Preliminary effects and acceptability of a co-produced physical activity referral intervention

Abstract

Objectives: To explore the preliminary effects and acceptability of a co-produced physical activity referral intervention. Study Design: Longitudinal design with data collected at baseline and post a 12-week physical activity referral intervention. Setting: Community leisure centre. Methods: In all, 32 adults with controlled lifestyle-related health conditions took part in a physical activity referral intervention (co-produced by a multidisciplinary stakeholder group) comprising 12 weeks subsidised fitness centre access plus four behaviour change consultations. A complete case analysis ( t-tests and magnitude-based inferences) was conducted to assess baseline-to-12-week change in physical activity, cardiometabolic, and psychological measures. Semi-structured interviews were conducted ( n = 12) to explore experiences of the intervention. Results: Mean improvements were observed in cardiorespiratory fitness (3.6 mL kg-1 min-1 [95% confidence interval: 1.9–5.4], p < .001) and moderate-to-vigorous physical activity (12.6 minutes per day [95% confidence interval: 4.3–29.6], p = .013). Participants were positive about the support received from exercise referral practitioners, but experienced some challenges in a busy and under staffed gym environment. Conclusions: A co-produced physical activity referral intervention elicited short-term improvements in physical activity and cardiometabolic health. Further refinements may be required, via ongoing feedback between stakeholders, researchers and service users, to achieve the intended holistic physical activity focus of the intervention, prior to a definitive trial.

Pragmatic evaluation of a coproduced physical activity referral scheme: a UK quasi-experimental study

“…A full description of the theoretical underpinning and behaviour change intervention components is available elsewhere. 23 Prior to the pilot of co-PARS 26 practitioners received training in self-determination theory-based communication strategies led by a sport and exercise psychologist (last author (PMW)), involving a workshop, one-to-one sessions and follow-up group meetings. Following the pilot, a further series of group meetings involving exercise referral practitioners and the research team were held to develop aspects of delivery that required refinement (as outlined in the introduction).…”

“…Sample size was determined to detect a meaningful difference in CRF at 12 weeks based on our pilot results. 26 To detect a difference of 2 mL/kg/min between co-PARS and usual care, 42 participants were required per arm (f=0.25, p=0.05, power=0.80). To detect a difference of 3.2 mL/kg/min between the intervention arms and the NTC, 17 participants were required for the NTC (f=0.5, p=0.05, power=0.80).…”

“…25 Underpinned by self-determination theory, 24 the coproduced intervention differed from usual ERS care in its focus on PA behaviour change (rather than exercise prescription), and inclusion of frequent one-to-one consultations with exercise referral practitioners (compared with usual care which included formal contact at induction only). A pilot of co-PARS 26 showed clinically meaningful improvements in cardiorespiratory fitness (CRF) and PA, although as we did not include a usual care control, it was unknown whether these effects were due to the fact participants were taking part in an ERS or due to the unique elements of co-PARS. Furthermore, despite having very low CRF (<27.7 mL/kg/min) 26 we found 64% of the baseline pilot sample were meeting the PA guidelines 27 of at least 150 min moderate-intensity PA per week (measured objectively via accelerometry).…”

“…A pilot of co-PARS 26 showed clinically meaningful improvements in cardiorespiratory fitness (CRF) and PA, although as we did not include a usual care control, it was unknown whether these effects were due to the fact participants were taking part in an ERS or due to the unique elements of co-PARS. Furthermore, despite having very low CRF (<27.7 mL/kg/min) 26 we found 64% of the baseline pilot sample were meeting the PA guidelines 27 of at least 150 min moderate-intensity PA per week (measured objectively via accelerometry). This suggested CRF may be a more appropriate primary outcome measure than PA for this low-fit population (while changing PA behaviour was the focus of the intervention, a target health outcome of this behaviour change was improved CRF).…”

“You’ve Got to Pick Your Battles”: A Mixed-Methods Investigation of Physical Activity Counselling and Referral within General Practice

“…To date, research has focussed on the intervention delivery aspect of GP referral schemes [ 14 ]. Recent work from our group demonstrated the promising potential of a co-created exercise referral scheme to improve patient health [ 15 , 16 , 17 ]. Anecdotal evidence from this work, however, highlighted a lack of communication between GP practices and the referral scheme, and unsystematic referral procedures across different GP practices.…”