An Evaluation of the Active Herts Physical Activity Programme

Physical Activity Promotion in Areas of Deprivation for Inactive Adults With Cardiovascular Disease (CVD) Risk: An Evaluation of Active Herts

There is a high prevalence of inactive adults in the United Kingdom (UK), many of whom suffer from conditions such as diabetes, cardiovascular disease, and poor mental health. These problems often co-exist more frequently in areas of higher socio-economic deprivation. There is an ongoing need to test the effectiveness, acceptability, and sustainability of community physical activity interventions. The Active Herts programme is a community physical activity programme aimed at inactive adults aged 16 and over who have one or more risk factors for cardiovascular disease (CVD) and/or a mild to moderate mental health condition. The programme uses the latest evidence-based behaviour change techniques to target physical activity, wellbeing, and key drivers of behaviour from the COM-B ('Capability', 'Opportunity', 'Motivation' and 'Behaviour') model of behaviour change.

This evaluation will follow a mixed-methods longitudinal (baseline, and 3, 6 and 12 month follow-ups) pragmatic observational design. Two types of programme are being delivered, each in a different area. In one, group participants will receive a behaviour change technique booklet, consultations (baseline, and optional at 3, 6, and 12 months), a booster phone call (week 2), motivational text messages (weeks 3, 6, and 12), and signposting to 12 weeks of exercise classes. In the other 'enhanced delivery' group, participants will receive the same but the 12 weeks of exercise will be free and tailored to their needs, and there will be optional exercise 'buddies' available. An outcome evaluation will assess changes in physical activity as the primary outcome, and sporting participation, sitting, wellbeing, psychological capability, and reflective motivation as secondary outcomes. A process evaluation will use both one-to-one interviews and focus groups to explore the views of stakeholders, delivery staff, and participants over three phases (set-up, deviations in the delivery of the intervention, and looking back over the intervention). Economic evaluation will examine the costs of the Active Herts programme against the benefits gained in terms of reduced risk of morbidity from a range of chronic conditions.

This study will measure key drivers of physical activity using up to date behaviour change theory, allowing evaluation of not only whether physical activity has increased but also why. The research will inform the future development of a scalable intervention that can be more robustly tested in a randomised controlled trial.

Study Overview

• Status: Unknown
• Conditions: Physical Activity
• Intervention / Treatment: Behavioral: Active Herts

• Study Type: Observational
• Enrollment (Anticipated): 739

Contacts and Locations

Study Locations

• United Kingdom
  • Norwich, United Kingdom, NR4 7TJ
    • Recruiting
    • University of East Anglia
    • Contact: Andy Jones, Prof; Phone Number: 0044 1603 593127; Email: A.P.Jones@uea.ac.uk

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 16 years and older (ADULT, OLDER_ADULT, CHILD)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Participants will live in one of four Hertfordshire districts (Broxbourne, Stevenage, Hertsmere, and Watford), United Kingdom. The four districts contain the highest number of deprived Lower Super Output Areas (LSOA) in Hertfordshire and are in the five highest rates of under 75 mortality rate from CVD (2-3%), adult obesity (8-10%), and diabetes (4-6%). A life expectancy gap of 6-9.6 years exists between the most and least deprived areas across these districts. Less than 50% of this population participate in 30 minutes of physical activity once per week.

Description

Inclusion Criteria:

• inactive adults and do less than 30mins of physical activity per week
• aged 16 or over
• resident of Hertfordshire boroughs, including Broxbourne, Hertsmere, Stevenage or Watford

Referred patients and clients may also have:

• a long term medical condition such as type 2 diabetes, hypertension, high cholesterol etc.
• a mild to moderate mental health condition such as anxiety, depression or stress
• a history or family history of heart disease

Exclusion Criteria:

