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

Benjamin Jr Buckley, Dick Hj Thijssen, Rebecca C Murphy, Lee Ef Graves, Madeleine Cochrane, Fiona Gillison, Diane Crone, Philip M Wilson, Greg Whyte, Paula M Watson, Benjamin Jr Buckley, Dick Hj Thijssen, Rebecca C Murphy, Lee Ef Graves, Madeleine Cochrane, Fiona Gillison, Diane Crone, Philip M Wilson, Greg Whyte, Paula M Watson

Abstract

Objectives: UK exercise referral schemes (ERSs) have been criticised for focusing too much on exercise prescription and not enough on sustainable physical activity (PA) behaviour change. Previously, a theoretically grounded intervention (coproduced PA referral scheme, Co-PARS) was coproduced to support long-term PA behaviour change in individuals with health conditions. The purpose of this study was to investigate the effectiveness of Co-PARS compared with a usual care ERS and no treatment for increasing cardiorespiratory fitness.

Design: A three-arm quasi-experimental trial.

Setting: Two leisure centres providing (1) Co-PARS, (2) usual exercise referral care and one no-treatment control.

Participants: 68 adults with lifestyle-related health conditions (eg, cardiovascular, diabetes, depression) were recruited to co-PARS, usual care or no treatment.

Intervention: 16-weeks of PA behaviour change support delivered at 4, 8, 12 and 18 weeks, in addition to the usual care 12-week leisure centre access.

Outcome measures: Cardiorespiratory fitness, vascular health, PA and mental well-being were measured at baseline, 12 weeks and 6 months (PA and mental well-being only). Fitness centre engagement (co-PARS and usual care) and behaviour change consultation attendance (co-PARS) were assessed. Following an intention-to-treat approach, repeated-measures linear mixed models were used to explore intervention effects.

Results: Significant improvements in cardiorespiratory fitness (p=0.002) and vascular health (p=0.002) were found in co-PARS compared with usual care and no-treatment at 12 weeks. No significant changes in PA or well-being at 12 weeks or 6 months were noted. Intervention engagement was higher in co-PARS than usual care, though this was not statistically significant.

Conclusion: A coproduced PA behaviour change intervention led to promising improvements in cardiorespiratory and vascular health at 12 weeks, despite no effect for PA levels at 12 weeks or 6 months.

Trial registration number: NCT03490747.

Keywords: behaviour change; cardiovascular health; exercise referral; self-determination theory; translational research; vascular medicine.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
‘PaT Plot’ describing intervention arm components. Co-PARS, coproduced PA referral scheme; ERS, exercise referral scheme; NTC, no-treatment control; PA, physical activity; HCPC, health & care professions council.
Figure 2
Figure 2
Participant flow diagram within the three study arms (March 2018–January 2019). Co-PARS, coproduced PA referral scheme; ERS, exercise referral scheme; PA, physical activity.

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