Exercise, service and support: client experiences of physical activity referral schemes (PARS)

Abstract

Physical Activity Referral Schemes (PARS) continue to represent one of the most prevalent interventions in the fight against chronic illness such as Coronary Heart Disease (CHD) and obesity. Despite this, issues surrounding low retention and adherence continue to hinder the potential effectiveness of such schemes on public health. This article reports on the second stage of a larger investigation into client experiences of PARS focussing specifically on findings from five client focus groups and interviews with five scheme organisers. The analysis reveals three main factors impacting on participants' perceptions of the quality of service and support at the scheme: the organisation of PARS provision, engagement with the PARS community, and the client support networks. The article demonstrates that staff have a considerable role to play in engaging clients in the PARS system and that scheme organisers should give serious thought to ensuring that clients have valuable and sustainable networks of support. Furthermore, it is suggested that scheme organisers need to facilitate a system in which staff are genuinely engaged with the needs of clients and are able to provide individualised programmes of physical activity.

Impact of an exercise programme on sustaining physical activity for recovering cancer patients: A qualitative study.

“…The research design adopted is noteworthy in that it contrasts with other studies in the exercise referral literature in 2 specific ways. Firstly, the majority of studies published in this area adopt a quantitative approach [28][29][30][31][32][33], although some studies do adopt a qualitative approach [34][35][36][37]. Through using a qualitative approach to data collection and analysis, this study was able to investigate the patients' experiences of involvement with an exercise referral scheme and its impact on sustaining physical activity levels for 3 months after completion of the programme.…”

Perceived changes to quality of life indicators following a physical activity intervention for recovering cancer patients: A qualitative study.

“…The research design adopted is noteworthy in that it contrasts with other studies in the exercise referral literature in 2 specific ways. Firstly, the majority of studies published in this area adopt a positivist approach [21][22][23][24][25], although some studies do adopt an interpretive approach [26][27][28][29]. Through using a qualitative approach to data collection and analysis, this study was able to investigate the patients' changing perceptions over a 6-month time period for the following QoL indicators of (i) self-efficacy, (ii) selfmanagement, (iii) chronic fatigue and (iv) increasing energy levels [12,16,18].…”

Long-term engagement with a practice-based exercise referral scheme: Patients’ perceptions of effectiveness

“…Previous findings from both qualitative [15,18,20,25] and quantitative [23,27,28,32] research in exercise referral has shown that ERS can promote physical activity in the short to medium-term (12-26 weeks). In our analysis of 12 seriously ill patients participating in an ERS, we found that long-term engagement with a practice-based scheme aided physical activity adherence and increased combined (walking and exercise classes) physical activity levels, in the long-term.…”

“…The study design contrasts with other studies on exercise referral in 3 specific ways. First, the majority of studies on exercise referral tend to be from a positivist theoretical perspective [20][21][22][23][24], rather than an interpretivist perspective [15,17,18,25]. Second, the deployment of 3 data collection and analysis phases differed to traditional schemes that have a 12 week intervention [15,[26][27][28][29][30] and a 12 week follow up [31,32].…”

“…Far fewer qualitative studies have been undertaken on the impact of ERS, particularly in the longer-term. However, those that have tend to represent schemes as having a more favourable impact on the promotion of physical activity than is generally represented with RCT evaluations [15][16][17][18]. We describe the impact that an ERS had on a group of patients with chronic lifestyle diseases, over a 12 month period of time.…”