• participants not able to give informed consent

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Standard delivery; Participants will receive a behaviour change technique booklet, consultations (baseline, and optional at 3, 6, and 12 months), a booster phone call (week 2), motivational text messages (weeks 3, 6, and 12), and signposting to 12 weeks of exercise classes.	Behavioral: Active Herts; Active Herts is a community physical activity intervention aimed at inactive adults aged 16 and over who have one or more risk factors for CVD and/or a mild to moderate mental health condition. The programme uses the latest evidence-based behaviour change techniques to target physical activity, wellbeing, and key drivers of behaviour from the COM-B model of behaviour change.; Other Names: Healthy and Active In Herts
Enhanced delivery; Participants will receive the same as intervention but the 12 weeks of exercise will be free and tailored to their needs, and there will be optional exercise 'buddies' available.	Behavioral: Active Herts; Active Herts is a community physical activity intervention aimed at inactive adults aged 16 and over who have one or more risk factors for CVD and/or a mild to moderate mental health condition. The programme uses the latest evidence-based behaviour change techniques to target physical activity, wellbeing, and key drivers of behaviour from the COM-B model of behaviour change.; Other Names: Healthy and Active In Herts

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Physical activity from baseline	Assessed using the International Physical Activity Questionnaire (IPAQ)	12 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in mental well-being from baseline	Assessed using Warwick Edinburgh well-being scale	Short term (3 months), longer term (6 and 12 months)
Change in perceptions of health from baseline	EuroQOL five dimensions questionnaire (EQ-5D)	Short term (3 months), longer term (6 and 12 months)
Readiness to change behaviour	Key determinants of behaviour - measured using COM-B Capability, Opportunity, and Motivation	Short term (3 months), longer term (6 and 12 months)

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Delivery fidelity	A process evaluation of Active Herts will take place in three phases with each phase exploring a different theme. Data will be collected in the form of one-to-one interviews with stakeholders, group interviews with the Get Active Specialists, and focus groups with participants. Stakeholders interviewed will include commissioners, higher intervention management, project delivery partners, and health service practitioners.	End February 2017, Summer 2017, Autumn 2018
Programme cost-effectiveness	The economic evaluation will examine the costs of delivery of the Active Herts intervention against the benefits gained in terms of reduced risk of morbidity from a range of chronic conditions, the risk of which is associated with physical inactivity.	October 2017 - October 2018

Collaborators and Investigators

• Sponsor: University of East Anglia
• Collaborators: University of Hertfordshire; Hertfordshire Sports Partnership; Sport England; Broxbourne Borough Council; East and North Hertfordshire Clinical Commisioning Group; Hertfordshire Valley Clinical Commisioning Group; Hertfordshire Public Health
• Investigators: Principal Investigator: Andy Jones, Prof, University of East Anglia

Publications and helpful links

General Publications

• Chater AM, Schulz J, Jones A, Burke A, Carr S, Kukucska D, Troop N, Trivedi D, Howlett N. Outcome evaluation of Active Herts: A community-based physical activity programme for inactive adults at risk of cardiovascular disease and/or low mental wellbeing. Front Public Health. 2022 Sep 9;10:903109. doi: 10.3389/fpubh.2022.903109. eCollection 2022.
• Howlett N, Jones A, Bain L, Chater A. How effective is community physical activity promotion in areas of deprivation for inactive adults with cardiovascular disease risk and/or mental health concerns? Study protocol for a pragmatic observational evaluation of the 'Active Herts' physical activity programme. BMJ Open. 2017 Nov 25;7(11):e017783. doi: 10.1136/bmjopen-2017-017783.

Helpful Links

• Website for community intervention

Study record dates

Study Major Dates

• Study Start (ACTUAL): January 7, 2016
• Primary Completion (ANTICIPATED): January 7, 2019
• Study Completion (ANTICIPATED): January 7, 2019

Study Registration Dates

• First Submitted: May 5, 2017
• First Submitted That Met QC Criteria: May 12, 2017
• First Posted (ACTUAL): May 15, 2017

Study Record Updates

• Last Update Posted (ACTUAL): May 15, 2017
• Last Update Submitted That Met QC Criteria: May 12, 2017
• Last Verified: April 1, 2017

More Information

Terms related to this study

• Keywords: physical activity; well-being; intervention; behaviour change techniques; behaviour change; inactive adults
• Other Study ID Numbers: ActiveHerts

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No