Does a physical activity referral scheme improve the physical activity among routine primary health care patients?

Leijon, Matti; Bendtsen, Preben; Nilsen, Per; Festin, Karin; Ståhle, Agneta

doi:10.1111/j.1600-0838.2008.00820.x

Cited by 61 publications

(76 citation statements)

References 22 publications

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“…For example, in addition to components described above, counselling techniques such as motivational interviewing (MI) are increasingly incorporated into ERS (Greater Glasgow Health Board, 2004;Hosper et al, 2008;Kallings et al, 2008;Lawton et al, 2009;Sorensen et al, 2008;Jolly et al, 2009;Leijon et al, 2009;Romé et al, 2009), while some emphasise provision of supportive social networks through patient-only classes (Isaacs et al, 2007). In Wales, until 2007, most local health board (LHB) areas operated local ERS.…”

Section: Introductionmentioning

confidence: 98%

Mixed-method process evaluation of the Welsh National Exercise Referral Scheme

et al. 2013

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Access to this document was granted through an Emerald subscription provided by emerald-srm:368933 [] For AuthorsIf you would like to write for this, or any other Emerald publication, then please use our Emerald for Authors service information about how to choose which publication to write for and submission guidelines are available for all. Please visit www.emeraldinsight.com/authors for more information. About Emerald www.emeraldinsight.comEmerald is a global publisher linking research and practice to the benefit of society. The company manages a portfolio of more than 290 journals and over 2,350 books and book series volumes, as well as providing an extensive range of online products and additional customer resources and services.Emerald is both COUNTER 4 and TRANSFER compliant. The organization is a partner of the Committee on Publication Ethics (COPE) and also works with Portico and the LOCKSS initiative for digital archive preservation. AbstractPurpose -Primary-care referral to community-based exercise specialists (exercise referral) is common in the UK despite limited evidence of effectiveness. A recent pragmatic randomised trial of the Welsh National Exercise Referral Scheme (NERS), demonstrated promising impacts upon physical activity and mental health. This paper presents a mixed-method process evaluation exploring how outcomes were achieved. Design/methodology/approach -Structured observation, implementer interviews and routine data assessed the extent to which NERS was implemented as intended. Baseline trial data were combined with routine monitoring data for the purposes of profiling uptake and adherence. Semistructured patient interviews explored processes of change and the emergence of social patterning in responses to the scheme. Findings -NERS offered patients a programme of supervised, group-based discounted exercise. However, motivational interviewing, goal-setting and patient follow-up protocols were delivered poorly. The high degree of professional support was perceived as helping patients to build confidence and assimilate into exercise environments. Patient-only classes provided social contacts, a supportive context and realistic models. Patterning in uptake emerged from access issues, with uptake lower among non-car owners. Adherence was poorer among mental health patients, younger patients and those who were least active prior to referral to NERS. Originality/value -In practice, although the NERS RCT demonstrated positive impacts on physical activity and mental health, process evaluation data indicate that the intervention was not entirely delivered as intended. Mixed-method process evaluation served crucial functions in understanding implementation and functioning, offering insights into the roles of professional support and exercise classes in promoting activity and mental health, and the emergence of social patterning in responses to an ERS.

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Section: Introductionmentioning

confidence: 98%

Mixed-method process evaluation of the Welsh National Exercise Referral Scheme

et al. 2013

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“…Several early as well as recent studies on the effectiveness of physical activity on prescription in the health care system are available from several countries and from different settings showing that the method is feasible and effective in increasing patients' physical activity levels [64][65][66][67][68][69][70].…”

Section: Evaluations Of Physical Activity On Prescriptionmentioning

confidence: 99%

Prescribing Exercise in Clinical Practice

Hellénius

2011

Curr Cardiovasc Risk Rep

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There is solid evidence that physical activity is essential to improve health as well as quality of life, and there is an urgent need to find effective strategies to implement this knowledge into health care delivery as well as to develop more effective strategies for the promotion of physical activity. A systematic literature review of methods of promoting physical activity from randomized controlled studies with at least 6 months follow-up published 2007 showed that advice or counseling on physical activity given by health care professionals (15 studies) leads to an increase in physical activity of 12% to 50%. Studies on theory-based behavioral interventions (21 studies) demonstrated a 10% to 15% increase in physical activity compared to usual care. More recent studies performed within the health care system indicate that "physical activity on prescription" can be a feasible and effective way to increase patients' physical activity levels. There is a great and urgent need to spread this new evidence-based knowledge as well as experiences and pedagogic skills to counteract the epidemic of a sedentary lifestyle. However, there are still major gaps in our knowledge about long-term effectiveness of various methods of promoting physical activity and about how to implement current knowledge into clinical practice. A focus on translational research and studies on implementation is needed.

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“…On the other hand, James et al (2009), Leijon et al (2009), Chen et al (2010) and Maia et al (2010) recognize that sport is a form of preventive medicine. Indeed, an increase in sporting activities can contribute to a reduction of publicly financed medicine.…”

Section: Introductionmentioning

confidence: 96%

Non-linear relationship between number of clubs and participants in sport

Carvalho

Nunes

2012

International Journal of Sport Policy and Politics

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Using panel data, this study shows that there is a non-linear relationship between clubs and participation in sport in Portugal. More specifically, a relationship in the form of an inverted U is found between clubs and participants. The empirical evidence obtained is particularly relevant because it shows that a greater number of clubs only produces an increased number of participants up to a certain threshold of clubs, with a negative relationship between clubs and sports participants beyond that critical level. It also shows that current expenditure on sport contributes to an increased number of sports participants, capital expenditure on sporting activities being of negligible importance for this purpose, and gross national product (GNP) contributes to increasing sport participation in high GNP districts and to restricting sport participation at low GNP levels.

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Does a physical activity referral scheme improve the physical activity among routine primary health care patients?

Cited by 61 publications

References 22 publications

Mixed-method process evaluation of the Welsh National Exercise Referral Scheme

Mixed-method process evaluation of the Welsh National Exercise Referral Scheme

Prescribing Exercise in Clinical Practice

Non-linear relationship between number of clubs and participants in sport

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