Making a move in exercise referral: co-development of a physical activity referral scheme

Abstract

The multidisciplinary co-development process highlighted cultural and pragmatic issues related to exercise referral provision, resulting in an evidence-based intervention framework designed to be implemented within existing infrastructures. Further work is required to establish the feasibility and effectiveness of the co-developed intervention in practice.

Preliminary effects and acceptability of a co-produced physical activity referral intervention

“…The standard programme involved an induction with an exercise referral instructor, followed by 12 weeks' subsidised access to gym, swimming and classes at the fitness centre. The co-produced intervention was piloted in one of the 11 fitness centres (Centre A), selected due to the centre's local popularity and due to the involvement of centre staff in the co-production phase (Buckley et al, 2018). The study used a mixed-methods, pre-post design to explore preliminary effects and acceptability of the coproduced PA referral intervention.…”

“…Focus continues to be on exercise prescription and few schemes have been underpinned by behaviour change theory (Dugdill et al, 2005;Beck et al, 2016). Furthermore, the failure to involve service-users and other stakeholders in development phases may compromise intervention acceptability (Din et al, 2015;Beck et al, 2016) To overcome such challenges, we co-produced a PA referral intervention with multidisciplinary stakeholders (commissioners, practitioners, service-users and academics) that was evidence-based, drew on behaviour change theory, and deemed feasible to implement within local infrastructures (Buckley et al, 2018). Underpinned by Self Determination Theory (SDT; Ryan & Deci, 2000), the co-produced intervention differed from usual care in its focus on PA behaviour change (rather than exercise prescription), and inclusion of frequent one-to-one consultations with exercise referral practitioners (rather than formal contact at induction only).…”

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

“…A full description of the theoretical underpinning and behaviour change intervention components is available elsewhere. 23 Prior to the pilot of co-PARS 26 practitioners received training in self-determination theory-based communication strategies led by a sport and exercise psychologist (last author (PMW)), involving a workshop, one-to-one sessions and follow-up group meetings. Following the pilot, a further series of group meetings involving exercise referral practitioners and the research team were held to develop aspects of delivery that required refinement (as outlined in the introduction).…”

“…[19][20][21] Though not a panacea, the involvement of practitioners, managers and service-users in coproduction has potential to improve intervention relevance, fidelity and effectiveness. 22 Previously, a theoretically grounded PA referral scheme (coproduced PA referral scheme, Co-PARS) was coproduced by academics, policy-makers, practitioners and service-users 23 in Liverpool, UK, with a focus on supporting sustainable PA behaviour change. Liverpool is the third most deprived local authority in England and has the second highest proportion of Lower Super Output Areas in the most deprived 10% nationally.…”

“You’ve Got to Pick Your Battles”: A Mixed-Methods Investigation of Physical Activity Counselling and Referral within General Practice

“…To date, research has focussed on the intervention delivery aspect of GP referral schemes [ 14 ]. Recent work from our group demonstrated the promising potential of a co-created exercise referral scheme to improve patient health [ 15 , 16 , 17 ]. Anecdotal evidence from this work, however, highlighted a lack of communication between GP practices and the referral scheme, and unsystematic referral procedures across different GP practices.…”