Access to exercise referral schemes – a population based analysis

Harrison, RA; McNair, F; Dugdill, L

Abstract

Background Sedentary behaviour is a public health priority in many countries. Hundreds of community-based exercise referral
schemes have been established in Europe and USA, to
increase physical activity. Experimental evidence questions the
effectiveness of these schemes. No previous evaluations have
considered a population approach nor provide detailed information
on the types of people accessing these schemes. This is of
concern given increasing health inequalities in other areas of
care. Our register-based study quantified the numbers and characteristics
of patients referred and accessing a district-wide
exercise referral scheme. The analysis considers the effectiveness
of these schemes to a geographically defined population.
Methods Data were collected prospectively from a patient
register for referrals made to a district-wide exercise referral
scheme in north-west England. Analysis examined referral
rates and the influence of practitioner and patient characteristics
on access to the scheme.
Results Over 5 years, 6610 adults were referred from 125
general practices, with 60.8 per cent female and a mean age
of 51.3 years (SD 12.6). This represents 4 per cent of the adult
sedentary population in that district. The most common reason
for referral was musculoskeletal or cardiovascular risk.
Overall, 79 per cent attended at least the first appointment,
with statistically significant predictors by age and reason for
referral. Those referred for ‘fitness’ or ‘mental health’ were
most likely to attend. Patients in the youngest and oldest age
groups were least likely to attend. Patient’s sex and deprivation
and the number of patients referred by each general
practice did not influence attendance.
Conclusions Primary-care patients seem to view the concept
of exercise referral schemes positively but practitioners remain
reluctant to refer many of their sedentary patients. There is
doubt that exercise referral schemes like this will influence
population levels of sedentary behaviour, when considered
alongside their impact on physical activity in the longer term.

Citation

Harrison, R., McNair, F., & Dugdill, L. (2005). Access to exercise referral schemes – a population based analysis. Journal of Public Health, 27(4), 326-330. https://doi.org/10.1093/pubmed/fdi048

• Journal Article Type: Article
• Publication Date: Jan 1, 2005
• Deposit Date: Feb 26, 2010
• Journal: Journal of Public Health
• Print ISSN: 1741-3842
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 27
• Issue: 4
• Pages: 326-330
• DOI: https://doi.org/10.1093/pubmed/fdi048
• Publisher URL: http://dx.doi.org/10.1093/pubmed/fdi048