Emma Bird Emma.Bird@uwe.ac.uk
Senior Lecturer in Public Health
General practice referral of ‘at risk’ populations to community leisure services: Applying the RE-AIM framework to evaluate the impact of a community-based physical activity programme for inactive adults with long-term conditions
Bird, Emma; Biddle, Michele; Powell, Jane
Authors
Michele Biddle Michele.Biddle@uwe.ac.uk
Research Fellow in Public Health
Jane Powell Jane.Powell@uwe.ac.uk
Professor in Public Health Economics
Abstract
Background: In the UK a high proportion of adults with long-term conditions do not engage in regular physical activity. General practice (GP) referral to community-based physical activity is one strategy that has gained traction in recent years. However, evidence for the real-world effectiveness and translation of such programmes is limited. This study aimed to evaluate the individual and organisational impacts of the ‘CLICK into Activity’ programme - GP referral of inactive adults living with (or at risk of) long-term conditions to community-based physical activity.
Methods: A mixed methods evaluation using the RE-AIM framework was conducted with data obtained from a range of sources: follow-up questionnaires, qualitative interviews, and programme-related documentation, including programme cost data. Triangulation methods were used to analyse data, with findings synthesised across each dimension of the RE-AIM framework.
Results: A total of 602 individuals were referred to CLICK into Activity physical activity sessions. Of those referred, 326 individuals participated in at least one session; the programme therefore reached 30.2% of the 1,080 recruitment target. A range of individual-, social-, and environmental-level factors contributed to initial physical activity participation. Positive changes over time in physical activity and other outcomes assessed were observed among participants. Programme adoption at GP surgeries was successful, but the GP referral process was not consistently implemented across sites. Physical activity sessions were successfully implemented, with programme deliverers and group-based delivery identified as having an influential effect on programme outcomes. Changes to physical activity session content were made in response to participant feedback. CLICK into Activity cost £175,000 over three years, with an average cost per person attending at least one programme session of £535.
Conclusions: Despite not reaching its recruitment target, CLICK into Activity was successfully adopted. Positive outcomes were associated with participation, although low 6- and 12-month follow-up response rates limit understanding of longer-term programme effects. Contextual and individual factors, which may facilitate successful implementation with the target population, were identified. Findings highlight strategies to be explored in future development and implementation of GP referral to community-based physical activity programmes targeting inactive adults living with (or at risk of) long-term conditions.
Citation
Bird, E., Biddle, M., & Powell, J. (2019). General practice referral of ‘at risk’ populations to community leisure services: Applying the RE-AIM framework to evaluate the impact of a community-based physical activity programme for inactive adults with long-term conditions. BMC Public Health, 19(1), Article 1308. https://doi.org/10.1186/s12889-019-7701-5
Journal Article Type | Article |
---|---|
Acceptance Date | Sep 27, 2019 |
Publication Date | Oct 17, 2019 |
Deposit Date | Sep 30, 2019 |
Publicly Available Date | Oct 2, 2019 |
Journal | BMC public health |
Electronic ISSN | 1471-2458 |
Publisher | BioMed Central |
Peer Reviewed | Peer Reviewed |
Volume | 19 |
Issue | 1 |
Article Number | 1308 |
DOI | https://doi.org/10.1186/s12889-019-7701-5 |
Public URL | https://uwe-repository.worktribe.com/output/3321950 |
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General practice referral of ‘at risk’ populations to community leisure services: Applying the RE-AIM framework to evaluate the impact of a community-based physical activity programme for inactive adults with long-term conditions
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Copyright Statement
© The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver
(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
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