Exploring the Effectiveness of Exercise Referral Schemes: Midlothian Active Choices

Abstract

Growing levels of physical inactivity and sedentary behaviour in the UK leading to an increase in health care costs for a number of chronic diseases such as coronary heart disease, diabetes and depression (Pavey et al. 2011). Primary care consultations are recognised as an opportunity to augment an individual's' physical activity, through methods such as motivational interviewing or referral to Exercise Referral Schemes (ERS). An ERS is provided by a third party service which takes responsibility for prescribing and monitoring exercise for the individual (NICE 2014). Since their introduction, there has been a sustained growth in the numbers of ERSs. Despite this, little research into their efficacy exists and the current evidence base is of poor quality (Gidlow et al. 2007). The aim of this research was to explore the effectiveness of one ERS, Midlothian Active Choices. A retrospective cohort study was undertaken to explore participant demographics, to compare pre and post participant health outcomes and to investigate if any associations exist between a patient's sociodemographic factors and attendance. Our results show that both BMI and PHQ-9 score are significantly reduced in those completing the 12-week programme. We further show a statistically significant association between age and attendance. No other statistically significant associations were identified. Without qualitative research, it is not possible to fully comprehend our research. Plausible reasoning could attribute reduction in BMI and improvement in mood to the social nature of the schemes with an encouraging leisure provider. Better attendance among older participants may be attributed to fewer time constraints experienced by the older population. Furthermore, this cohort may value the opportunity for social interactions during group-based activities (Clarke 2013). We have shown that ERS can be effective in reducing an individual's BMI and PHQ-9 score and that there is an association between age and attendance. Qualitative research must be undertaken to further the field.