Aim: To compare the characteristics of mental health and physical health participants attending an exercise referral scheme (ERS) and investigate associations with their adherence to exercise. Background: While people referred to an ERS with a mental health diagnosis have similar initial rates of uptake as physical health participants, they are more likely to drop out. Comparisons of the groups to understand their differences and how these might impact on their adherence have been limited by the typically low numbers of mental health referrals in many schemes. Methods: Retrospective analysis of a participant cohort. Data were extracted on all participants enrolled over a 12-month period (n = 701) and included measurements at baseline, mid-point (13 weeks) and end of programme (20-26 weeks). Differences were explored between the mental health (n=141) and physical health (n=560) sub-cohorts, and between adherers and non-adherers in each group. Binomial logistic regression estimated the effect of group-level factors associated with adherence. Findings: Mental health referrals were more likely to be younger, White and unemployed, and had a lower mean body mass index and lower proportion of participants with high blood pressure. They were also more likely to drop out. While occupation was associated with exercise adherence among the physical health group, no predictive factors were identified in the mental health group. Conclusion: Participants referred for mental health disorders are more likely to drop out of exercise referral schemes than those with physical health problems. While no factors were found to be predictive of their exercise adherence, an understanding of their distinguishing characteristics and attendance behaviour can guide in making better referral decisions concerning them and planning more appropriately tailored support.
The investigation reported here started out as an exploratory study of the nature of 'support' in a supported housing development for people with mental health problems. It was intended that this would suggest appropriate changes in staff practices. This report describes how ideas around a number of themes identified were gradually developed and refined to provide a focus for investigation. The eventual focus centred on my apparently pivotal role in supporting 'unqualified' support staff. An inter-relationship between how residents experience 'being supported' and the learning needs of support staff is identified, teased out and described. Action research methods were found to be a useful means of generating areas of learning that appeared to be most relevant in this particular work context. The discoveries and insights that developed helped inform the tentative application of some initial action steps aimed at meeting these learning needs and guiding the activities of support staff.
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