Top

International Journal of Behavioral Medicine

Published in:

01-06-2018

Service Evaluation of an Exercise on Referral Scheme for Adults with Existing Health Conditions in the United Kingdom

Authors: Grant J. McGeechan, Dawn Phillips, Lynn Wilson, Vicki J. Whittaker, Gillian O’Neill, Dorothy Newbury-Birch

Published in: International Journal of Behavioral Medicine | Issue 3/2018

Abstract

Purpose

This paper outlines a service evaluation of an exercise referral scheme for adults suffering from a variety of physical or mental health conditions or who were deemed are at risk of developing such conditions. The evaluation aimed to assess the impact of the scheme at increasing physical activity and at reducing BMI and waist circumference.

Method

This was a retrospective evaluation looking at levels of physical activity and changes to anthropometric measures over a period of 6 months. Each participant self-reported their levels of physical activity for the previous 7 days at three time points: baseline (T1), at 12-week exit from the scheme (T2), and at 6-month follow-up (T3). Waist circumference and BMI were also recorded by either a health professional or self-reported at these time points.

Results

Six hundred seventy participants were referred during the evaluation period, of whom 494 were eligible. Of those 494, 211 completed the 12-week scheme and 135 completed a 6-month follow-up. Significant increases in levels of physical activity were recorded between T1 and T2 and between T1 and T3. Furthermore, significant reductions in waist circumference were noted between T1 and T2 and between T1 and T3, and BMI significantly decreased between T1 and T2 but significantly increased between T2 and T3.

Conclusion

The service has proven effective at increasing levels of physical activity among participants and has had a positive impact on waist circumference and BMI for clients who remain engaged with the programme.

Department of Health, Start active, stay active: a report on physical activity from the four home countries’ Chief Medical Officers: London; 2011.

Batty GD, Shipley MJ, Kivimaki M, Marmot M, Davey Smith G. Walking pace, leisure time physical activity, and resting heart rate in relation to disease specific mortality in London: 40 years follow up of the original Whitehall study: an update of our work with professor Jerry N Morris (1910–2009). Ann Epidemiol. 2010;20(9):661–9. https://doi.org/10.1016/j.annepidem.2010.03.014.CrossRefPubMed

Williams PT. Reductions in incident coronary heart disease risk above guideline physical activity levels in men. Atherosclerosis. 2010;209(2):524–1. https://doi.org/10.1016/j.atherosclerosis.2009.09.018.CrossRefPubMed

Thomson CA, McCullough ML, Wertheim BC, Chlebowski RT, Martinez ME, Stefanick ML, et al. Nutrition and physical activity cancer prevention guidelines, cancer risk, and mortality in the women’s health initiative. Cancer Prev Res. 2014;7(1):42–53. https://doi.org/10.1158/1940-6207.CAPR-13-0258.CrossRef

Lee DC, et al. Leisure-time running reduces all-cause and cardiovascular mortality risk. J Am Coll Cardiol. 2014;64(5):472–81. 6CrossRef

Armstrong MJ, Sigal RJ. Exercise as medicine: key concepts in discussing physical activity with patients who have type 2 diabetes. Can J Diabetes. 2015;39(S1):S129–33.CrossRef

Farrell L, Hollingsworth B, Propper C, Shields MA. The socioeconomic gradient in physical inactivity: evidence from one million adults in England. Soc Sci Med. 2014;123:55–63. https://doi.org/10.1016/j.socscimed.2014.10.039.CrossRefPubMed

Garcia-Palmieri MR, Costas R Jr, Cruz-Vidal M, Sorlie PD, Havlik RJ. Increased physical activity: a protective factor against heart attacks in Puerto Rico. Am J Cardiol. 1982;50(4):749–55. https://doi.org/10.1016/0002-9149(82)91229-2.CrossRefPubMed

Jansen AP, et al. Effectiveness of case management among older adults with early symptoms of dementia and their primary informal caregivers: a randomized clinical trial. Int J Nurs Stud. 2011;48(8):933–43. https://doi.org/10.1016/j.ijnurstu.2011.02.004.CrossRefPubMed

10.

Haskell WL, et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007;39(8):1423–34. https://doi.org/10.1249/mss.0b013e3180616b27.CrossRefPubMed

11.

Hillsdon M, Thorogood M, White I, Foster C. Advising people to take more exercise is ineffective: a randomized controlled trial of physical activity promotion in primary care. Int J Epidemiol. 2002;31(4):808–15. https://doi.org/10.1093/ije/31.4.808.CrossRefPubMed

12.

Williams NH. “The wise, for cure, on exercise depend”: physical activity interventions in primary care in Wales. Br J Sports Med. 2009;43(2):106–8. https://doi.org/10.1136/bjsm.2008.051458.CrossRefPubMed

13.

