds, “But with this program, instead of saying the same thing to three patients, you’re bringing a group of patients together so we can use the time to go beyond surface information, build support networks and go on a walk.”

These connections are particularly valued by Andy Liu, a Mississauga resident and regular Walk with a Future Doc participant.

“My wife and I joined the program to help with her recovery after she had two strokes and brain surgery,” he explains.

“She has a family doctor, but it is different on a walk. There are more opportunities to ask questions and learn more about all sorts of conditions. Plus, being new to the area, it’s a great way to talk and make friends. You can’t be staring at your phone the whole time when you are walking.”

Although it began with a small pilot group, Dr. Kolker and the team saw improvements in blood sugar level management in nearly all participants over a 12-week period.

These programs demonstrate the power of blending education, exercise and social connection to foster stronger relationships between patients and clinicians and take care beyond the clinic, one step at a time.

Originally published in the 2024-2025 Family Medicine Report. Read the full report