Электронный научный журнал

The need to expand health-promotion programs delivered by fitness trainers is driven by the state strategy for fostering a healthy lifestyle and the limited capacity of the medical workforce. However, in the Russian legal system, the trainer's activity is artificially confined to the sphere of leisure, which precludes their full integration into preventive work with the population. The article systematically outlines the trainer's competency potential in primary and secondary prevention, categorizes specific regulatory and legal barriers, and proposes a concept of a «health promotion specialist» – a new professional institute for the Russian Federation that would integrate the efforts of physicians and trainers. Objective: To substantiate the necessity of creating legal mechanisms that would allow the lawful utilization of the fitness trainer's potential when working with comorbid populations, and to formulate a package of legislative initiatives. Materials and Methods. The study employed a systematic analysis of regulatory acts, the method of legal modeling, and a synthesis of expert opinions. Results. A paradox has been identified: a trainer who possesses sufficient methodological competencies to supervise individuals with chronic diseases in the compensation stage cannot apply them due to the risk of being accused of illegal medical practice. As a solution, a model is proposed in which the trainer acts on the basis of a formalized physician's prescription, and their liability is insured. Conclusion. The absence of a special legal status blocks the scaling-up of preventive programs. Specific amendments to legislation are proposed that would enable the establishment of a system of health-promotion support in Russia by fitness professionals without compromising patient safety.