The health benefits of a physically active lifestyle are well established and there is evidence that a sedentary lifestyle plays a significant role in the onset and progression of chronic disease. There is a recognised need for effective exercise referral schemes encouraging sedentary people with a medical condition to become more active. However, there are few rigorous evaluations of the effectiveness of such schemes.
In Wales, in the early half of the last decade, most local health board areas operated exercise referral schemes, each following different protocols. However, in 2006, existing good practice was assessed and standardised in national protocols, and the National Exercise Referral Scheme (NERS) subsequently rolled out throughout Wales. The scheme consists of a series of motivational interview consultations with an exercise professional based in a community sports centre, and access to a tailored, subsidised 16 week activity programme. The primary aim is for participants to achieve 30 minutes of moderate physical activity on at least five days per week.
Randomised control trial.
- The evaluation adopted a randomised controlled trial design, with nested economic and process evaluations to assess whether NERS was effective, for whom, under what circumstances and at what cost.
- The study aimed to investigate whether self-reported physical activity (as well as depression and anxiety) at 12 months differed among patients participating in the NERS compared to those receiving usual GP care.
- Participants (n = 2104) were randomised to either a treatment or control group, and outcomes were measured at baseline and at six- and twelve-month follow-up.
- Moore G, Raisanen L, Moore L, Din N, Murphy S. ‘Mixed-method process evaluation of the Welsh National Exercise Referral Scheme’. Health Education 2013; 113(6).
- Murphy S, Tudor Edwards R, Williams N, Raisanen L, Moore G, Linck P, Hounsome N, Ud Din N, Moore L. ‘The evaluation of the National Exercise Referral Scheme in Wales’ – Report for Welsh Government, 2010
- ‘National Exercise Referral Scheme’ – Welsh Local Government Association (WLGA) project information page
- Murphy S, Tudor Edwards R, Williams N, Raisanen L, Moore G, Linck P, Hounsome N, Ud Din N, Moore L. ‘An evaluation of the effectiveness and cost effectiveness of the National Exercise Referral Scheme in Wales UK: a randomised controlled trial of a public health policy initiative’. Journal of Epidemiology and Community Health 2012, 66(8):745-53.
- Moore G, Moore L, Murphy S. ‘Integration of motivational interviewing into practice in the National Exercise Referral Scheme in Wales: a mixed methods study’. Behavioural and Cognitive Psychotherapy Oct 2011, 3:1-18.
- Moore G, Moore L & Murphy S. ‘Facilitating adherence to physical activity: Exercise professionals’ experiences of the National Exercise Referral Scheme in Wales. A qualitative study’. BMC Public Health 2011, 11:935
- Murphy S, Raisanen L, Moore G, Tudor Edwards R, Linck P, Williams N, Ud Din N, Hale J and Moore L. ‘A pragmatic randomised controlled trial of the Welsh National Exercise Referral Scheme: protocol for trial and integrated economic and process evaluation’ BMC Public Health 2010, 10:352
Welsh Government, Health Promotion division