Taylor AH, Doust J, Webborn N. Randomised controlled trial to examine the effects of a GP exercise referral programme in Hailsham, East Sussex, on modifiable coronary heart disease risk factors. J Epidemiol Community Health. 1998;52(9):595–601. https://doi.org/10.1136/jech.52.9.595.CrossRefPubMedPubMedCentral

14.

Pavey TG, Taylor AH, Fox KR, Hillsdon M, Anokye N, Campbell JL, et al. Effect of exercise referral schemes in primary care on physical activity and improving health outcomes: systematic review and meta-analysis. Br Med J. 2011;343(nov04 2):d6462. https://doi.org/10.1136/bmj.d6462.CrossRef

15.

Rouse PC, Ntoumanis N, Duda JL, Jolly K, Williams GC. In the beginning: role of autonomy support on the motivation, mental health and intentions of participants entering an exercise referral scheme. Psychol Health. 2011;26(6):729–49. https://doi.org/10.1080/08870446.2010.492454.CrossRefPubMed

16.

Williams H, et al. Effectiveness of exercise-referral schemes to promote physical activity in adults: systematic review. Br J Gen Pract. 2007;57(545):979–86. https://doi.org/10.3399/096016407782604866.CrossRefPubMedPubMedCentral

17.

Murphy S, et al. An evaluation of the effectiveness and cost effectiveness of the National Exercise Referral Scheme in Wales, UK: a randomised controlled trial of a public health policy initiative. J Epidemiol Community Health. 2012;66(8):745–53. https://doi.org/10.1136/jech-2011-200689.CrossRefPubMedPubMedCentral

18.

Lee ASW, Griffin SJ, Simmons RK. An evaluation of the effectiveness of ‘Active for Life’: an exercise referral scheme in West Suffolk. Public Health. 2009;123(10):670–2. https://doi.org/10.1016/j.puhe.2009.09.005.CrossRefPubMed

19.

Murphy S, Raisanen L, Moore G, Edwards RT, Linck P, Williams N, et al. A pragmatic randomised controlled trial of the Welsh National Exercise Referral Scheme: protocol for a trial and integrated economic and process evaluation. BMC Public Health. 2010;10(1):352–63. https://doi.org/10.1186/1471-2458-10-352.CrossRefPubMedPubMedCentral

20.

Hanson CL, Allin LJ, Ellis JG, Dodd-Reynolds CJ. An evaluation of the efficacy of the exercise on referral scheme in Northumberland, UK: association with physical activity and predictors of engagement—a naturalistic observation study. BMJ Open. 2013;3(8):e002849. https://doi.org/10.1136/bmjopen-2013-002849.CrossRefPubMedPubMedCentral

21.

Jones F, Harris P, Waller H, Coggins A. Adherence to an exercise prescription scheme: the role of expectations, self-efficacy, stage of change and psychological well-being. Br J Health Psychol. 2005;10(3):359–78. https://doi.org/10.1348/135910704X24798.CrossRefPubMed

22.

Sharma H, Bulley C, van Wijck FMJ. Experiences of an exercise referral scheme from the perspective of people with chronic stroke: a qualitative study. Physiotherapy. 2012;98(4):336–43. https://doi.org/10.1016/j.physio.2011.05.004.CrossRefPubMed

23.

Morton KL, Biddle SJH, Beauchamp MR. Changes in self-determination during an exercise referral scheme. Public Health. 2008;122(11):1257–60. https://doi.org/10.1016/j.puhe.2007.11.006.CrossRefPubMed

24.

Morgan O. Approaches to increase physical activity: reviewing the evidence for exercise-referral schemes. Public Health. 2005;119(5):361–70. https://doi.org/10.1016/j.puhe.2004.06.008.CrossRefPubMed

25.

McGeechan GJ, Wilkinson KG, Martin N, Wilson L, O’Neill G, Newbury-Birch D. A mixed-method outcome evaluation of a specialist Alcohol Hospital Liaison Team. Perspect Public Health. 2016;136(6):361–7. https://doi.org/10.1177/1757913916638687.CrossRefPubMed

26.

McGeechan GJ, Woodall D, Anderson L, Wilson L, O’Neill G, Newbury-Birch D. A coproduction community based approach to reducing smoking prevalence in a local community setting. J Environ Public Health. 2016;2016:1–8. https://doi.org/10.1155/2016/5386534.CrossRef

27.

McGeechan GJ, Richardson C, Weir K, Wilson L, O’Neill G, Newbury-Birch D. Exploring men’s perceptions of a community-based men’s shed programme in England. J Public Health. 2016. https://doi.org/10.1093/pubmed/fdw116.

28.

