Objective The aim of the present review was to examine epidemiological evidence to determine if there is strong evidence of a positive gradient of increasing physical activity across the socio-economic strata, and how relationships are affected by socio-economic measurement. Design Systematic review. Method A search of major databases was conducted to identify published studies that reported physical activity in relation to socio-economic position (SEP) in adults. Results Twenty-eight cross-sectional and five longitudinal studies met the inclusion criteria. Approximately half of these were American. Consequently education and income were most commonly used to represent SEP. The majority of studies were secondary analyses of existing health survey data, which could explain the generally large sample sizes and methodological weaknesses in physical activity and SEP measurement. There was consistent evidence of a higher prevalence or higher levels of leisure-time or moderate-vigorous intensity physical activity in those at the top of the socio-economic strata compared with those at the bottom. Evidence for positive gradients across the socio-economic strata was less consistent. Education produced the most stable relationships, less susceptible to confounding effects of ethnicity and the environment. Conclusion Those at the top of the socio-economic scale appear to perform more leisure-time activity than those at the bottom. Diverse and often crude physical activity and socio-economic measurement made it difficult to distinguish between artefact and true effect in a relationship with so many potential confounding influences. Further studies using up-to-date methods of socio-economic and physical activity measurement are necessary to further explore this relationship and its confounders.

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The relationship between exercise and mental health is well documented and has led to the inclusion of exercise into the treatment of people with mental health problems. A qualitative (grounded theory) methodology, using focus groups, investigated the experiences of people with mental health problems, who had successfully participated in exercise as part of their treatment. The aim of this study was to investigate the experiences of service users who had successfully participated in sports therapy as part of their treatment. One of the researchers is also a service user who has participated in sports therapy and these experiences provided an insight into the research, especially in the design of the interview schedule, data collection (empathy with participants), and in the interpretation of the data. The dual role of service user and researcher is commended in contemporary mental health research and as such makes this study unique. A conceptual model is presented that explains the participants' subjective experiences, opinions, and perceptions of the role exercise has in their treatment, and their perceived outcomes from participation. The findings support sports therapy as an acceptable and beneficial adjunct to usual treatment for some people with mental health problems within the community, but that problems exist regarding knowledge and understanding of the theory underpinning its use.

The relationship between physical activity and mental health is well documented and has led to the inclusion of physical activity into the treatment of people with mental health problems within heath care. However, little research has been conducted on the outcomes these programmes have for the people who participate in them. This study investigated the perceived health outcomes of people with mental health problems who had successfully participated in a walking project. The research is a descriptive qualitative study that used individual interviews and the constant comparative method of analysis. Findings conclude that physical activity programmes have a significant part to play in the quality of life of people with mental health problems and have the potential to be an integral part of their health care.

The PARS format may be inappropriate for younger adults or people living in relative deprivation and rural areas. They appear most appropriate for adults of middle-to-old age who are more likely to require supervision, and should be targeted accordingly.