Are Exercise Referral Schemes Associated With an Increase in Physical Activity? Observational Findings Using Individual Patient Data Meta-Analysis From the National Referral Database
in Journal of Physical Activity and HealthClick name to view affiliation
Objectives: To examine if exercise referral schemes (ERSs) are associated with meaningful changes in physical activity in a large cohort of individuals throughout England, Scotland, and Wales from The National Referral Database. Methods: Data were obtained from 5246 participants from 12 different ERSs, lasting 6–12 weeks. The preexercise referral scheme and changes from the preexercise to the postexercise referral scheme in self-reported International Physical Activity Questionnaire scores were examined. A 2-stage individual patient data meta-analysis was used to generate the effect estimates. Results: For the pre-ERS metabolic equivalent (MET) minutes per week, the estimate (95% confidence interval [CI]) was 676 MET minutes per week (539 to 812). For the change in MET minutes per week, the estimate (95% CI) was an increase of 540 MET minutes per week (396 to 684). Changes in the total PA levels occurred as a result of increases in vigorous activity of 17 minutes (95% CI, 9 to 24), increases in moderate activity of 29 minutes (95% CI, 22 to 36), and reductions in sitting of −61 minutes (95% CI, −78 to −43), though little change in walking (−5 min; 95% CI, −14 to 5) was found. Conclusions: Most participants undergoing ERSs are already “moderately active.” Changes in PA behavior associated with participation are through increased moderate to vigorous PA and reduced sitting. However, this was insufficient to change the International Physical Activity Questionnaire category, and the participants were still “moderately active.”
Rowley, Horton, and Jimenez are with the Centre for Innovative Research Across the Life Course (CIRAL), Faculty of Health and Life Sciences, Coventry University, Coventry, United Kingdom. Steele, Wade, Mann, and Jimenez are with the ukactive Research Institute, London, United Kingdom. Steele is also with the School of Sport, Health, and Social Sciences, Solent University, Southampton, United Kingdom. Wade is also with St Mary’s University, London, United Kingdom. Copeland is with the National Centre for Sport and Exercise Medicine, Sheffield, United Kingdom; and Sheffield Hallam University, Sheffield, United Kingdom. Mann is also with Places for People Leisure, London, United Kingdom. Liguori is with The University of Rhode Island, Kingston, RI, USA. Jimenez is also with the GO fit LAB, Ingesport, Madrid, Spain.
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