Pragmatic evaluation of a co-produced physical activity referral scheme: A quasi-experimental study

Benjamin R. Buckley, D.H.J. Thijssen, R.C. Murphy, Lee Graves, Madeleine Cochrane, Fiona Gillison, Diane Crone, Philip Wilson, Greg Whyte, Paula Watson

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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 (Co-PARS) was co-produced 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 to a usual care ERS and no treatment for increasing cardiorespiratory fitness.
Design. A three-arm quasi-experimental trial.
Setting. Two leisure centres providing a) Co-PARS, b) usual exercise referral care, and one no treatment control.
Participants. 68 adults with lifestyle-related health conditions (e.g. cardiovascular, diabetes, 12 depression) were recruited to Co-PARS, usual care, or no treatment.
Intervention. 16-weeks of physical activity 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 wellbeing were measured at baseline, 12 weeks, and 6 months (PA and mental wellbeing 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=.002) and vascular health (p=.002) were found in Co-PARS compared to usual care and no-treatment at 12 weeks. No significant changes in PA or wellbeing 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 co-produced 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.
Original languageEnglish
Article numbere034580
JournalBMJ Open
Early online date1 Oct 2020
Publication statusPublished - 31 Oct 2020


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