McGeechan GJ, Richardson C, Weir K, Wilson L, O’Neill G, Newbury-Birch D. Evaluation of a pilot police-led suicide early alert surveillance strategy in the UK. Inj Prev. 2017. https://doi.org/10.1136/injuryprev-2017-042344.

29.

Pettman TL, Armstrong R, Doyle J, Burford B, Anderson LM, Hillgrove T, et al. Strengthening evaluation to capture the breadth of public health practice: ideal vs. real. J Public Health. 2012;34(1):151–5. https://doi.org/10.1093/pubmed/fds014.CrossRef

30.

Cooke J, Ariss S, Smith C, Read J. On-going collaborative priority-setting for research activity: a method of capacity building to reduce the research-practice translational gap. Health Res Policy Syst. 2015;13(1):25. https://doi.org/10.1186/s12961-015-0014-y.CrossRefPubMedPubMedCentral

31.

Sallis JF, et al. Physical activity assessment methodology in the five-city project. Am J Epidemiol. 1985;121(1):91–106. https://doi.org/10.1093/oxfordjournals.aje.a113987.CrossRefPubMed

32.

Richardson M, et al. Validation of the Stanford 7-day recall to assess habitual physical activity. Ann Epidemiol. 2001;11(2):145–53. https://doi.org/10.1016/S1047-2797(00)00190-3.CrossRefPubMed

33.

Norcross JC, Krebs PM, Prochaska JO. Stages of change. J Clin Psychol. 2011;67(2):143–54. https://doi.org/10.1002/jclp.20758.CrossRefPubMed

34.

Fortier MS, Sweet SN, Tulloch H, Blanchard CM, Sigal RJ, Kenny GP, et al. Self-determination and exercise stages of change: results from the Diabetes Aerobic and Resistance Exercise trial. J Health Psychol. 2012;17(1):87–99. https://doi.org/10.1177/1359105311408948.CrossRefPubMed

35.

Kim T, et al. Intake of brown rice lees reduces waist circumference and improves metabolic parameters in type 2 diabetes. Nutr Res. 2011;31(2):131–8. https://doi.org/10.1016/j.nutres.2011.01.010.CrossRefPubMed

36.

Park S, et al. Waist circumference and waist-to-height ratio as predictors of cardiovascular disease risk in Korean adults. Circ J. 2009;73(9):1643–50. https://doi.org/10.1253/circj.CJ-09-0161.CrossRefPubMed

37.

Cerhan J, et al. A pooled analysis of waist circumference and mortality in 650,000 adults. Mayo Clin Proc. 2014;89(3):335–45. https://doi.org/10.1016/j.mayocp.2013.11.011.CrossRefPubMedPubMedCentral

38.

Ruf KC, Fehn S, Bachmann M, Moeller A, Roth K, Kriemler S, et al. Validation of activity questionnaires in patients with cystic fibrosis by accelerometry and cycle ergometry. BMC Med Res Methodol. 2012;12(1):43. https://doi.org/10.1186/1471-2288-12-43.CrossRefPubMedPubMedCentral

39.

Gidlow C, Johnston LH, Crone D, Morris C, Smith A, Foster C, et al. Socio-demographic patterning of referral, uptake and attendance in physical activity referral schemes. J Public Health. 2007;29(2):107–13. https://doi.org/10.1093/pubmed/fdm002.CrossRef

Title: Service Evaluation of an Exercise on Referral Scheme for Adults with Existing Health Conditions in the United Kingdom
Authors: Grant J. McGeechan
Dawn Phillips
Lynn Wilson
Vicki J. Whittaker
Gillian O’Neill
Dorothy Newbury-Birch
Publication date: 01-06-2018
Publisher: Springer New York
Published in: International Journal of Behavioral Medicine / Issue 3/2018
Print ISSN: 1070-5503
Electronic ISSN: 1532-7558
DOI: https://doi.org/10.1007/s12529-017-9699-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Service Evaluation of an Exercise on Referral Scheme for Adults with Existing Health Conditions in the United Kingdom

Abstract

Purpose

Method

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Method

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 3/2018

One-Year Cardiovascular Prognosis of the Randomized, Controlled, Short-Term Heart Rate Variability Biofeedback Among Patients with Coronary Artery Disease

Secondary Prevention in Younger vs. Older Coronary Heart Disease Patients—Insights from the German Subset of the EUROASPIRE IV Survey

Cross-Cultural Validation of the Korean Version of the Chalder Fatigue Scale

Tinnitus, Traumatic Brain Injury, and Posttraumatic Stress Disorder in the Military

The Relationships Between Depressive Symptoms, Functional Health Status, Physical Activity, and the Availability of Recreational Facilities: a Rural-Urban Comparison in Middle-Aged and Older Chinese Adults

Measuring Fear of Physical Activity in Patients with Heart Failure