Randomised controlled trial of an augmented exercise referral scheme using web-based behavioural support for inactive adults with chronic health conditions: the e-coachER trial

ABSTRACT Objective To determine whether adding web-based support (e-coachER) to an exercise referral scheme (ERS) increases objectively assessed physical activity (PA). Design Multicentre trial with participants randomised
to usual ERS alone (control) or usual ERS plus e-coachER (intervention). Setting Primary care and ERS in three UK sites from 2015 to 2018. Participants 450 inactive ERS referees with chronic health conditions. Interventions Participants received a pedometer, PA recording sheets and a user guide for the web-based support. e-coachER interactively encouraged the use of the ERS and other PA options. Main outcome measures Primary and key secondary outcomes were: objective moderate-to-vigorous PA (MVPA) minutes (in ≥10min bouts and without bouts), respectively, after 12 months. Secondary outcomes were: other accelerometer-derived and self-reported PA measures, ERS attendance, EQ-5D-5L, Hospital Anxiety and Depression Scale and beliefs about PA. All outcomes were collected at baseline, 4 and 12 months. Primary analysis was an intention to treat comparison between intervention and control arms at 12-month follow-up.
Results There was no significant effect of the intervention on weekly MVPA at 12 months between the groups recorded in ≥10min bouts (mean difference 11.8min of MVPA, 95%CI: −2.1 to 26.0; p=0.10) or
without bouts (mean difference 13.7min of MVPA,
95%CI: −26.8 to 54.2; p=0.51) for 232 participants
with usable data. There was no difference in the primary
or secondary PA outcomes at 4 or 12 months.
Conclusion Augmenting ERS referrals with web-based
behavioural support had only a weak, non-significant
effect on MVPA.
Trial registration number ISRCTN15644451.