TY - JOUR

T1 - Effectiveness of exercise-referral schemes to promote physical activity in adults

T2 - systematic review

AU - Williams, Nefyn H

AU - Hendry, Maggie

AU - France, Barbara

AU - Lewis, Ruth

AU - Wilkinson, Clare

PY - 2007/12

Y1 - 2007/12

N2 - BACKGROUND: Despite the health benefits of physical activity, most adults do not take the recommended amount of exercise.AIM: To assess whether exercise-referral schemes are effective in improving exercise participation in sedentary adults.DESIGN OF STUDY: Systematic review.METHOD: Studies were identified by searching MEDLINE, CINAHL, EMBASE, AMED, PsycINFO, SPORTDiscus, The Cochrane Library and SIGLE until March 2007. Randomised controlled trials (RCTs), observational studies, process evaluations and qualitative studies of exercise-referral schemes, defined as referral by a primary care clinician to a programme that encouraged physical activity or exercise were included. RCT results were combined in a meta-analysis where there was sufficient homogeneity.RESULTS: Eighteen studies were included in the review. These comprised six RCTs, one non-randomised controlled study, four observational studies, six process evaluations and one qualitative study. In addition, two of the RCTs and two of the process evaluations incorporated a qualitative component. Results from five RCTs were combined in a meta-analysis. There was a statistically significant increase in the numbers of participants doing moderate exercise with a combined relative risk of 1.20 (95% confidence intervals = 1.06 to 1.35). This means that 17 sedentary adults would need to be referred for one to become moderately active. This small effect may be at least partly due to poor rates of uptake and adherence to the exercise schemes.CONCLUSION: Exercise-referral schemes have a small effect on increasing physical activity in sedentary people. The key challenge, if future exercise-referral schemes are to be commissioned by the NHS, is to increase uptake and improve adherence by addressing the barriers described in these studies.

AB - BACKGROUND: Despite the health benefits of physical activity, most adults do not take the recommended amount of exercise.AIM: To assess whether exercise-referral schemes are effective in improving exercise participation in sedentary adults.DESIGN OF STUDY: Systematic review.METHOD: Studies were identified by searching MEDLINE, CINAHL, EMBASE, AMED, PsycINFO, SPORTDiscus, The Cochrane Library and SIGLE until March 2007. Randomised controlled trials (RCTs), observational studies, process evaluations and qualitative studies of exercise-referral schemes, defined as referral by a primary care clinician to a programme that encouraged physical activity or exercise were included. RCT results were combined in a meta-analysis where there was sufficient homogeneity.RESULTS: Eighteen studies were included in the review. These comprised six RCTs, one non-randomised controlled study, four observational studies, six process evaluations and one qualitative study. In addition, two of the RCTs and two of the process evaluations incorporated a qualitative component. Results from five RCTs were combined in a meta-analysis. There was a statistically significant increase in the numbers of participants doing moderate exercise with a combined relative risk of 1.20 (95% confidence intervals = 1.06 to 1.35). This means that 17 sedentary adults would need to be referred for one to become moderately active. This small effect may be at least partly due to poor rates of uptake and adherence to the exercise schemes.CONCLUSION: Exercise-referral schemes have a small effect on increasing physical activity in sedentary people. The key challenge, if future exercise-referral schemes are to be commissioned by the NHS, is to increase uptake and improve adherence by addressing the barriers described in these studies.

KW - Adult

KW - Costs and Cost Analysis

KW - Exercise

KW - Great Britain

KW - Health Behavior

KW - Health Promotion

KW - Humans

KW - Motor Activity

KW - Patient Compliance

KW - Program Evaluation

KW - Randomized Controlled Trials as Topic

KW - Referral and Consultation

KW - Journal Article

KW - Meta-Analysis

KW - Research Support, Non-U.S. Gov't

KW - Review

M3 - Article

C2 - 18252074

VL - 57

SP - 979

EP - 986

JO - British Journal of General Practice

JF - British Journal of General Practice

SN - 0960-1643

IS - 545

ER -